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Clinical Specializations

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Mood & Anxiety Disorders

Mood and anxiety disorders can affect far more than how you feel emotionally. Depression, bipolar disorder, and anxiety can influence energy, motivation, concentration, relationships, self-esteem, sleep, decision-making, and your ability to manage everyday responsibilities. At times, these experiences can feel overwhelming or difficult to make sense of, particularly when symptoms become persistent or begin to interfere with daily life.

 

I provide compassionate, evidence-based therapy that considers the whole person and the ways psychological symptoms intersect with relationships, stress, life circumstances, and daily functioning. Together, we’ll work to better understand your patterns and experiences while developing practical strategies for emotional regulation, coping, communication, and navigating periods of increased distress or instability.

 

My approach is individualized and grounded in curiosity, compassion, and respect for the complexity of each person’s experience. I recognize that living with a mood or anxiety disorder can affect how you see yourself, your relationships, and your sense of what feels possible.

When appropriate and with your permission, I can also coordinate care with psychiatrists, physicians, or other members of your healthcare team. Collaborative care can be particularly valuable when symptoms are complex, persistent, or significantly affecting daily functioning.

Burnout & Chronic Stress

Burnout isn’t just being tired. It’s a deep kind of exhaustion that builds over time and touches every part of you: emotionally, physically, and mentally. It might look like constant fatigue, irritability, anxiety, numbness, or just going through the motions. Whether it’s coming from work, caregiving, or the nonstop pressure to keep it all together, burnout can quietly chip away at your well-being and sense of self.

A lot of the folks I work with are professionals, parents,  and are  just really good at showing up for everyone else, often at the expense of their own needs. Some are supporting loved ones with big emotional needs or mental health struggles, which can mean always being on alert, pushing down your own feelings, and making impossible decisions. Others are stuck in work cultures that glorify overworking and self-sacrifice. It’s exhausting. And lonely.

 

In therapy, we slow things down and take a closer look at what’s underneath the burnout, like people-pleasing, perfectionism, or the fear of letting others down. We work on regulating your nervous system, building emotional awareness, and developing tools to actually manage stress (not just push through it). We also explore what it could look like to relate to work, rest, and responsibility in a more sustainable, self-honoring way.

 

Burnout isn’t a personal failure. It’s a sign that something needs to change. And with the right support, that change can be not just healing, but life-changing.

Grief Work

Grief is an experience I approach with particular care and compassion. Loss can take many forms; the death of someone you love, the end of a relationship, or the loss of a future you had imagined. These experiences can affect not only how you feel, but also your sense of stability, connection, purpose, and identity. 
Grief is rarely linear. It can come in waves, shift unexpectedly, and resurface during milestones, transitions, or ordinary moments. Together, we can make sense of your experience without imposing a timeline or expectation for how grief should look. Our work can focus on honoring what has been lost while also exploring how to adapt to what is changing, reconnect with what matters to you, and move forward in a way that respects both your loss and your ongoing life.

Neurodivergence

As a neurodivergent therapist, I bring both clinical experience and personal understanding to my work with neurodivergent adults, including Autistics, those with ADHD, learning disabilities, and other cognitive and sensory differences. Many clients have spent years feeling misunderstood, overwhelmed, or as though they are falling short despite significant effort. Therapy can offer a space to develop greater self-understanding, challenge internalized expectations, and build practical strategies that support how you function best.


For clients seeking more practical support, I also offer executive function coaching. Together, we identify what is getting in the way and develop individualized strategies that fit your cognitive style, responsibilities, and circumstances. This may include planning, prioritizing, time management, organization, routines, task initiation, attention, and follow-through.

Rather than viewing these challenges as failures of motivation or discipline, we can understand them within the larger context of your cognitive profile, emotional experience, environment, and demands.Together, we identify barriers to follow-through and develop practical strategies that work with your individual strengths, cognitive style, and circumstances.

Family Therapy

When a crisis occurs—whether due to trauma, sudden loss, mental health challenges, or major life transitions—it affects not just one individual but the entire family system. My approach is to create a safe, structured environment where each family member’s experience is acknowledged, and we work together to understand how the crisis is impacting relationships and improve communication within the family. This collaborative process helps interrupt unproductive patterns and fosters healing and resilience.  Together, we’ll identify patterns that keep you stuck and build practical tools for navigating conflict, deepening connection, and fostering emotional safety at home. It’s okay to come in unsure. You just need a willingness to show up and move forward, one conversation at a time.

Family therapy can be a powerful resource during both stable periods and times of crisis. We’ll explore how mood symptoms may influence family roles, conflict patterns, and emotional safety, and we’ll work together to strengthen coping strategies, improve boundaries, and foster a sense of connection and resilience. With the right support, families can move from feeling overwhelmed or disconnected to feeling more grounded, informed, and united in their approach to managing challenges over time.

Employee Mental Health Services

Critical Incident Debriefing: Making Sense of Crisis

When something traumatic or shocking happens—a sudden accident, a workplace crisis, or a community tragedy—it can feel impossible to process. Our nervous systems go into overdrive. We shut down or go numb.

Critical incident debriefing offers structured, supportive care soon after the event. These sessions are designed to:

  • Reduce the intensity of stress reactions

  • Normalize what you’re feeling

  • Begin integrating the experience without retraumatization

  • Offer psychological first aid and resources for further support

As a certified critical incident debriefing facilitator, I have experience guiding workplaces through debriefings following deaths and crises. I offer tailored interventions on-site that can include both group and individual sessions, designed to support your team’s healing and resilience.

Fees

Rates: $235 for 45 minute session. I do not take insurance. I can provide you with a superbill.

Burnout & Chronic Stress
Grief Work
Mood Disorders
Neurodivergence
Employee Mental Health
Family Therapy
Kiersten Kotaka, LMFT
2 Fifer Ave., Suite 120
Corte Madera, CA 94925
415-966-3007
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© 2025-2026, Kiersten Kotaka, LMFT

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