Our Services
Couples Therapy
Couples Therapy in San Francisco
LGBTQ+, Polyamorous & Kink-Affirming
Rouse Relational Wellness offers couples therapy in San Francisco for LGBTQ+, polyamorous, and kink-practicing couples who want to communicate better, resolve conflict, and deepen intimacy. Our Licensed Marriage and Family Therapists (LMFTs) and Associate Marriage and Family Therapists (AMFTs) specialize in non-traditional relationship structures and sex-positive approaches. We serve couples throughout California via telehealth and in-person at our Castro district office.
Common Reasons Couples Come to Rouse
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When you’ve hit a wall, you stop seeing your partner and start seeing a 'character flaw'. Instead of recognizing the impact of high-stress jobs, neurodiversity, or the weight of caregiving for an elderly parent, you find yourself thinking, 'they’re just lazy and entitled'. This shift often leads to misunderstandings and a growing sense of resentment that can make your sex life feel non-existent. Couples Therapy helps you move past the 'blame cycle' by establishing new rules of engagement and mastering rupture and repair strategies that bring you back to the same team.
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It starts with a gap in frequency—maybe you want intimacy 2-3 times a week, while your partner is content with twice a month—and ends with you feeling increasingly resentful and frustrated. When one partner needs emotional intimacy and comfort to feel safe, while the other believes the physical connection is the primary gateway, you hit a relational wall. This "sexless" cycle isn't about a lack of love; it’s about a lack of emotional safety. Therapy helps you bridge the gap between physical and emotional needs, rebuilding a connection where both partners feel seen and desired.
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Whether it’s broken trust through infidelity or porn addiction causing friction, the path back to each other feels impossible alone. When multiple boundaries have been broken, your relationship hits a communication wall. Our couples counseling approach is committed to healing, growth, and creating a more fulfilling, honest partnership. We use structured rupture and repair strategies to help you stop the cycle of deceit and start building collaboration again.
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Moving toward polyamory or an ENM dynamic is about more than just "permission"—it’s about redefining your partnership. While it’s often an exploratory and playful transition, it can also trigger deep attachment anxiety. In therapy, we establish a safe container to move beyond basic "rules" and into rupture and repair strategies, ensuring that jealousy or insecurity doesn't lead to broken trust. We help you build a strong foundation so you can navigate this crossroads with playful curiosity rather than fear.
What to Expect in Couples Therapy at Rouse
Book a free consult
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Chat with our client care coordinator to discuss your goals in therapy and get matched with a provider. You can also book directly with a provider of your choosing.
Join the free consult
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You and your partner(s) will join the free consult to discuss goals, scheduling, and payment options.
Fill out paperwork before your session
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You will receive a link to our client portal to fill out the necessary paperwork to get us started. This includes informed consent and intake questionnaires. We use Simple Practice, which is an encrypted HIPAA-compliant platform to store sensitive client data.
Upload your insurance information and a picture of your insurance ID card so our billers can verify your benefits, whether for in-network or out-of-network courtesy billing.
Attend your first session
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You and your partner(s) will attend your first session over zoom or in our Castro office. The first few sessions involve a lot of questions and information-gathering to help the provider with their treatment plan. You’ll discuss individual goals and intentions for your time in therapy. At the end of the session, you’ll schedule your follow up appointments with your provider.
Schedule a Free Consult
At Rouse Relational Wellness, we understand that sex and intimacy are fundamental aspects of human connection and personal well-being. It's why we've cultivated a space right in the heart of San Francisco's vibrant Castro District, where individuals and couples from all communities, including our LGBTQ+ family, can explore and enhance their sexual health and happiness.
Sex Therapy Services Tailored to You
SERVICES
Refine your relationship through…
Couples Therapy
Weekly or bi-weekly 75-minute sessions providing a neutral space to work through stuck issues, learn and practice new communication, conflict and empathy skills.
Short-Term Couples Therapy
The Rouse Relational Roadmap is a short term, Gottman-based, couples therapy program offered in our San Francisco office and to California couples who want to work online.
Intensives Sessions
Three-hour sessions to help couples work through big questions involving sex, polyamory, money, kids, their future, and more.
Online Courses
Advance your knowledge in sex and relationship skills through online courses designed by experts in our field.
WHY US
Why people choose Rouse?
It all starts with creator & founder of Rouse Therapy, David Khalili.
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20 years of experience in the sexual wellness field
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15 in mental health
But what makes him stand out are his cultural upbringings and the network of professionals he has curated along the way. David didn’t read a blog about sex & identity struggles, he lived them. Constantly questioning societal norms towards sexual identity and gender and then going home to have all this clash with with religious roots. He’s had feelings of self-doubt and loneliness but also pushed himself to keep going which resulted in getting some real life experience answers.
Gathering all of the information, generating a team of like minded individuals, connecting with a community, all with the sole purpose to help you find your true self. And love it
Couples Therapy Cost and Insurance
Licensed Providers
75 min sessions: $300
Our California-licensed couples therapists have completed graduate degrees in marriage and family therapy and 3,000+ hours of supervised clinical training. They maintain expertise through ongoing education in sex therapy, polyamory counseling, LGBTQIA+ affirming care, and evidence-based relationship interventions—ensuring you receive specialized, culturally competent support. (Some providers available in Florida)
Registered Associate MFTs
75 min sessions: $255
Our Associate Marriage and Family Therapists (AMFTs) hold Master's degrees in Counseling Psychology or Clinical Psychology and have completed clinical traineeships at community mental health organizations. They provide therapy under licensed supervision while completing California's 3,000-hour requirement for full LMFT licensure, ensuring quality care at accessible rates.
Couples Intensives
Starting at $1200
Our three-hour couples intensives provide focused, deep-dive therapy sessions to transform your relationship communication and intimacy. Work through complex topics like sexual concerns, financial conflict, future planning, premarital counseling, and relationship patterns in an extended format that allows for real breakthroughs—without the constraints of traditional 50-minute sessions.
Insurance Options
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In Network:
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Out-of-Network:
Let us take care of the paperwork for you by filing your insurance claims on your behalf. Saving you time and up to 70% on qualifying plans.
How to Get Started
— Sexuality and intimacy should be a source of joy and connection—not anxiety.
Book a consultation with Rouse Relational Wellness today, and take the first step towards cultivating the fulfilling, empowered sexual life you deserve.
