
We help couples navigating three major turning points:
High-Conflict Cycles
- The Feeling: Every minor disagreement feels like stepping on a landmine. You are trapped in an exhausting loop of defense and attack, feeling lonely, drained, and misunderstood.
- How I Step In: I do not sit back and watch you argue. I actively step in to halt the escalation, lower the room’s temperature, and map your cycle. The pattern is the enemy—not your partner. Together, we build an alliance to work against it.
Attachment Wounds & Trauma
- The Feeling: Past relationship pain shows up today as a painful “push-pull.” When stress hits, one partner shuts down and retreats, while the other pursues connection with deep anxiety.
- How We Heal: We move strictly at your pace. We build a safe alliance with your protective “parts.” I help you enhance somatic grounding skills so your nervous systems can learn to coregulate instead of trigger.
Premarital Discernment (For Young Couples)
- The Feeling: You love each other, but marriage talks trigger intense anxiety. You’re stuck in limbo, wondering: Are we truly compatible? How do we handle our core differences? Can we build a lifetime without repeating the painful cycles we grew up with?
- Our Sustainable Plan: No generic checklists. We identify the core values that brought you together, heal early emotional wounds, and co-create a hopeful, practical plan for your lifetime together.

How can therapy help us manage high conflict?
Couples therapy manages high conflict by identifying the unconscious “demand-withdraw” cycle and treating the loop itself as the problem. Rather than watching couples argue, I actively step in to halt reactivity in real-time. This helps partners express their core needs without triggering defensiveness.
What is trauma-informed couples therapy, and why does attachment matter?
Trauma-informed couples therapy explores how childhood wounds and past relational trauma shape your current security and trust. Attachment styles dictate how we react when we feel disconnected. By using gentle pacing and somatic grounding, we teach your nervous systems to coregulate and feel safe again.
What is premarital discernment counseling?
Premarital discernment counseling is a structured, hopeful therapy that helps young couples clarify compatibility and resolve relationship anxieties before marriage. Together, we identify your core values, heal early emotional wounds, and co-create a sustainable, practical plan for your future.
Weaving Science and Emotion: Gottman vs. Emotionally Focused Therapy (EFT)
| Modality Feature | Gottman Method Couples Therapy | Emotionally Focused Therapy (EFT) |
|---|---|---|
| Primary Focus | Behavioral patterns, daily communication habits, and conflict management tools. | Emotional attachment styles, core vulnerabilities, and safe co-regulation. |
| How It Works | Introduces practical, daily communication adjustments (like using “softened startups” to replace criticism, defensiveness, or stonewalling). | Identifies your recurring negative relational loop and helps partners express deeper primary emotions to restore secure attachment. |
| Clinical Goal | Build relationship friendship, manage conflict constructively, and establish shared life meaning. | Re-establish emotional accessibility, responsiveness, and a safe relational bond. |
| How I Apply It | We use these structured behavioral tools to quickly de-escalate high-conflict patterns and rebuild your communication blueprint. | We use this gentle, trauma-informed approach to safely explore the underlying attachment wounds driving your protective cycles. |

Hello! I am Josh Ramirez, a Licensed Clinical Social Worker (LCSW)
Specializing in helping couples navigate complex relational seasons.
“DSM diagnoses are always secondary to who a person actually is.”
As a clinical social worker, my lens is uniquely systemic. I do not look at either partner as the “problem” or the “diagnosis” to be fixed. In fact, my clinical philosophy is that DSM diagnoses are always secondary to who a person actually is. The body and the psyche handle various life challenges, childhood environments, and stressors differently—often taking on the outward appearance of a “disorder.” In my room, we focus on the root: as emotional traumas are safely processed and healed, these symptoms naturally begin to resolve.
Here is what it feels like to work with me:
I guide you to lean into emotions. We go beyond intellectualizing to build real, lasting emotional security.
I am warm and empathetic. I use gentle humor to break heavy tension and keep our sessions feeling deeply human.
I am highly analytical. I am constantly assessing patterns, processes, and cycles to build your emotional intelligence.
I don’t believe in cold, clinical detachment. I will guide you to lean safely into emotions, helping you expand your emotional intelligence skills so that you leave therapy with a stronger internal compass and a more resilient connection to your partner.

Stepping Out of Limbo in 3 Simple Steps
[ Step 1: 15-Min Consult ] ---> [ Step 2: Assessment ] ---> [ Step 3: Begin Rebuilding ]
Step 1: Book Your Free 15-Minute Consultation Use my secure portal to choose a brief, zero-pressure time to connect. This call lets us discuss your high-level goals and ensure my clinical style feels like a mutual fit before scheduling an intake session.
Step 2: The Compassionate Assessment During our first intake sessions, we slow down the noise. We map your unique relational cycle, identify the values that connect you, and establish clear, collaborative goals for our work together.
Step 3: Gentle Healing & Grounding In our regular sessions, we put tools into practice. Moving at your nervous system’s pace, you will learn to build emotional intelligence, somatic grounding skills, and secure co-regulation that lasts long after our work together is complete.
Frequently Asked Questions
What are your session fees?
My session fee is $225 per standard clinical hour (60 minutes) for couples therapy, trauma-informed counseling, and premarital discernment. Extended assessment or somatic therapy sessions (80 minutes) are available upon request and billed pro rata. I accept all major credit cards, HSA, and FSA cards securely through my HIPAA-compliant portal.
Do you accept insurance?
I operate as an out-of-network private practice and do not bill insurance panels directly. However, if you have a PPO insurance plan, they may cover a significant portion of out-of-network outpatient mental health services. Upon request, I provide a monthly Superbill (a detailed medical receipt) that you can easily submit to your insurance carrier for potential reimbursement.
Can we do couples counseling online?
Yes. I provide secure, HIPAA-compliant telehealth video sessions for clients located anywhere within the state of California. Online therapy is highly effective and allows both partners to join from different physical locations if needed, making therapy accessible for busy schedules or virtual arrangements.
What is your cancellation policy?
Because your scheduled clinical hour is reserved exclusively for your relationship, I require 24 hours’ notice for any cancellations or rescheduling. Sessions cancelled within this window are billed at the standard rate.
