Nicole Ruston

Marlene Otero

Therapist, LMHCA

Types of Therapy

Individual
Couples
Child and Adolescent

Specialties

Codependency
Divorce
Immigrant Experiences
Women's Issues
Trauma
Existential/Identity crisis
Anxiety
Depression
PTSD
Relationship Issues
Self Esteem
Stress Management
Sex Positive
Pregnancy / Postpartum

Insurance

Premera
Kaiser
United/Optum
First Choice
Regence
Cigna
Aetna

Serves ages

Children
Teens
Adults

Languages

English
Spanish

Pay out-of-pocket

Individual Intakes: $150
Individual Ongoing: $125

Couples/Families Intake: $175
Couples/Families Ongoing: $155

Licensed in

Washington

Verified by

Verified by Psychology TodayLogo Online Therapy Directory

Life can be overwhelming for adolescents and adults alike. It’s not uncommon to feel stuck in unwanted patterns, negative thoughts, sleepless nights, or the constant pressure to perform. Maybe the past still impacts you in ways you don’t fully understand, or perhaps current challenges—like academic demands, social pressures, career stress, or major life transitions—are affecting your life. Together, we’ll create a personalized plan to ease anxiety, enhance focus, strengthen relationships, and bring a greater sense of balance to your life. When you're ready, we can also explore how past experiences may be influencing your progress.

As a mother, partner, lawyer, and business owner, I understand how mental health influences every aspect of life. I take a holistic, individualized approach to therapy, focusing on your unique needs and goals. My therapeutic framework includes cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), psychodynamic analysis, dialectical behavior techniques, and mindfulness practices. When working with adolescents, I incorporate developmentally appropriate strategies, such as narrative therapy, emotional regulation skills, and digital play therapy to foster engagement in a meaningful way.

Starting therapy can feel like a big step, but you don’t have to do it alone. Whether you're figuring out who you are, managing stress and expectations, or striving for a more fulfilling life, I'm here to support you every step of the way.