No bullcrap. With love.
Direct, gentle, and always in your corner.
My practice is telehealth across California, in English and Español — anxiety, trauma, relationships, and the patterns underneath.
Direct · with love
The reasons people almost didn't reach out.
If any of these sound familiar, you're in good company.
"You've tried therapy before and it didn't help."
That's a fair thing to walk in with. If it helps, tell me on the first call what didn't land last time — I'd rather know up front than repeat it.
"You're not sure your problems are “bad enough.”"
Whatever's making you read this page is enough. You don't have to be in crisis to deserve a real conversation.
"You think you should be able to figure this out alone."
A lot of the people who call me have gotten this far on their own. That doesn't mean the next part has to be solo, and it doesn't mean asking for help is a downgrade.
The paperwork side.
Third-party verifiable. If any of this matters to you before we talk, it should be easy to check.
You can also read reviews on my Grow Therapy profile.
- Education
- MSW, Columbia University
- License
- CA LCSW #121584
- Experience
- 5+ years in practice
- Trained in
- EMDR · Gottman Method · DBT · CBT · psychodynamic
- Languages
- English & Español
- Background
- Child welfare · justice-involved populations · substance use recovery · codependency
Four steps. No pitch.
So the call feels knowable before you show up to it.
You send a message or pick a time
The contact form or the booking link — either works. Tell me as much or as little as you want up front.
We get on video for about 15 minutes
I'll ask what's going on, what you've already tried, and what you're hoping the work does. You can ask me anything back.
If we're a fit, we schedule a first full session
I'll say what I think would help and how I'd want to start. You take the time you need to decide.
If we aren't a good fit, we can decide together
It doesn't help either of us to force it. Where I can, I'll point you toward someone I trust for the work you're after.
The full range of work. One way of doing it — honestly.
Depth work, not a quick fix.
We don't paper over the symptom. We understand the pattern beneath it — and then, together, we change it.
A real first conversation
A free 15-minute call to hear what's going on and see whether we're a fit. No pitch. If I'm not the right person, I'll say so and try to point you somewhere better.
The map, not just the moment
In the first few sessions we look at the pattern beneath the symptom — where it started, what it's been protecting, what it's costing you now. I'll say what I'm noticing; you tell me where I'm off.
The work of actually changing
Depending on what fits — EMDR, CBT, DBT, psychodynamic, mindfulness — we move at a pace that's honest about what you can hold right now. I'll push when it helps, and back off when it doesn't.
Joshua Acosta-Duque, LCSW.
"I didn't become a therapist because I have all the answers. I became one because I believe people deserve someone who's willing to sit with them, ask the hard questions, and not look away when life gets messy. Some of the most meaningful moments in my career have come from watching clients realize they're capable of more than they ever believed."
On our first call I'll ask what you've already tried and why it stopped working. If I don't think I'm the right fit, I'll tell you and try to point you somewhere better.
Two wheels, open road.
When I'm not in session, I'm usually on the bike — trails, canyons, the long way home. Same reason I like this work: you have to stay honest with what's in front of you.
Servicios de terapia completos en español — con un LCSW latino que te entiende.
Self-pay practice. On purpose.
No insurance company deciding what "medical necessity" means for your life. No mandatory diagnosis in your record. Reach out and we'll talk specifics — including what a self-pay practice actually buys you.
Who this actually works for.
We're probably a good fit if you
- Are ready to look at patterns, not just symptoms
- Want long-term change more than short-term relief
- Are carrying anxiety, trauma, or relationship patterns you've had a while
- Are willing to look at your own part in things
- Are a high-functioning adult who's been holding a lot quietly
I'm probably not the right fit if you
- Are looking for a quick fix or short-term symptom relief
- Want advice or someone to solve it for you
- Aren't up for self-reflection or accountability right now
- Aren't ready to engage in the work yet
If the second list is you right now, that's a real answer and not a failure. Tell me on the call and I'll point you toward what would actually help.
The questions people actually ask.
How do I know if we're a fit?
A free 15-minute call. I'll ask a few direct questions, you'll get a feel for how I work, and if I'm not right for you, I'll tell you and point you somewhere better.
I've tried therapy before and it didn't help.
That's fair to walk in with. If you tell me on the call what didn't land last time, I'd rather know up front than repeat it. My job isn't to defend therapy — it's to figure out with you whether this version of it is worth your time.
I don't know where to start.
You don't have to. Start with whatever is loudest right now and I'll take it from there. I'll ask the follow-up questions; you don't need a prepared statement.
I'm worried I'll be judged.
You won't be. I've sat with people through the parts of their lives they thought they could never say out loud, and none of it is disqualifying. If something you tell me lands hard for me, I'll be honest about that too — not judgmental, honest.
I'm not sure my problems are “bad enough” for therapy.
You don't have to be in crisis to deserve a real conversation. If it's costing you something to keep carrying, that's enough. We can figure out together whether therapy is the right container for it.
I should be able to figure this out on my own.
A lot of the people I work with have gotten a long way on their own before they called. That isn't nothing — and it also isn't the same as this next part being solo. Asking for help isn't a downgrade from whatever you've been doing.
I don't have the time.
It's an hour a week, on video, from wherever you are in California. That's the honest answer to the logistics. The other honest answer is that most people who tell me they can't find the time are describing the exact pattern the work is about.
I can't afford therapy.
This is a self-pay practice, so I won't pretend cost isn't a real factor. Start with the free 15-minute call — we can talk specifics and I'll be straight with you about whether the numbers work. If they don't, I'll point you toward lower-fee options I trust.
Talking about it won't change anything.
Talking alone doesn't. Talking with someone who is watching for the pattern underneath what you're saying — and willing to name it — does. If we do six sessions and nothing has moved, I want you to tell me, and we'll change the approach or I'll help you find someone whose approach fits better.
I'm afraid of opening things up if I can't put them back together.
That fear is the wisest one on this list, and it deserves to be taken seriously. Depth work doesn't mean prying things open without a plan for what comes next — we spend real time on stabilization and resourcing before we go near the hard material. You stay in the driver's seat the whole time.