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Meet Rafaella Smith-Fiallo

Rafaella (she/ella) is a Licensed Clinical Social Worker, Certified Sexuality Educator, and Therapist who is passionate about helping others go through a journey of healing as they find a healthy perception of their sexual selves. With over 10 years of experience in different healing spaces, she has built a reputation as a compassionate, patient, and professional educator, speaker, and therapist.

Rafaella sitting in a large wooden chair wearing an orange dress. A tall green plant is positioned beside her.
Rafaella Smith-Fiallo, LCSW, CSE, CCTP-II (she/ella)

In 2015, she co-founded Afrosexology with Dalychia Saah, a pleasure based sex education multimedia platform that creates content centering pleasure and liberation. In 2018, she opened her therapy practice, Healing Exchange, with the intention to provide a space "where dialogue leads to healing and discovery". In recognition of the positive impact she's had in the community, her work with Afrosexology and Healing Exchange as been featured in numerous media outlets including the New York Times, The Washington Post, HuffPost, Teen Vogue, Vibe Magazine, Broadly, and much more.

Specialty areas

  • Developmental trauma and complex PTSD

  • LGBTQIA+ identity identity and exploration

  • Adult survivors of abuse and violence

  • Self-harm and suicidality

  • Substance use and addiction

  • Relationship struggles and concerns

  • Sex and sexuality


  • Internal Family Systems (IFS)

  • Eye-Movement Desensitization Reprocessing (EMDR)

  • Cognitive Processing Therapy (CPT)

  • Cognitive Behavioral Therapy (CBT)

  • Gottman Method Couples Therapy

  • Dialectical Behavioral Therapy (DBT)

  • Somatic Experiencing (SE)

  • Bibliotherapy


  • Licensed Clinical Social Worker (LCSW) - Missouri & Nevada

  • Certified Clinical Trauma Therapist Level 2 (CCTP-II)

  • Certified Sexuality Educator (CSE)


  • American Association of Sexuality Educators, Counselors, and Therapists (AASECT)

  • Association of Black Sexologists and Clinicians (ABSC)

  • International Association of Trauma Professionals (IATP)


  • Washington University in St. Louis, Master of Social Work, concentration in Mental Health

  • North Carolina A&T State University, Psychology

Book a free 15 minute consultation and let's see if we're a good fit.


More from Rafaella: Destined To Do This Work

Rafaella standing for a portrait, hand on her hip and laughing while looking to the side.

Now, I don’t identify as a healer of anyone except myself but learning the meaning of my name decades ago was definitely telling and motivating. And I wouldn’t have any other name!

Name pronunciation

Eng: Rah-fee-l-la

Sp: Rrah-fah-eh-lah

My name means: God heals, God has healed, Healer, Doctor

For over 10 years I have worked in different helping and healing spaces and for nearly 15 years I've worked in sex education roles. This has included working with patients on hospice and their families, mentoring and providing counsel to high school and college students, educating children and youth in group home settings, and providing services to children and adults with severe mental illness.

People often ask me how I got into doing the work that I do because on the outside it seems like heavy, tiring, traumatic work. And, in some ways it definitely can be. Holding space for stories and energy exchanges around the darkest, loneliest, and confusing moments can do that. But with that, I also have the immense pleasure and privilege of witnessing people reach the light, build community, and gain more clarity about themselves. That is what keeps me coming back to do this deeply rich and rewarding work with every single client.

I believe that we all, at one time or another, encounter issues and obstacles that overwhelm us. We do the best that we can and work with what we have, but may find ourselves stuck in a cycle of survival, denial, and avoidance. If you have ever been in a situation when your go-to solutions were no longer working, you may know the feelings that I’ve described. And, you may know the feeling of being ready to seek and accept additional resources.

In working with me, you'll see that I apply concepts of several therapeutic approaches as appropriate for each person, taking into account that we all navigate our lives as complex beings. These approaches include: Pleasure-Centered Theory (exploring your right to experience and demand pleasure) as I believe that your life is meant for more than surviving trauma and pain; Cognitive Behavior Therapy (examining and challenging your thoughts to affect your feelings and actions) techniques to uncover how critical your self-talk is to your livelihood, Trauma-Informed modalities to address symptoms and facilitate healing, Narrative therapy which allows space between you and your problems in order to develop a new perspective, and creative arts and bibliotherapy to process through the use of art and other creative expression.

During the years, I've learned just how therapeutic the right dialogue and relationship can be. I have witnessed people heal when they decided to face their truth, challenge years of silence, and were empowered to take control of their story. I opened Healing Exchange as a space:​

  • To prioritize time to focus completely on yourself.

  • For lovers to explore connection and enhance intimacy.

  • To unpack negative sexual experiences and other traumas.

  • To talk about your sexuality and ways to experience more pleasure.

We are a therapy practice where we value choice and you being in control over what happens in your life and therapy sessions. We take the approach of being on a collaborative team while offering education, tools, and space to explore your options and help you discover solutions. Each client relationship is individually tailored to best meet your needs.

Ready to be supported in addressing your challenges and empowered towards making the changes you want? Our team at Healing Exchange is committed to helping you improve your emotional wellness, sexual health, and relationship satisfaction.

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