Overview

I provide trauma-focused therapy, primarily EMDR Therapy, for individuals experiencing PTSD, anxiety, depression, and other trauma-related concerns.

In select cases, I provide Nexus letters for clients seeking to establish a connection between their mental health condition and military service or related experiences. Nexus letters are only considered after an established therapeutic relationship and when clinically appropriate.

My Background and Experience

I have extensive experience working with veterans, active-duty service members, and military families. As a military spouse, I also understand the unique stressors associated with military life, deployments, transitions, trauma exposure, and the impact these experiences can have on mental health and family systems.

This combination of professional and lived experience informs my trauma-focused, culturally responsive approach to care.

What Is a Nexus Letter?

A nexus letter is a formal clinical opinion written by a licensed professional that addresses whether a current condition is:

“At least as likely as not related to a specific event, injury, or experience.”

These letters are commonly used in disability claims to provide supporting clinical rationale for:

• Direct service connection
• Secondary service connection (conditions caused or worsened by another condition)
• Aggravation of a pre-existing condition

A nexus letter is not a guarantee of any outcome and is one component of a larger claims review process.

Therapeutic Relationship Requirement

Nexus letters are only considered after an established therapeutic relationship has been developed.

This typically includes:

• Multiple therapy sessions over time
• Clinical assessment and diagnosis when appropriate
• Trauma-focused treatment (such as EMDR when indicated)
• Observation of symptom patterns and functional impairment

This ensures that any clinical opinion provided is ethically grounded, clinically supported, and based on sufficient understanding of the individual.

What a Nexus Letter May Include

When clinically appropriate, a nexus letter may include:

• Diagnostic impressions based on DSM-5 criteria
• Summary of relevant symptoms and clinical history
• Onset and progression of symptoms over time
• Clinical reasoning regarding causation or aggravation
• Discussion of functional impairment in daily life

Standardized VA language such as “at least as likely as not” when supported by evidence

What a Nexus Letter Does NOT Include

To maintain ethical and clinical integrity, I do not:

• Guarantee outcomes or disability determinations
• Provide opinions that are not supported by clinical evidence
• Write letters without sufficient clinical context or treatment history
• Offer predetermined conclusions

If the clinical evidence does not support a nexus opinion, one will not be provided.

Fees

Nexus letters are a separate service from therapy and are only provided when clinically appropriate.

Typical fees:

• Record review (if applicable): $300–$500
• Nexus letter: $1,200–$1,800

Fees reflect the time required for clinical review, documentation, and professional opinion writing.

How to Get Started

If you are currently a client and believe a nexus letter may be appropriate, we can discuss this during session. New clients will begin with a clinical intake and ongoing treatment before any consideration of a nexus opinion.

Final Note

My priority is providing ethical, trauma-informed care. Any clinical opinion I provide is grounded in professional standards, clinical evidence, and a thorough understanding of each individual’s history, symptoms, and lived experience.