Couples Therapy

Adrien Monti, LCSW, provides specialized couples therapy in Roanoke, Virginia for partners seeking to move past gridlock and rediscover their connection.  Most of the couples she works with love each other deeply, have done everything they can think of to address the issues on their own, and feel stuck. 

Common concerns to address in couples therapy include:

  • Communication challenges, such as not feeling heard or understood

  • Conflict avoidance, or fear of bringing things up, which can lead to distance and loneliness

  • High conflict, when casual conversation can rapidly escalate into a cycle of defensiveness and reactivity

  • Challenges with equity in distribution of duties

  • Anxious attachment, avoidant attachment

  • Desire discrepancy

  • Different sexual preferences, sexual incompatibility, or alternative interests

  • Dry spells and dead bedrooms

  • Queer couples / same sex couples / LGBTQIA+

  • Navigating open relationship structures, such as ENM and polyamory

  • Broken relationship agreements

  • Affair recovery / betrayal trauma

  • Desire to feel more connection, more like partners on the same team

Qualifications and Approach

Adrien has training in several well-established couples therapy modalities, including Gottman levels 1, 2, and 3, Developmental Model, Relational Life Therapy, and Imago.  As the only AASECT certified sex therapist offering couples therapy in person in Roanoke, Virginia, Adrien provides a level of specialized expertise not found elsewhere in the region. 

Adrien’s approach to working with couples is clear, structured, and relatively short-term.  She presents as a strong leader in sessions in order to prioritize emotional safety. Adrien steers the ship so you don’t have to.  She provides direct feedback and holds each partner accountable for behaviors that are derailing the relationship.  Adrien remains focused on teaching each person effective communication skills that they can use at home.  The goal of couples therapy is to build a sustainable future together.  Partners will graduate from couples therapy with a stronger connection and better skills for navigating conflict.

Adrien offers extended 75-minute sessions, which allows more time to deep dive without the cliffhanger ending of a 50-minute session.

When Adrien starts working with a new couple, she first meets with them together, then meets with each person once individually (to truly understand their perspective and side of things) and then continues with couples sessions from that point forward.  Most people appreciate the opportunity to meet with Adrien privately to share their side of the story.

Adrien does not offer:

  • Insurance billing or insurance reimbursement (all services are private pay)

  • Participation in divorce proceedings or custody disputes

  • Court ordered therapy

  • Therapy outside of Virginia

  • Couples therapy for relationships with current domestic violence

  • Treatment of substance use disorders or severe untreated mental illness.  Adrien will see couples facing these issues if they are willing to seek specialized outside help and support while participating in couples therapy.

Individual Therapy

Adrien Monti, LCSW, provides individual therapy in Roanoke, Virginia for people who are tired of being held back by shame and pain from the past, and who want to stop feeling constricted and repressed. If you want to experience more self-acceptance and authentic connection with others, therapy with Adrien might be a good fit for you. 

Common concerns to address in therapy include:

  • Low libido or loss of sexual interest

  • Painful sex

  • Erection challenges (erectile dysfunction, rapid ejaculation)

  • Conflicted relationship with porn

  • Difficulty with orgasm

  • Alternative interests, such as kink and BDSM

  • Open relationships, ENM, polyamory

  • Betrayal trauma

  • LGBTQIA+

Qualifications and Approach

 As the only AASECT certified therapist offering in person sessions in Roanoke, Virginia, Adrien has extensive training and experience to address a variety of sexual and relationship concerns.  She has been a licensed therapist in Virginia since 2008.  Adrien offers education, resources, and recommendations for follow up actions in between sessions.  She believes in the mind-body connection and finding ways to access deeper emotions.  She is trained in EMDR, an evidence-based modality for processing painful past experiences.

Adrien does not offer:

  • Therapy for minors

  • Court ordered therapy

  • Therapy outside of Virginia

  • Crisis therapy or intervention

  • Insurance billing or insurance reimbursement (all services are private pay)