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Couples & Relationship Therapy in St. Louis

Creating a space for reconnection and enhancing intimacy in all of your relationships.

Ready for healthier relationships?


Building healthy relationships is essential for our overall development, well-being and survival. Whether it’s a familial, romantic, or friendship bond, establishing and maintaining healthy relationships can provide the support, love, and sense of belonging to live a fulfilling and harmonious life. Although relationships can be a source for healing, they are also a source of our deepest pain. Therefore, building and maintaining healthy relationships is often a struggle for many people.


Relationships can have a significant impact on your emotional, physical, and mental well-being. When you feel unloved, unsafe, abandoned, or unworthy in your relationships, it can damage and distort your sense of self and negatively shape how you show up in various relationships. For instance, if you struggle with building and maintaining healthy relationships you are more likely to experience low self-esteem or self-worth, emotional concerns (e.g., anxiety, depression, and suicide), higher relational discord and dissolution, intimacy concerns, and overall life dissatisfaction. Therefore, learning to build and maintain healthy relationships will require consistent collaborative and individual effort, understanding, and willingness to challenge and confront old patterns and traumas. Remember, it’s okay not to have it all together when it comes to your relationships. Building and nurturing relationships is an ongoing journey that can flourish over time.

Do you struggle with vulnerability and trust in your relationships?


  • You don't want to replicate the unhealthy relationship dynamics you witnessed in your household or environment.

  • You desire emotional safety, support, and love you didn’t receive in childhood or adulthood.

  • You avoid having difficult conversations in your relationships due to fear of losing the connection or not being fully accepted.

  • You struggle with building trust after infidelity, relational trauma, or your boundaries being crossed.

  • You feel disconnected from your partner(s), friends, or family and don’t know where to start to restore intimacy in your relationship(s).

  • You want to improve communication and conflict resolution skills that lead to understanding rather than resentment.

  • You struggle to express your needs, desires, and emotions within your relationships.

  • You want to develop a deeper understanding of how your past traumas have shaped your view of relationships, self-worth, and attachment needs.

  • You find it difficult to trust and prioritize yourself in life and love.

  • Your old wounds, fear of rejection, or being vulnerable get in the way of building healthy relationships.

Black friends pose together for a photo


You might be unsure of how to build healthy relationships because they were never modeled to you. Maybe you realized that you are outgrowing your relationships and don’t know how to have difficult conversations about the disconnection. Or you’ve experienced relationship rupture and you’re unsure how to repair the connection. Relationship therapy can support you in unpacking your relationship concerns and exploring what it would look like for you to build thriving relationships.

Building healthy relationships starts with you. You might have difficulty building relationships because you haven’t nurtured the relationship you have with yourself. Maybe you haven’t explored your relational needs or desires and you feel stuck in relationships that don’t align with who and where you are. Relationship therapy can be the container for you to explore all parts of yourself and develop an understanding of how you want to show up in your relationships.


Healing Exchange is committed to embracing all identities, relationship structures, and dynamics while supporting you in exploring how you want your relationships to look and how you want to feel in them.

It is common for people to seek relational therapy for their romantic and familial concerns. However, we might have relationship issues that expand traditional relationship structures and dynamics.

Whatever the nature of the relationship, it is important that you feel supported in addressing your concerns and fulfilling your desires.


It is common for people to seek relational therapy for their romantic and familial concerns. However, we might have relationship issues that expand traditional relationship structures and dynamics. At Healing Exchange, we support and embrace a wide range of relationships, including:

  • Parent and child relationships (including parents and their adult children)

  • Siblings

  • Friendships

  • Engaged and married couples

  • Long-term and long-distance couples

  • Dating

  • Consensual non-monogamous relationships (e.g., polyamory, swinging, open marriage, friends with benefits, solo polyamory, etc.)

  • Business partners 


It may seem taboo or untraditional to go to therapy with a friend, someone you are newly dating, or a business partner. This hesitation is understandable because these types of relationships are not highlighted enough in therapy. Typically, relationship therapy centers couples and families; but that doesn’t make your love or relationship any less valid or worth fighting for. Truth be told, friendships can be the longest and most fulfilling relationships that many people have. And, they can be the most gut wrenching if they end. So, maybe you fear being judged or question if the issue is serious enough for therapy. Or you might struggle with stigmas or misconceptions that therapy is for traditional relationship structures and types.. But every relationship you’re in is worth extra support if needed. At Healing Exchange, we embrace the diversity and complexities of all relationships that matter to you.

The longer I live, the more deeply I learn that love — whether we call it friendship or family or romance — is the work of mirroring and magnifying each other’s light.

James Baldwin


family photo of lesbian couple with their kid

Gottman Method Couples Therapy

Emotion Focused Therapy

Sex Therapy & Education

Prepare/Enrich Assessment & Counseling

Family and Friendship Therapy

Clinicians Specializing in Couples & Relationship Therapy

Rafaella Smith-Fiallo, level 3 gottman therapist

Rafaella Smith-Fiallo (she/ella)

LCSW, Gottman Level III 

Rafaella specializes in helping people understand how their history shows up in present relationships. She is attachment oriented and teaches clients that regardless of their 'attachment response' they are deserving of stability and security. She works with all relationship types, from friends to polyamorous triads, with the goal of fostering connection and intimacy that feels nurturing to everyone involved. Learn more about Rafaella.

Rafaella's specific areas of focus within relationship therapy include:

  • Helping individuals identify and better navigate the cycles of trauma that keep them in a loop of defensiveness, withdrawing, shutting down, and anxious pursual.

  • Fostering a sense of empathy that leads to stronger relationship accountability and emotional ownership.

  • Creating a culture of vulnerability and transparency that soothes self-doubt and aligns with their goals of having a healthy relationship.

  • Challenging societal standards and 'rules' that just don't work in your relationship so that you can form relationship tenets that actually work for you.

  • Develop intentional relationship rituals that affirm the commitment that all parties have to strengthen the relationship.

Melony Crayton, prepare/enrich and relationship therapist in St. Louis

Melony Crayton (she/her)


Melony is a Provisional Licensed Professional Counselor (PLPC), Somatic Experiencing Practitioner (SEP), and Sex Therapy Informed Professional (CSTIP) in training who specializes in treating relational concerns through intimacy development and relationship exploration. Melony is a trauma-informed, attachment theory-oriented, queer and non-monogamy affirming, and sex-positive therapist, who is committed to embracing all identities and relationship needs while supporting clients in building and maintaining healthy relationships with themselves and others. Learn more about Melony.

Melony’s specific areas of focus within relationship therapy:

  • Supporting adult children and their parents in addressing unresolved wounds and conflict. The parent-child dynamic is unique, and together we can explore the possibility of healing and forgiveness, if appropriate, and work towards building mutual respect and compassion.  

  • Supporting all partnerships in navigating and finding resolve after betrayal, breaches of boundaries, and relational trauma. It is possible to rebuild a healthy and loving connection after relational breakdowns. We can work together to restore the love.    

  • Supporting all partnerships in navigating transitional periods in their relationships, including premarital, co-parenting, cohabitating (non-married included), and dating to long-term relationships. You may feel challenged by life transitions or change, especially when it is unexpected, unwelcomed, or unfamiliar. Together, we can explore how you can navigate and grow from the changes you experience in your relationships.

  • Supporting adults in exploring their sexual desires, pleasures, curiosities, and concerns within an individual or relationship capacity. We can create an inviting space for you to explore, meet, or honor your full sexual self.  

  • Supporting adults who want to explore and build healthier relationships with themselves. Deepening your relationship with yourself is an ongoing and unique journey of self-discovery, self-acceptance, and self-growth. Together we’ll create space for you to unfold, embrace, and nurture all facets of yourself.

Eric Jones, couples and relationship therapist intern in St. Louis

Eric Jones (he/they)

Couples and Relationship Therapist Intern

Eric supports you as you navigate, nurture, and assess your relationships whether they are with friends, romantic partner(s), family members, or any other relationship you value and want to improve. Eric is a queer and trans affirming, kink-aware, sex-positive, pleasure-focused, and ethically non-monogamous/poly affirming therapist who is focused on helping you achieve the relationship goals that you desire. Learn more about Eric.

Eric's specific areas of focus within relationship therapy include:

  • Working with clients interested in nurturing their relationship with themselves. Maybe you’ve been so focused on external relationships, you forgot to care for the relationship you have with yourself and need a space to focus and process what it means to be in partnership with yourself.

  • Exploring non-traditional relationship dynamics. We often receive different messages from the world around us, telling us how our relationships should look and function and which ones we should value more over others. If you are ready to question or explore forms of relationships more aligned with how you see the world, this is a place to start. 

  • Navigating the hurt and harm from past betrayals. You are seeking to repair your relationship and heal from those moments of betrayal, but you don’t know how to or if it’s even worth it. We can work together to figure out what is best for both the relationship and the individuals in it.


Kat Seal (they/she/any)


Kat is passionate about supporting partners in all relationship models who are dedicated to creating healthy and pleasurable dynamics but feel stuck from past wounds or boxes society has placed around them. Their approach is trauma-informed, queer and trans-affirming, kink-aware, and pleasure-centered. Our intimate relationships can serve as sanctuaries from the outside world, but oftentimes they take intentional work and collaboration for all partners to feel affirmed and supported. Kat is committed to helping clients improve the relationships in their lives, whether that be with a monogamous partner, triad, life-long friend, or even the relationship you hold with yourself. Learn more about Kat.

Kat's specific areas of focus within relationship therapy include:

  • Creating a container for all members of the relationship to feel safe and encouraged in exploring their authentic desires, identities, and sexual expressions. 

  • Working with relationships to shed unwanted societal norms or expectations about what their relationship should look or feel like and to create a relationship culture that celebrates you. 

  • Assisting partners in relationships improve communication patterns and express their needs so that all partners can feel loved, seen, supported to thrive. 

  • Supporting relationships who are navigating neurodivergent identities and helping to create more understanding for connection and play within the partnership.


What’s the difference between a healthy relationship and a relationship that is not healthy?

Like people, relationships come in all shapes and sizes. Healthy relationships can look different depending on the relationship structures, dynamics, and conditions that are mutually safe and agreed upon. Also, every relationship comes with its challenges, moments of disconnection, or hardships. Nonetheless, a healthy relationship is one that is built on mutual goals and values, trust, respect, support, safety (mental, physical, sexual, and emotional), collaborative effort, reciprocity, effective communication, and relationship repair skills. On the other hand, unhealthy relationships tend to occur when one or more of these areas become unstable and lack repair causing harm to one or multiple people in the relationship over time. For example, infidelity is a common concern in romantic relationships. When repair does not happen to restore trust and harmony within the relationship, recovering from infidelity becomes infeasible.

Can going to relationship therapy make things worse?

Participating in relationship therapy is an opportunity to support you in fulfilling your relationship needs and build and maintain a healthy connection. One common reason for avoiding relationship therapy is the fear of confronting the pain stemming from past issues. Other times, people may want to avoid feeling “stuck” talking about their problems if they don’t see an opportunity for real solutions or repair. Therefore, addressing concerns in relationship therapy can be uncomfortable or even painful. But, understand that this is part of the therapeutic process of healing relationship wounds. Individuals who consistently invest effort in resolving their relationship issues can discover that their experience becomes meaningful and worthwhile. Alternatively, individuals may come to the realization that, despite their best efforts, ending the relationship is the most beneficial course of action for their overall well-being. It is perfectly acceptable, and we are here to provide support during the process of uncoupling. 


Is going to therapy beneficial for relationships that are already healthy?

When folks think of participating in relationship therapy, it’s typically when things are too painful to repair, or the relationship connection is severely ruptured. However, those who participate in therapy when the relationship is thriving are more proactive in preventing and navigating their issues when they arise, are able to deepen their mutual understanding, increase emotional intimacy, and gain and practice skills they will need to sustain a healthy relationship in the long term.

What would going to therapy look like for my unique relationship needs (e.g., consensual non-monogamous, business, newly dating, or long-distance relationships)?

It can be difficult to imagine what therapy may look like for your unique relationship needs, especially when your specific relationship structure or dynamic isn’t highlighted or is neglected. Fortunately, we support and embrace the diversity and complexities of all relationships that matter to you. Relationship therapy at Healing Exchange will accommodate your specific relationship needs, including understanding your relationship concerns or questions, identifying goals, supporting individual exploration, and exercising practices that align with your values and meeting your goals. It’s important to note that every relationship therapist will bring a unique approach to supporting relationships through their therapeutic journey. At Healing Exchange, we are committed to providing quality, diverse, creative, therapeutic, and educational approaches to support you and all of those you bring with you.

What is the structure and commitment when attending therapy?

The structure and commitment for relationship therapy vary in length and are unique to each relationship. Sessions are 60 minutes but a longer session time (up to 90 minutes) can be negotiated with therapists who offer it and as schedules allow. We structure the first three sessions as follows:


Session 1: Relationship Intake session. This is an assessment where we gather background information from all parties participating in therapy. 


Session 2: Individual sessions with all parties. This is to better understand individual histories and perspectives regarding the relationship.


Session 3: Overview/Goal planning. This session brings everyone back together for the therapist to provide assessment feedback and insight, to finalize therapy goals, and begin the course of therapy.  


Though there may be times when we request to meet individually with all parties throughout the duration of therapy, we will generally plan to meet all together for all sessions. We recommend therapy occurs once a week for at least six weeks to build momentum before offering bi-monthly or monthly sessions.


What is Prepare/Enrich Assessment & Counseling?

Prepare/Enrich is an evidence-based and customizable pre-engagement, premarital, marriage, and couples counseling and online assessment tool to help couples deepen their understanding of their relationship, including their relationship goals, concerns, expectations, and skills. Certified Prepare/Enrich facilitators support couples in processing and understanding the results of their pre-marital/marriage assessment, including:

  • Exploring strength and growth areas

  • Strengthening communication skills

  • Identifying and managing major stressors

  • Resolving conflicts using the Ten-Step Model

  • Developing a more balanced relationship using Couple and Family Maps

  • Understanding personality differences and maximizing teamwork


Prepare/Enrich online assessment is required and costs $50. Prepare/Enrich Counseling sessions for couples last 4-8 weeks. The Prepare/Enrich assessment online tool and counseling can be utilized by all relationship types, structures, and sexual and gender identities despite its traditional and monogamous-oriented origins.


Does insurance cover relationship therapy?

Not all therapists at Healing Exchange are in-network with insurance. Be sure to read the FAQs on each provider’s profile, which will state if they accept insurance or not.

Insurance may cover family and couples counseling. This is typically covered when one person is diagnosed with a mental health disorder and therapy is provided to help minimize or alleviate symptoms related to the mental health diagnosis. This is because insurance requires treatment to be “medically necessary” and that someone is being established as the “identified client”.

Alternatively, relationship therapy that centers goals like developing communication skills, repairing friendships, conflict management, enhancing intimacy, building non-monogamous relationships, premarital counseling, and having better sex will not be covered by insurance. And, there is no “identified client” being treated for a “mental health diagnosis” because the entire unit is treated as the client.

So, I don’t think I need therapy. Do you offer relationship coaching?

Yes, some of our therapists can work in the capacity of a facilitator, educator, or coach. For example, we facilitate Prepare/Enrich Assessments for premarital couples and also have a team of relationship and sex coaches. Read more about the difference between therapy and coaching here and learn about sex and relationship coaching here.

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