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Pebble Beach

Permission & Pleasure

6-month Group Therapy for Trauma Survivors 

What to expect:

I encourage you to bring to the group whatever topic you want support around or discuss what has been coming up for you. A few common topics may include:

  • Sexual health

  • Changes in desire and interest in sex

  • Problems with orgasm

  • Sexual pain

  • Intimacy avoidance

  • Relationship conflict

Additionally, we will learn and use a variety of tools and interventions such as narrative therapy, music, mindfulness, deep breathing, communication skills, etc.


This group is “closed", meaning that members commit to regular attendance (twice per month). Casual drop-in participants will not be accepted for this group.

Wild Nature

Experiencing trauma and violence can be very isolating and some survivors report feeling like they are alone in their experiences. Though you are unique in your situations, you are not alone in your struggles. My hope is that in this group work we will turn to one another for support, seek and provide feedback, and explore ways to take risks and be vulnerable in a way that leads to growth and healing.


Led by Rafaella Smith-Fiallo, MSW, LCSW

Society says we shouldn't talk about sex, but I say, "Let's talk about it more and as a group!" Permission & Pleasure will center adult survivors of trauma who’d benefit from being in a structured, therapeutic environment while obtaining education, skills/resources, and who to talk about sex and sexuality in a shame-free, sex-positive, trauma-informed, and inclusive environment. Each group is led by Rafaella who is a sex and trauma therapist and the owner of Healing Exchange.

A quick reminder. . .

  • It is not mandatory that you be engaged in individual therapy in order to participate in this group. Your route to healing is completely up to you, but I am here for guidance when needed.

  • The process of unpacking your traumatic experiences deserves the individual attention and support of a licensed professional. If that is what you'd like to do, I encourage you to participate in individual therapy.

  • You will not be asked to share your trauma stories but instead to share how trauma has impacted your life—your sex life, relationships, pleasure, trust, intimacy, and other aspects.

Sign me up!
virtual group therapy st. louis

What you need to know

  • Meetings: Every 2 weeks, beginning Feb 1, 2022; 430p-6p CST 

  • Location: Virtual via Zoom

  • Only open to members residing in Missouri & Nevada.

  • Space availability: 8 group members, all potential members must schedule an intake appointment.

  • Cost: $100 per session

    • Insurance will be billed where possible. We are in network with Anthem, BCBS, Optum, & UnitedHealthcare.

*Financial assistance may be available.

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