Thoughtful Starting Points
Questions Worth Exploring
Find a guide that speaks to what is on your mind. These pages can help you prepare for a conversation about care.
Anxiety and Overthinking
When Worry Takes Over at Night
The day is finally quiet, but your mind starts reviewing everything you said and everything tomorrow might bring. You may be looking for support with the worry itself rather than another instruction to relax. Marie’s CBT approach offers a way to explore the thoughts and responses that keep repeating.
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Replaying Conversations Afterward
You leave a conversation and begin reviewing your tone, the other person’s expression, and the sentence you wish you had said differently. Reflection can be useful; an endless replay can leave you less certain. Therapy can give that pattern a more deliberate place to be explored.
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Social Anxiety in Your Late Teens and Twenties
Maybe you rehearse a text for twenty minutes, skip the club meeting you wanted to join, or leave a party early so nobody notices you are struggling. Social anxiety often shows up during years full of new people and new settings. CBT gives you a structured way to look at what you expect will happen and what you do to stay safe.
Read the Guide ↗Test Anxiety and Performance Pressure
You studied, but the moment the exam starts your mind goes blank. Or the presentation is next week and you already feel it in your stomach. Performance anxiety tends to show up when something feels like it measures you. CBT can help you understand the pattern before, during, and after these moments so they feel less like a verdict.
Read the Guide ↗When Perfectionism Feeds Anxiety
High standards can be a strength. But when every email needs three rereads, a small mistake ruins your day, or you avoid starting because it might not be good enough, perfectionism may be keeping anxiety running. CBT offers a way to examine the rules you live by without asking you to stop caring.
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Panic Attacks and How CBT Approaches Them
A panic attack can arrive suddenly: your heart pounds, your breath feels short, and you may feel sure something is badly wrong. Afterward, many people start watching for the next one and avoiding places where it happened. CBT offers a clear model for understanding that cycle and practical ways to work with it.
Read the Guide ↗Reassurance Seeking and Why It Rarely Settles the Worry
You ask a partner if they are upset with you, then ask again an hour later. You search online until something finally sounds calming, then the doubt returns. Reassurance seeking is common with anxiety, and it often brings relief that does not last. CBT looks at what the reassurance is doing and what else might help.
Read the Guide ↗Decision Paralysis and Overthinking Choices
Choosing a major, a job offer, an apartment, or even a restaurant can turn into days of research and second-guessing. When every option seems to carry a risk of regret, deciding can feel impossible. CBT can help you look at the thinking and habits that make decisions so heavy.
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Health Worry Loops
A small ache becomes an hour of searching symptoms. A clear test result brings relief for a day before the doubt returns. Health worry can be exhausting, and it is easy to feel embarrassed about it. CBT treats it as a pattern worth understanding, while respecting that real medical care matters.
Read the Guide ↗Anxiety in Your First Years of Work
Your first jobs come with new rules no one fully explains. You may worry about every Slack message, dread one-on-ones, or feel like everyone else knows what they are doing. Early career anxiety is common, and CBT can help you sort real work concerns from the worry that piles on top of them.
Read the Guide ↗ADHD and Daily Life
When Starting a Task Is the Hardest Part
You know what needs doing, but beginning feels strangely difficult. The unfinished task grows in your mind while the first step stays unclear. Marie’s ADHD and executive-functioning work focuses on practical difficulties like these without reducing your experience to laziness.
Read the Guide ↗ADHD and the Transition to College
A new schedule can reveal how much structure you used to get from school or home. You may be managing deadlines, meals, friendships, and studying with fewer reminders. Therapy can be a place to examine what support you need as a young adult.
Read the Guide ↗Life Transitions
Therapy for Young Adults
Other people may assume you should already know what comes next. You may be making decisions about work, study, relationships, or where to live while feeling less certain than you look. Marie works with young adults who want a practical place to think through those pressures.
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Therapy for Life Transitions and Turning Points
It might be a break-up, a move, a new job, or a new baby at home. Marie Sarte, LCSW, especially enjoys working with adults at turning points like these. Each one can reshape your routines, your roles, and your thoughts, even when the change is welcome. Marie's CBT approach can help you find your footing again, one small step at a time.
Read the Guide ↗Relationship Recovery
Finding Support After Emotional Abuse
A relationship may be over while its effects still occupy your day. You might question your memory, feel embarrassed about what happened, or find it difficult to trust your reactions. Marie’s relationship-recovery work provides space to discuss your experience without requiring a label for the other person.
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Rebuilding Trust in Your Own Judgment
After a painful relationship, ordinary decisions can become difficult. You may look for reassurance about what you remember or whether your reaction is reasonable. Seeking support can begin with that uncertainty, without requiring you to present a perfectly settled account.
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Recognizing Signs of Emotional Abuse
Emotional abuse rarely announces itself. It often shows up as a pattern of small moments that leave you smaller, quieter, and less sure of your own read on things. This page offers language for those patterns without asking you to label anyone, and explains how therapy with Marie can help you sort through what happened.
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Gaslighting and Doubting Your Own Memory
After a relationship where your version of events was regularly denied or rewritten, you may find yourself doubting simple memories. That uncertainty can linger long after the relationship ends. This page looks at how memory doubt tends to work and how therapy can help you rebuild a steadier relationship with your own perceptions.
Read the Guide ↗Second-Guessing After Leaving a Relationship
Leaving does not always bring the relief people expect. Instead, you may find yourself replaying good moments, wondering if you overreacted, or missing someone who also hurt you. Those mixed feelings are common, and they deserve space rather than judgment. This page explores the second-guessing that often follows and how therapy can help.
Read the Guide ↗Setting Boundaries After Emotional Abuse
If your limits were ignored or punished in a past relationship, setting boundaries now can feel risky, selfish, or simply unfamiliar. You might over-explain, give in quickly, or avoid conflict altogether. This page looks at what boundaries can look like in everyday life and how CBT can help you practice them at a pace that feels manageable.
Read the Guide ↗Dating Again After an Emotionally Abusive Relationship
Thinking about dating after a harmful relationship can stir up hope and dread at the same time. You may wonder whether you will recognize warning signs, whether you can trust your own attraction, or whether you are ready at all. This page explores those questions and how therapy can support you whenever you choose to date again, or not.
Read the Guide ↗When Friends and Family Don't Understand
Sometimes the people closest to you do not see what happened. They may have liked your former partner, minimized what you described, or asked why you did not leave sooner. Feeling misunderstood can add a second layer of hurt. This page explores that experience and how therapy can offer a place where your account is taken seriously.
Read the Guide ↗Working Through Self-Blame After Abuse
Many people who leave a harmful relationship carry a running list of what they should have done differently: noticed sooner, left earlier, said less, said more. Self-blame can feel like a way to regain control, yet it often keeps the hurt fresh. This page explores where self-blame comes from and how CBT can help you look at it more fairly.
Read the Guide ↗Choosing Support
Understanding CBT
What Is Cognitive Behavioral Therapy?
You may have heard CBT described as practical or skills based, without a clear picture of what actually happens. This page explains the basic ideas behind cognitive behavioral therapy and how Marie uses it in a collaborative way with teens, young adults, and adults.
Read the Guide ↗How CBT Thought Records Work
A thought record is one of the most common tools in CBT. It can look like a simple worksheet, but it is a structured way to slow down a moment that felt overwhelming. This page walks through what a thought record includes and how it might be used in therapy.
Read the Guide ↗CBT Compared With Other Talk Therapy
If you are looking for a therapist, you will see many approaches listed. CBT is often described as more structured than some other forms of talk therapy. This page explains how CBT tends to differ in practice so you can think about what might suit you.
Read the Guide ↗Behavioral Experiments in CBT
Arguing with an anxious thought only goes so far. Sometimes the most convincing information comes from trying something and seeing what happens. Behavioral experiments are a CBT tool for testing predictions in real life, planned carefully and reviewed together.
Read the Guide ↗Practice Between CBT Sessions
CBT often includes something to try between appointments. For some people, the word homework brings back stressful memories of school. Here is what between-session practice usually looks like in CBT, why it is part of the approach, and how it can be shaped to fit a real schedule.
Read the Guide ↗ADHD and Executive Function
Making Sense of an ADHD Diagnosis as an Adult
Getting an ADHD diagnosis in your twenties, thirties or later can bring relief, grief and a long list of questions all at once. You may be rethinking years of missed deadlines and harsh self-talk. Therapy can offer a place to sort through what the diagnosis means for your daily life now.
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Working With Time Blindness
You meant to leave in ten minutes, and somehow forty have passed. Time blindness is a common way people describe the gap between how time feels and how it actually moves. Therapy can help you build outside cues that do the tracking your brain does not do automatically.
Read the Guide ↗Procrastination, ADHD and the Shame Cycle
Putting something off, feeling terrible about it, and then avoiding it even more is an exhausting loop. When attention and motivation work differently, procrastination often has less to do with not caring and more to do with how hard it is to begin. Therapy can look at both the task and the shame that builds around it.
Read the Guide ↗ADHD and Big Emotions
Frustration that flares in seconds, a small criticism that stings for days, or excitement that makes it hard to slow down: many people with ADHD describe emotions that feel fast and intense. Therapy can help you notice the build earlier and choose a response with a little more room.
Read the Guide ↗Supporting a Teen With ADHD: Notes for Parents
Homework battles, forgotten assignments and morning arguments can wear down the whole household. If your teen has ADHD or seems to struggle with focus and follow-through, therapy can offer them a space of their own while giving the family more workable ways to approach daily routines.
Read the Guide ↗When ADHD and Anxiety Show Up Together
Is it distraction or worry? Restlessness or nerves? For many people, attention struggles and anxiety tangle together in ways that are hard to separate. Therapy can help you tell the threads apart in daily moments, so the strategies you try match what is actually going on.
Read the Guide ↗Building Work Routines That Fit an ADHD Brain
Open-plan offices, endless messages and tasks with no clear start can make work feel like a constant scramble. Generic productivity advice often assumes a brain that sorts and prioritizes on its own. Therapy can help you design routines around how your attention actually works.
Read the Guide ↗Teens, College and Young Adults
Therapy for Teens in Portland
Teens carry a lot: school pressure, friendships, family expectations and questions about who they are becoming. Therapy can give a teen a space that belongs to them, with an adult who listens and offers practical tools. Marie works with Portland-area teens through online sessions and can discuss current office availability.
Read the Guide ↗For Parents Making the First Call
Reaching out about your teen or young adult can feel like a big step, especially if things have been tense at home. You do not need to have everything figured out. This page walks through what the first call can cover and how to prepare without overthinking it.
Read the Guide ↗Getting Through a Stressful Semester
Midterms stack up, a group project stalls and sleep slides. College semesters can move from manageable to overwhelming quickly. Therapy can help you look at what is driving the stress and make practical changes that hold up during the busiest weeks.
Read the Guide ↗Navigating Your First Year of College
New roommates, unfamiliar schedules and no one checking whether you went to class. The first year of college brings freedom along with a lot of change. If the adjustment feels harder than you expected, therapy can help you sort through it and build routines that work in your new life.
Read the Guide ↗Life After Graduation
Graduation is often treated as a finish line, but many people feel more lost after it than before. Without the structure of classes and semesters, questions about work, identity and direction can get loud. Therapy can be a steady place to sort through this transition.
Read the Guide ↗Teens and School Stress
Grades, homework, tests, sports and college applications can fill every hour of a teen's week. Some stress can be motivating, but when it starts affecting sleep, mood or relationships, it may be time to look closer. Therapy can help teens understand their stress and build practical ways to manage it.
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Therapy for College Students in Oregon
College asks a lot of you at once: classes, money, friendships, and choices about what comes next. Marie Sarte, LCSW, works with students online anywhere in Oregon and in person in Portland, and college students are among the people she especially enjoys working with. This guide covers what you can bring, how location works over breaks, and how to reach out.
Read the Guide ↗Getting Started
Understanding the Cost of Private Pay Therapy
Cost is one of the first practical questions people have about therapy, and it deserves a clear answer. Marie's practice is mostly private pay. This page lays out current session rates, what private pay means, and how to bring insurance and payment questions to the free consultation.
Read the Guide ↗What to Expect From a Free Consultation
Reaching out to a therapist can feel like a big step, especially if you are not sure what to say. Marie offers a free 15-minute consultation so you can ask questions and get a feel for her approach before committing. This page walks through what that call usually covers and how to make the most of it.
Read the Guide ↗How Online Therapy in Oregon Works
Online therapy can make it easier to fit sessions around classes, work, and family life, and it removes the commute. Marie offers online CBT for teens, young adults, and adults located in Oregon. This page explains how online sessions typically work and what to consider before deciding whether they fit you.
Read the Guide ↗In-Person Therapy in Portland
Given the intimate nature of sessions, some people feel more comfortable with in-person sessions in Marie's Portland office. She also offers online sessions across Oregon. This page covers why people choose in-person therapy, what to ask about availability, and how to decide between formats.
Read the Guide ↗How to Choose a Therapist Who Fits
Searching for a therapist can feel overwhelming, with long directories and unfamiliar terms. Fit matters, and it is reasonable to ask questions before committing. This page offers practical considerations for choosing a therapist, whether or not you end up working with Marie.
Read the Guide ↗Your First Three Appointments With Marie
Starting therapy can feel easier when you know what the early weeks hold. After the free 15-minute consultation, if you decide to go ahead, Marie Sarte, LCSW, uses the first three appointments to build a foundation: the present, your story, and your goals. Weekly practice begins once that groundwork is in place.
Read the Guide ↗Superbills and Out-of-Network Benefits
You may have a health plan and still want to see a therapist outside its network. Most of Marie's clients pay privately. If you have a PPO plan, she can give you monthly superbills to submit to your insurance for out-of-network reimbursement. This guide explains superbills and what to ask your plan first.
Read the Guide ↗Your Right to a Good Faith Estimate
If you pay for therapy yourself, federal law gives you the right to know what your care is expected to cost before it starts. That right comes from the No Surprises Act, and it applies when you are uninsured or are not using insurance to pay for your sessions. This guide explains how a Good Faith Estimate works with Marie Sarte, LCSW.
Read the Guide ↗Therapy Services
Individual Therapy in Portland and Online in Oregon
You may have been carrying something alone for a while: a worry that will not quiet down, a to-do list that keeps winning, or doubt left over from a relationship. Individual therapy with Marie Sarte, LCSW, gives it a regular place, online for clients located in Oregon or in person in Portland.
Read the Guide ↗Couples and Family Therapy in Portland
When the same argument keeps circling back, or a change at home has everyone on edge, a steady outside voice in the room can help you slow things down. Couples and family therapy with Marie Sarte, LCSW, is for partners or family members working on something together, focused on the pattern you want to change.
Read the Guide ↗Portland and Across Oregon
A CBT Therapist in Southeast Portland
If you would rather talk with someone face to face than through a screen, it helps to know who will be in the room. Marie Sarte, LCSW, offers cognitive behavioral therapy for teens, college students, and adults at her office in Southeast Portland, and online for clients located in Oregon.
Read the Guide ↗Therapy Options for Lake Oswego Residents
Maybe you just started a new job, ended a relationship, moved, or welcomed a new baby. Maybe a teen at home is carrying more school pressure than they let on. From Lake Oswego, south of Portland, you can see Marie Sarte, LCSW, at her Southeast Portland office or online from a private space in Oregon.
Read the Guide ↗Therapy Options for Beaverton Residents
When work is where things pile up, the signs are easy to spot: a task you keep circling, a deadline that turns urgent overnight, a review you dread for weeks. If you live in Beaverton, west of Portland, you can work with Marie Sarte, LCSW, face to face in Southeast Portland or online from wherever you have privacy in Oregon.
Read the Guide ↗Online Therapy for Clients in Salem
It is 1 a.m., and you are still going over something you said earlier, chased by what-ifs you know are not rational. If you live in Salem, Oregon's capital, Marie Sarte, LCSW, offers online CBT for anxiety and overthinking to clients located in Oregon, so you can work on the loop without a trip to Portland.
Read the Guide ↗Online Therapy for Eugene Students and Adults
In a college town like Eugene, life can run on deadlines. For students, the term sets the pace: easy first weeks, then exams and projects stacking up, then the night-before panic. Adults juggling work and home know their own version of that squeeze. Marie Sarte, LCSW, offers online CBT for students and adults located in Oregon, including support with ADHD and executive functioning.
Read the Guide ↗Online Therapy for Bend and Central Oregon
Bend is in Central Oregon, east of the Cascades and a long drive from Portland, so sessions with Marie Sarte, LCSW, happen online. That can suit the kind of work you would rather keep private: recovering from an emotionally abusive relationship, or finding your footing after a move, a new job, or a break-up. Sessions are for clients located in Oregon.
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