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Clinical Specializations

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Mood Disorders

Living with mood disorders like depression, bipolar disorder, or anxiety can be really tough, and they often affect more than just your mood. They can impact your energy, motivation, relationships, and how you see yourself. I’m dedicated to providing compassionate, and knowledgeable care that truly meets you where you are. 

 

If you want, I’m happy to coordinate care with your other providers like your doctor or psychiatrist to make sure everyone is on the same page. This teamwork helps make your treatment feel more connected and supportive, especially if you’re managing more complex mood challenges.

 

Mood disorders can feel overwhelming, but with the right tools and support, you can find your footing again and live a life that feels more balanced and meaningful.

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.

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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 another area I hold with deep care. Whether you're grieving the loss of a loved one, a relationship, a sense of identity, or a version of life you thought you'd have, our work together creates space to feel, remember, and integrate. Grief doesn’t follow a linear path—it often moves in waves, catching you off guard or slowing you down when you least expect it. Therapy offers a place to tend to those waves with gentleness and meaning.

Neurodivergence

I’m a neurodivergent  therapist who specializes in working with neurodivergent folks; Autistics, people with ADHD, learning differences, or  brains that just don’t quite fit the mold. My approach is strengths-based and affirming, with a focus on helping clients better understand their unique wiring and unlearn all the unhelpful stories they’ve been told about how they “should” function. A lot of the people I work with are smart, creative, and deeply insightful but they’ve spent years feeling like they’re too much, not enough, or constantly behind. Therapy can be a space to unpack that, get clear on what actually matters to you, and find ways to move through the world with less shame and more self-trust.

 

Alongside therapy, I also offer executive function coaching. That means we get into the nitty-gritty of how your brain handles (or avoids) things like planning, prioritizing, getting started, staying on track, and following through. This isn’t about forcing yourself to become a productivity machine—it’s about finding systems and strategies that actually work for your life. Whether you’re overwhelmed by everyday tasks, constantly putting things off, or just tired of white-knuckling your way through your to-do list, EF coaching gives us a chance to try different tools, stay curious, and figure it out together.

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.

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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

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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.

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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

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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.

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

© 2025 by Kiersten Kotaka, LMFT

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