Now scheduling new clients! Virtually and in-person at 462 N Taylor Ave Suite B2, St. Louis, MO 63108 Call/text us: 314-414-4700 or Choose your provider!

ABOUT ME
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I'm Rafaella Smith-Fiallo
LCSW, CSE, CST, she/ella
I specialize in helping people process trauma and heal the patterns it leaves behind in the body, relationships, and sense of self. My work focuses on reconnecting with yourself in ways that feel more grounded, authentic, and connected to pleasure, intimacy, and choice. Many of the people I work with are navigating the lingering impacts of childhood experiences, relational wounds, sexual trauma, shame, or feeling disconnected from themselves or others.
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I integrate EMDR, Internal Family Systems (IFS), somatic therapy, and relational approaches to support deep and lasting change. Therapy with me is not just about understanding what happened but also creating new experiences of safety and connection in the present, so that old patterns don’t have to keep running the show.
MY PRACTICE
Many clients come to me after already doing a lot of insight-oriented work. They understand their history and patterns, but still feel stuck in cycles that are hard to shift. My approach brings the work into the body and nervous system, helping clients process experiences in a way that goes beyond talking alone.
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I offer both weekly therapy, extended sessions, and therapy intensives for people who want deeper, more focused work. These longer sessions create space for EMDR, IFS, and somatic processing to support meaningful shifts in attachment patterns, trauma responses, and relational dynamics.
"You deserve pleasure in all of your relationships, especially the one that you have with yourself."
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Areas of Interest
FAQs
Childhood and complex trauma, attachment wounds, sexual trauma, relationship and intimacy challenges, sexuality and desire, LGBTQIA+ identity exploration, consensual non-monogamy, kink/BDSM-informed therapy, body image, shame, identity development, and reconnecting with the body and nervous system after experiences of disconnection or overwhelm.
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I work with: Adults
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Availability: Tuesday - Thursday, some weekends
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Setting: In-person and virtual options
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Insurance: UnitedHealth Care / Optum
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Rate: Individual therapy - $200; Couples therapy - $225​
