Registered Associate Professional Clinical Counselor (APCC #21919, California)
Employed and Supervised by David F. Khalili, Licensed Marriage and Family Therapist
Mikey LaBruna, APC
Authentic therapy for men navigating relationships, intimacy, and substance use
You're successful in other areas of your life, but your relationships and intimacy feel stuck. Whether you're struggling to communicate with your partner, navigating sexual dysfunction or desire issues, or addressing substance use through harm reduction, you deserve support that meets you where you are. I create a collaborative space where change feels aligned with what you actually want, not what society or anyone else expects.
WHO I WORK WITH
I work with young adults (19-25) and adults (26-64), with a focus on:
Men (including LGBTQ+ men) navigating relationships, intimacy, and identity
Couples working to improve communication, empathy, and connection
Individuals dealing with sexual dysfunction or intimacy challenges
People addressing substance use through a harm reduction approach
Those managing anxiety that impacts relationships or daily life
Anyone seeking LGBTQ+ affirming care
I'm especially committed to serving:
Men seeking to show up more authentically in their relationships
Couples working to cultivate compassion and empathy for each other
LGBTQ+ individuals navigating relationship and intimacy challenges
People who want harm reduction approaches rather than abstinence-only models
Those seeking a therapist who's approachable, direct, and real
Services available both in-person in San Francisco and via telehealth throughout California.
MY APPROACH
I'm engaging, authentic, and collaborative. I have an approachable demeanor and like to ask a lot of questions, offer reflections, and am not afraid to challenge you or be direct if I think it will be received.
My Framework:
Couples & Relationship Work: When working with couples, I acknowledge content vs. process—what you're arguing about versus how you're relating to each other. I work to help you cultivate compassion and empathy for each other, understand attachment patterns, and build new ways of connecting. The goal is deeper understanding and more authentic intimacy.
Sex & Intimacy: I provide a sex-positive, shame-free space to explore sexual dysfunction, intimacy challenges, desire discrepancies, and relationship dynamics around sex. For LGBTQ+ individuals, I understand how identity, culture, and sexual health intersect. We'll work on communication, desire, connection, and building the sex life you want.
Relational Cultural Therapy (RCT): I prioritize the therapeutic relationship as the channel through which change happens. Connection and authenticity in our relationship creates the foundation for growth. I work to build trust, acknowledge power dynamics, and create genuine collaboration.
Harm Reduction & Substance Use: I work from a harm reduction lens, which means meeting you where you are with substances rather than requiring abstinence. We'll collaborate on changes that feel aligned with what you want at this time in your life. Whether that's moderating use, understanding patterns, or building healthier coping strategies, the goal is sustainable, self-directed change.
My Methods:
Relational Cultural Therapy (RCT)
Emotionally Focused Therapy (EFT)
Attachment Based Therapy
Acceptance and Commitment Therapy (ACT)
Motivational Interviewing
Solution Focused Therapy
Narrative Therapy
Psychodynamic and Humanistic approaches
Harm reduction approaches
WHAT TO EXPECT
Our Process Together
1. Therapeutic Relationship, Client History, and Assessment We'll build our relationship while exploring what brings you to therapy, your history, and what you're hoping will be different.
2. Collaborative Treatment Planning/Intention Setting Together, we'll identify what you want to work on and set intentions that feel aligned with your goals and values.
3. Processing We'll explore patterns, emotions, relationships, and experiences—making sense of what's happening and why.
4. Integration/Putting It to Practice You'll practice applying new insights and skills in real life, experimenting with different ways of being in relationship with yourself and others.
5. Feedback/Circling Back We'll regularly check in on what's working, what's not, and adjust our approach to keep therapy effective and relevant.
ABOUT ME
I work at SF Therapy Collective and Rouse Relational Wellness, where I see individual clients and couples. My clinical work focuses on helping men and couples navigate relationships, intimacy, sexual health, and substance use through harm reduction approaches.
I'm a Pisces with a Scorpio rising and The Helper archetype in the Enneagram. I consider myself an extroverted-introvert—I love connection and also need my recharge time.
Clinical Focus:
Couples counseling
Sexual health and intimacy
Men's issues
Harm reduction approaches to substance use
LGBTQ+ affirming care
Education & Credentials:
MA, Saybrook University (2025)
Registered Associate Professional Clinical Counselor (APCC #21919, California)
Employed and Supervised by David F. Khalili, Licensed Marriage and Family Therapist
IN MY FREE TIME
I enjoy knitting, reading, and playing cozy games—activities that honor my need for rest and creativity.
FEES & INSURANCE
Session Rates
50-minute sessions: $190
75-minute sessions: $235
Insurance: I accept Optum and United Healthcare insurance plans.
For other insurance plans, I'm out of network but can provide superbills for you to submit for potential reimbursement.
FREQUENTLY ASKED QUESTIONS
Do you work with couples? Yes! I'm actively building my couples practice and work with partners to cultivate compassion and empathy for each other, understand attachment patterns, and improve how they relate and communicate. I utilize Emotionally Focused Therapy (EFT) and Attachment-based approaches.
What's your approach to sex and intimacy issues? Sex-positive and shame-free. We'll explore what's getting in the way of the intimacy or sexual connection you want, whether that's desire discrepancies, performance anxiety, communication challenges, or relational dynamics. For LGBTQ+ individuals, I understand how identity and culture intersect with sexual health.
Are you LGBTQ+ affirming? Yes. I have experience working with LGBTQ+ individuals, particularly queer men, and understand the intersection of queer identity, relationships, substance use, and sexual health.
What does "harm reduction" mean? Harm reduction means meeting you where you are with substances rather than requiring abstinence. We'll work together on changes that feel aligned with your goals—whether that's cutting back, using more safely, understanding your patterns, or eventually stopping. The focus is on reducing harm and building healthier coping strategies at a pace that works for you.
Do you work with people who aren't ready to quit substances? Absolutely. You don't need to be "ready to quit" to benefit from therapy. We can work on understanding your relationship with substances, building awareness of patterns, developing skills, and making changes that feel right for you.
Will you challenge me? Yes, when I think it will be helpful and you're ready for it. I'm not afraid to be direct or point out patterns I'm seeing. But this always comes from a place of care and collaboration—I'm not here to lecture you.
Do you offer in-person sessions? Yes! I offer both in-person sessions in the Castro neighborhood of San Francisco, and telehealth throughout California.
What insurance do you accept? I accept Optum and United Healthcare. For other insurance plans, I'm out of network but can provide superbills for potential reimbursement.