A Conversation with Sage Grazer, LCSW: How I Work With Anxiety, Burnout, and Change
For adults, professionals, and founders seeking an integrative, collaborative approach to therapy in Los Angeles, CA and across California and Hawaii.
Starting therapy is a meaningful step. If you are wondering how to find a therapist for the first time and want a sense of how I work, this interview-style Q&A is for you.
About My Work
What drew you to this work, and what keeps it meaningful for you today?
I became a therapist because I care about how people grow in the context of relationships. Real change often begins when someone feels safe enough to say what is true for them. I aim to offer a supportive and non-judgmental space where we can look at what is hard and practice skills that help in daily life.
What keeps this work meaningful is witnessing those small but powerful shifts over time–a little more calm before a meeting, setting a clearer boundary at work, speaking to yourself with more compassion. These seemingly subtle changes add up, and they’re often the moments when people realize therapy is working in the places that matter most.
How would you describe your style in a few lines?
I’d describe my style as integrative and collaborative. I use the approaches that best fit your needs rather than sticking to one method, and I pace the work so it feels manageable and grounded. I check in often about what’s helping and what isn’t, and we adjust together.
People often describe me as warm, clear, and practical. I value insight, but I also want you to leave sessions with something you can use in your daily life, whether that’s a new perspective, a tool, or a next step that feels doable.
How do you blend psychodynamic work with CBT skills in session?
Psychodynamic therapy looks at long-standing patterns and the stories we carry from earlier experiences. Cognitive Behavioral Therapy focuses on present-moment thoughts and behaviors that you can change with practice. When people ask about psychodynamic therapy vs cbt, I explain that we do not have to choose only one. Depth work helps us understand the root. Skills help your day go better now.
A typical session might include a short grounding exercise, a focused look at a current situation, and one or two practices to try between sessions. We keep an eye on patterns and also on what is happening this week. Over time, insight and skills reinforce each other.
Who do you work best with?
I work with adults across California and Hawaii, especially people navigating anxiety, stress, and big life transitions. Many of my clients are professionals dealing with workplace anxiety or chronic overthinking, founders and creatives managing burnout, women balancing caregiving and career demands, and young adults figuring out identity, relationships, and next steps.
I work well with entrepreneurs who want a private, grounded space to think, plan, and regulate, especially those experiencing founder stress, decision fatigue, or perfectionism. A large part of my practice focuses on online anxiety therapy, burnout recovery, and support for people in high-pressure or high-responsibility roles.
I also support clients who struggle with people-pleasing, conflict avoidance, or feeling overly responsible for others’ emotions. A lot of the work involves helping people strengthen boundaries, tolerate discomfort, and build confidence in their own needs and limits.
If you’re looking for an online therapist in Hawaii or California who understands anxiety, burnout, and career transitions, we can build a plan that fits your schedule and your life.
What can someone expect in the first month of working together?
Session one is about fit, emotional safety, and clarity. We talk about what brings you in and your goals for therapy or what you would like to see change. During the first session, I ask a lot of questions to help understand where you’re at now and begin to uncover what aspects of your life or history might be contributing to that. We set a simple plan that includes frequency, early goals, and one small practice to carry with you.
Questions Clients Often Ask Me
How do I know what type of therapy I need for anxiety or self-esteem?
We’ll decide together after a discussion of what issues you’re currently facing, repeating patterns from earlier experiences, your inner dialogue, and where avoidance keeps you stuck. Then we match tools to goals: CBT for quick, practical skills (grounding, cognitive restructuring, exposure), or psychodynamic/attachment work when old relational patterns keep replaying.
In the first few sessions, we focus on developing a clear vision of what you'd like to see change in your life. We’ll agree on a simple focus and choose one or two practices you can realistically try between sessions. I check in about what feels helpful (and what doesn’t), adjust the pace, and refine the plan so the work stays manageable and relevant to your day-to-day life.
Should I consider medication for social anxiety?
Medication can be helpful for some people. As a LCSW therapist, prescribing medications is not in my scope of practice but I do collaborate with prescribers, such as psychiatrists or primary care physicians, to coordinate care and consult on cases as needed. My goal is to make the mental health care process streamlined and simple for you.
As a therapist, if I feel that you may benefit from medication, I will recommend that you get an evaluation with a psychiatrist. We can talk about what that would entail, discuss pros and cons, and explore your feelings about the use of medications. If you choose to take medication for social anxiety, I will help you track symptoms to better understand what is improving and what needs more focus.
I’m changing careers. How would therapy support that?
Therapy can be incredibly helpful during a career change. When everything feels uncertain, it gives you a grounded space to slow down, clarify what you actually want, and sort through all the competing thoughts and expectations. We look at your values, your strengths, and the kind of life you’re trying to build, and from there we outline options that make sense for you.
I also help people break big transitions into smaller steps so the process feels less overwhelming and more doable. That reduces the pressure and helps you make decisions based on real information, not fear, urgency, or self-doubt.
And then there’s the emotional side of change. Career shifts often bring up a mix of excitement, hope, doubt, grief, and sometimes guilt. Therapy gives you space to process all of that, challenge old narratives about success or failing, and build trust in your own decision-making. You don’t have to navigate it alone; having a steady place to land can make the whole transition feel so much more manageable and aligned with who you are becoming.
Can therapy help me set healthy boundaries at work without hurting my career?
Yes. Boundaries are about directing your time and attention toward what matches your role and values, not saying “no” to everything. Together we’ll clarify what’s draining you and what supports your best work, then choose one or two small, realistic changes to try (for example, clearer response windows or a short protected focus block) so the shifts feel doable in your day-to-day.
We’ll move at a manageable pace and check in about what’s helping, where friction shows up, and how conversations are landing. If something doesn’t fit your team culture, we’ll adjust the language and approach. The goal is a steadier “yes” to what matters, with more energy and less reactivity, so your work stays strong while your wellbeing is better protected.
Do I need a therapist or a life coach?
It depends on what you’re looking for right now. Coaching is typically short-term and very goal-focused. It’s great when you want concrete steps, accountability, and support around things like productivity, leadership, communication skills, or building healthier habits. Coaching can help with stress management and burnout prevention, but it doesn’t diagnose or treat mental health conditions.
Therapy goes deeper. Psychotherapy is focused on your mental health and overall quality of life. We look at the patterns, often shaped by earlier experiences, that contribute to anxiety, self-doubt, low self-worth, dysfunctional relationship cycles, or chronic overwhelm. In therapy, we work with the emotional roots of what’s keeping you stuck and use evidence-based approaches to help you build regulation, insight, and lasting change.
Both can be valuable; the right choice depends on whether you need structured guidance toward a specific goal or support in healing the underlying issues that make certain goals feel hard to reach.
I’m nervous to begin therapy. How do I find a therapist for the first time, and what happens in a consult?
A good first step is to talk with one or two therapists and notice whether the conversation feels clear, respectful, and at a pace that helps you feel understood rather than rushed.
In a brief consult, you’ll share what’s bringing you in and what you hope will feel different in your life. You can ask about their approach, fees, scheduling, and what sessions typically look like. It’s really an opportunity for you to get a sense of fit. The goal isn’t always to commit on the spot; it’s simply to see whether the therapist feels like someone you could trust and open up with over time.
How will I know if we are a good fit, and when is it okay to switch?
Feeling understood and safe enough to be honest is usually the strongest sign of a good fit. You don’t have to feel instantly comfortable, but there should be a sense that the therapist “gets” you and that the work feels collaborative.
If something isn’t landing, whether it’s the pace, the tools, or the focus, I always encourage you to let me know. Therapy can be flexible, and we will adjust together. It’s also important to give it a little time. Trust builds gradually, and I need a few sessions to understand your history, relationships, and the patterns you’re navigating. Most people have a good sense by session three or four of whether the approach is helping them move forward.
And if it doesn’t feel right, it’s absolutely okay to switch at any point and for any reason. Your comfort matters. I’m always happy to talk it through and offer referrals so you can find the best fit for you.
Is online therapy as effective as in-person? What are the benefits?
For many areas of treatment, including anxiety, burnout, self-esteem, and life transitions, online therapy can be as effective as in-person therapy when the relationship is strong and sessions are structured. Benefits of online therapy vs. in-person therapy include access (no commute), flexibility (easier to fit into a busy schedule), and comfort (you can join from a familiar space). If you travel for work, care for kids, or live outside major metro areas, online sessions help you stay consistent, which is the biggest predictor of change.
Work With Me
If you’re ready to explore options for therapy or coaching, I’d love to connect. Getting started is simple: reach out to schedule a brief consultation where we can talk through what’s bringing you in, what you’d like support with, and what working together would look like. I offer online therapy for adults across California and Hawaii, with flexible scheduling to fit your life.
My coaching services are available to clients located anywhere, offering flexible online support no matter your state or time zone. It’s a great option if you’re seeking guidance but live outside California or Hawaii.
I believe you deserve a life that feels calmer, clearer, and more connected. My work is about helping you break free from patterns that keep you anxious, overwhelmed, or second-guessing yourself, so you can move through your days with more confidence, ease, and self-trust.
About the Author: Sage Grazer, LCSW
I am a licensed psychotherapist providing online therapy to adults struggling with anxiety, burnout, trauma, low self-esteem, and relationship issues. I help clients develop the insight, skills, and resilience to cope with whatever life stresses come their way. I specialize in helping high-achieving young professionals overcome anxiety and burnout to feel more confident, empowered, and effective in their lives. If you’re a resident of California or Hawaii, schedule a free consultation to learn more.