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Relationship, Sexuality & Trauma Therapy

A place to learn how to feel pleasure in your relationships, confident in your identities, and release from your pain.

Providing Therapy in Missouri & Nevada and Coaching Worldwide

Were you taught to never air out your dirty laundry and feel exhausted from carrying it all?

While being told, "What happens in this house, stays in this house" might have been said with good intentions, it probably caused you a lot of pain, confusion, and loneliness. So where do you go to discuss all the topics you've been taught to avoid?

You're here because you're...


  • Done carrying the weight of a lifetime of secrets.

  • Ready to trade in years of silence and unburden yourself from shame.

  • Unlearning generational patterns and learning healthier ones.

  • Retiring the mask you've worn to protect yourself.

  • Ready to create a life that's all your own.

The most taboo topics center the most intimate areas of our lives -- our relationships, our sexuality, and our traumas.

But the truth is...

Couple in a hammock

You deserve to feel good in your relationships.

You don't have to follow the path others have led in your family or even society. You get to choose how your relationships look and to feel good in them.

Learn more about relationship therapy

Confidence in your sexual expression is possible.

Being flooded with messages and images about who you are supposed to be as a sexual person can be confusing but it's never too late to figure it all out.

Learn more about sex & gender therapy

Image by Warm Orange
Model in Red Outfit

Trauma is what happened, not who you are.

Your whole identity can shift because of trauma but reclaiming yourself and meeting new versions of yourself will be part of the healing journey.

Learn more about trauma therapy

Hey, I'm Rafaella (she/ella)

And I'm the founder and director of Healing Exchange LLC. I opened Healing Exchange as a space to:

  • Explore how to build a healthier relationship with yourself and others.

  • Reconnect with your partner(s) and enhance intimacy.

  • Talk about your sexuality and ways to experience more pleasure and confidence.

  • Unpack negative lived experiences and traumas and reclaim your life.

  • Prioritize time to focus completely on yourself, shamelessly.

Rafaella Smith-Fiallo, founder and director at Healing Exchange

Discovery is right on the other side of what you've been taught to hide.

Let us help you lay your burdens down and walk away lighter.

Gay Family

Working together
will build...

We'll explore your experiences and thoughts through a lens that seeks to understand your many possible truths instead of using judgement and shame.

We value differences, encourage self-discovery of your authentic self, and prioritize maintaining an openness that allows you to love all parts of yourself.

We are dedicated to thinking outside of the box and incorporating different therapeutic and educational approaches to your treatment. Your situation is unique, and your treatment should be, too.

And help center...

We are aware, critical, and reflective of the many ways that power and privilege present in daily life and are committed to fostering anti-oppressive practices and spaces.

Your life is intended to be more than experiencing pain, survival, and trauma. We'll use a pleasure-centered approach to identify & prioritize your core needs.

We take the approach of a collaborative team member while offering education, tools, and space to explore your options that help you discover solutions.

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Begin the Exchange!

Use this form to inquire about services and we'll get back to you soon.

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