Let's Find Your Way Through the WoodsPerson-focused online and in-person individual therapy services in Washington State.
Reach out now for a free 20-minute consultation!
Meet Dr. Paup
I am a clinical psychologist specializing in identity growth and development. I have extensive experience working with LGBTQIA+ individuals, professionals, and college students.
I work with clients ages 15-65 experiencing anxiety, depression, trauma, stress, phobias, difficulties with sex, obsessive compulsive disorder, and interpersonal difficulties, and more.
I especially love working alongside clients who feel “lost in the woods” and are looking to grow, heal, and better understand who they want to be.
Working with Dr. Sierra Paup
Still have questions? Find your answers here:
If you’re interested in becoming a client, click the link below and I will reach out to schedule a free 20 minute phone consultation with you.
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I am not in-network with any insurance companies. However, 70% of my clients pay for their services using a sliding-fee scale, meaning they select the percentage of my normal rate they can able to afford to pay for each session based on their level of need.
I can also provide superbills for any clients who would like to seek out-of-network reimbursement for therapy services with their own insurance companies.
Every client is different, so I discuss how much services would cost for each client during the initial phone consultation.
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I received my PhD in clinical psychology from Washington State University in 2023. I completed my internship at University of Minnesota’s Student Counseling Services, and then my postdoctoral fellowship at a Minneapolis private practice. My undergraduate education is in psychology and anthropology!
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I draw primarily from Cognitive Behavioral Therapy (CBT) and third-wave approaches like ACT, DBT, mindfulness therapy, Compassion-Focused Therapy, and Schema Therapy. I also integrate elements of Interpersonal Psychotherapy (IPT) and Emotion-Focused Therapy (EFT). For specific concerns, I use gold-standard, evidence-based treatments like Cognitive Processing Therapy (CPT) for trauma/PTSD, Exposure and Response Prevention (ERP) for OCD, and exposure techniques for social anxiety and phobias.
While my work is grounded in research, I take a client-centered, humanistic approach influenced by multicultural and feminist perspectives. I have been described in the therapy rooms as warm, caring, transparent, and collaborative. I am not a “clinical-feeling” therapist, and I believe every client deserves a tailored experience to their specific needs.
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I am a queer, transgender woman who believes in bringing her genuine self into the therapy room. I ask my clients to show me their true selves, and I feel its only fair to do the same. I like to travel and go to restaurants across the country with my wife, cuddle with my two cats, and play board games. I am crafty and nerdy, two skills I utilize often running regular tabletop roleplaying games with my friends. I’m passionate about my work and dedicated to helping my clients meet their therapy goals in a timely manner.
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Due to my own level of expertise, I do not typically work with clients experiencing severe eating disorders, psychosis or manic episodes, issues with rage or physical violence, and those who are at high risk of harming themselves or others. I also typically only work with individuals, so no couples or families (aside from occasional work with parents of minor clients).
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I share more information about who I am as a therapist, my specialties, and the techniques I typically use. I will ask you some questions about what you are looking for in a therapist as well. Together we will determine if working together is the right fit! You get 20 minutes to ask me whatever questions you’d like to see if I am the therapist for you, and it’s totally free.
We will also discuss how much therapy services would cost for you based on my sliding scale payment system.
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Currently I can only meet with clients who are located in Washington State. However, during the summer of 2026 I will be applying to get my “E. Passport”, meaning I will be able to meet with clients online in participating PSYPACT states. See the map of participating PSYPACT states here. I will update my site when this has happened!