Brain Injury, Stroke and Health Crisis
How do I deal with brain injury?
Medical treatment looks after the body. It is very good at that.
What it is not built for is the rest of it. The person you were before. The marriage that has changed shape. The parent who is still here and is not quite the same. The exhaustion of being the one who copes.
That part is workable, and it is what we do.
The first conversation is free and it lasts 55 minutes.
Open seven days a week.
Who this is for
People living with the effects. After a brain injury, a stroke, a concussion, an aneurysm, a cancer diagnosis, a progressive illness, or an injury that changed what your body will do.
Families. Partners, adult children, parents. You are welcome here as a client in your own right. You do not need the person you are caring for to agree to anything, or to know.
Most of the people who call us are in the second group.
What people bring
- Depression after a stroke. Very common. Often assumed to be a reasonable response to circumstances and left alone for that reason. It is treatable whether or not it is reasonable.
- Anger and a shorter fuse after a brain injury. Sometimes this is the injury itself and sometimes it is the frustration of living with it. Either way it is not a character failure and it is not permanent.
- Personality changes after a brain injury. The hardest one to say out loud, usually said by a partner: this is not the person I married. That is worth bringing here rather than carrying.
- Grief for someone who is still alive. There is no ceremony for it and most people around you do not recognize it as grief. It behaves like grief and it responds to being treated as grief.
Caregiver exhaustion, the guilt that comes with resenting it, and the slow disappearance of your own life underneath somebody else’s needs.
Cancer, MS, Parkinson’s, early dementia, chronic pain, chronic illness. The medical team handles the illness. Nobody is assigned to handle what it did to your sense of the future.
When one person has changed and the two of you have to work out what the relationship is now. Very few couples therapists work with this. It is one of the gaps this practice was built around.
What we do not do
We do not do neuropsychological testing or cognitive assessment. If that is what you need, your neurologist or rehabilitation team is the right route and we will help you find it.
We do not do physical, occupational or speech therapy.
What we do is the emotional and relational part, alongside your medical care rather than instead of it.
How we work
Every clinician here works with this, which is unusual and which means you can be seen quickly.
Sessions are an hour. In person at our Tigard office, or by secure video anywhere in Oregon, which matters when driving is difficult or when the person who needs the appointment is also the person providing the care.
We work with individuals, with couples, and with families in the room together.
We will go at your pace, and we will say things plainly. If reading is harder than it used to be, or if noise and busy rooms are difficult now, tell us and we will change how we work rather than expecting you to keep up.
Nobody is told what to do. Not in the first session, not ever.
What this costs
$205 an hour with a licensed clinician, $180 with a supervised associate. Couples $230 and $205. Families $245 and $210.
We are in network with Kaiser, PacificSource, Cigna, Aetna, and United Healthcare and Optum, and with Medicare, both Open Card and in-network Advantage plans. Medicare matters on this page more than most, and we bill it. Regence Blue Cross Blue Shield is expected from 1 October 2026 and Moda from 15 October 2026, both for associates as well as licensed clinicians. For the Oregon Health Plan we can bill Open Card, but not the coordinated care organizations, and most OHP members are enrolled with a CCO rather than Open Card. There is no sliding scale.
Questions people ask
Is depression after a stroke normal?
Common, yes. Something to accept, no. It is one of the most treatable parts of stroke recovery and it is frequently the part nobody offers to treat.
My husband is not the same person since his brain injury. Is that something therapy helps with?
Yes, for him and for you, together or separately. It is one of the most common reasons people call this page.
Can we come as a family?
Yes. Family sessions are $245 with a licensed clinician and $210 with a supervised associate.
Do you do cognitive testing?
No. That is neuropsychology and it needs a different professional. Ask your neurologist or rehabilitation team, and we can help you work out who to ask.
How long after the injury should we come?
Whenever it is a problem. Some people come in the first months and some come four years later when the medical part is finished and the emotional part has not moved. Both are normal.
I am the one caring for them, not the one who was injured. Can I come on my own?
Yes, and many people do. You do not need their permission and you do not need to tell them.
Does Medicare cover this?
Yes. We bill Medicare Noridian, which is Open Card Medicare in Oregon, and we are in network with Medicare Advantage plans from Aetna, United Healthcare and Optum, PacificSource and Kaiser. If your Advantage plan is with a different carrier we are out of network with it, so tell us which plan you have and we will check before you book rather than after.
Book a free 55 minute consultation
An hour, at no cost, with a clinician rather than an intake screener.
Book online · In person in Tigard, by video anywhere in Oregon