Therapeutic Guidance Jessica Giambra, LCSW, CADC

How I help

The work is different for everyone. The starting point is the same.

Below is what I actually treat and how I go about it. If what you're carrying isn't on this page, call anyway — I'd rather tell you honestly whether I'm the right fit than have you guess from a list.

Individuals

Adult therapy

One-to-one, fifty minutes, usually weekly at the start. The most common reasons people come: anxiety, trauma, low mood, substance use, and the feeling that life stopped fitting somewhere along the way.

Ages 13+

Teens

Anxiety, school refusal, self-esteem, vaping and substance use, family conflict, and the aftermath of something that happened. Parents get looped in on what matters without the teenager losing their own space to talk.

Couples & families

Relationships

Communication that's turned into a loop, trust after a betrayal, parenting as a united front, and families organising themselves around one member's addiction or mental health.

How I can help

The areas I know best.

Anxiety & stress
Panic, worry, health and social anxiety, burnout

We start with what anxiety is doing in your day — the avoiding, the checking, the 2 a.m. rehearsals — and get you tools that work on that this week. Then we go after what's feeding it. Mostly cognitive behavioral work, with mindfulness where it helps.

Trauma & PTSD
Single-incident, childhood, and complex trauma

Trauma-informed from the first minute. We build stability and coping before we open anything, and you control the pace throughout. Nothing gets dragged out of you. For many people, a large part of the relief comes from finally understanding why the body reacts the way it does.

Addiction & recovery
Alcohol, drugs, early recovery, relapse, family impact

I'm a Certified Alcohol & Drug Clinician as well as a licensed therapist, which means the substance use and whatever sits underneath it get treated together instead of being handed off between two providers. Motivational interviewing rather than confrontation. You don't have to have decided to quit before you come in.

Depression & transitions
Low mood, grief, divorce, job loss, empty nest, diagnosis

Depression is rarely just chemistry — usually there's a life underneath it that has quietly stopped working. We treat the mood and address the life at the same time, in whatever order is realistic for you right now.

Also treated

Other things people bring in.

Often alongside one of the four above rather than on their own.

  • ADHD
  • Anger management
  • Behavioral issues
  • Bipolar disorder
  • Borderline personality
  • Codependency
  • Domestic abuse
  • Eating concerns
  • Emotional disturbance
  • Family conflict
  • Grief and loss
  • Obsessive-compulsive concerns
  • Peer relationships
  • Relationship issues
  • Self-esteem
  • Self-harm
  • Sleep problems
  • Stress management
  • Suicidal thoughts
  • Women's issues

What I don't do

I don't provide inpatient or detox care, court-ordered custody evaluations, disability determinations, or emergency after-hours coverage. If you need one of those, tell me on the consultation call and I'll point you to the right place in Chester County.

How I work

A personalized approach, grounded in what works.

I draw from evidence-based approaches and years of clinical experience to tailor therapy to you — your needs, your goals, and where you are right now.

Where I specialise

Cognitive Behavioral Therapy

CBT is an evidence-based approach that helps you understand how your thoughts, emotions and behaviors influence one another. Together, we identify patterns that may be contributing to anxiety, depression, or feeling stuck — and develop practical strategies to help you respond differently and feel more in control.

Curious about how CBT helps with anxiety?

Learn more about CBT and anxiety from the American Psychological Association →

Always

Trauma-informed care

Safety, choice and pacing built into how every session runs — not a separate module we get to later.

Change and ambivalence

Motivational Interviewing

For when part of you wants to change and part of you doesn't. We work with both parts instead of pretending one isn't there.

Short-term goals

Solution-Focused Brief Therapy

When you've come in for something specific and defined, and you want it handled rather than explored.

Longer work

Psychodynamic

For the patterns that keep repeating across relationships and decades, where the current situation is only the latest version.

Throughout

Strengths-based & mindfulness

Starting from what you already do well, and building the ability to notice what's happening before reacting to it.

In person or remote

Telehealth that isn't a downgrade.

Sessions run by phone, FaceTime or Google Meet for anyone located in Pennsylvania. For most of what I treat, the research shows outcomes hold up remotely — and for people managing anxiety, small children, shift work or a long commute, the session that actually happens beats the one you had to cancel.

Plenty of clients mix the two: in the office when it matters, remote when the week is against them. You don't have to choose once and stick with it.

Next step

Not sure which of these you need?

That's normal, and it's genuinely my job rather than yours. Fifteen minutes on the phone is usually enough to sort it out.

In a crisis right now? Call or text 988 (Suicide & Crisis Lifeline), call Chester County Crisis Services at 610-280-3270, or dial 911. This website is not monitored for emergencies.