Compassionate Mental Health


Couples Counseling

in Seattle, WA

June 2022 Update: I am full and not accepting new clients.


Hello & Welcome!

I'm Sarah. I'm so glad you're here. Maybe you are considering individual or couples counseling for the first time ever, or looking to return but with a new counselor. Perhaps you're feeling overwhelmed, stuck in negative patterns, or simply wanting to explore and grow?


As someone who's been in individual and couples counseling a few times, I can relate to the common hesitation and trepidation that can come with asking for and finding help, the vulnerable feelings of opening up, the process of building trust in a counselor, and the challenging work of being in counseling. None of this is easy, but I know how incredibly worthwhile and transformative it can be. I hope this website helps you get to know me and my practice better to determine if I might be the right fit for you.

I believe we humans are designed for relationships. When we feel seen, heard, and cared for, even just by a few significant people in our lives, we tend to thrive. Depending on your needs and goals, I’d like to help you improve your relationship with yourself, and with the important people in your life. And I'd like to build a trusting, positive working relationship with you, as that's the key that makes counseling effective.


I believe you are the expert in the room, even if you feel lost right now. I use my training and experience to link you to your inner-expert, so that you may find more clarity, ease, connectedness, and freedom in your life. 




My areas of expertise are stress management, adjustment/life transitions, relationship issues, communication, self-esteem, parenting support, and foster care/adoption issues. I work with all personality types, but am especially skilled working with people who describe themselves as introverts or highly sensitive (read more about highly sensitive people here). I also love to work with parents and expectant parents.

Nature Explorer
Happy Couple

I welcome couples of all sexual identities and expressions. I work with folks feeling stuck in frequent conflict, those who don’t often feel they “click” anymore, and those who just experienced a major breach of trust or other stressful event. I also work with couples facing a milestone or life change, such as marriage or welcoming a new child, to help them prepare and adjust their relationship.



Clients have described me as down-to-earth, warm, and candid yet gentle. I appreciate playfulness and humor and can laugh at myself. I  identify as a white, cisgender, heterosexual woman, and aim to maintain a feminist, anti-racist, anti-bias lens in my work and life. I'm continually learning and seeking to grow in these areas.


I keep a small caseload and focus on the quality of my work -- making time for my own growth, consultation, and training -- not the quantity of clients I see. Being a clinical social worker is my true privilege and joy.


I earned my Masters in Social Work from Smith College School for Social Work in 2008, and a BA from Brandeis University with a major in Sociology in 2004. I have over ten years of experience as a counselor, case manager, and Gottman workshop facilitator. I've worked as a counselor to couples, adults, and children/families in various settings in Seattle, including Seattle Therapy Group, Harborview Abuse and Trauma Center, and Catholic Community Services. I've also worked as a case manager at Amara, where I assessed and supported foster and adoptive parents. 


I grew up in Massachusetts, and have also lived in North Carolina and Chile and Argentina, South America. I came to Seattle in 2006 for a graduate school internship thinking it would be short-term, but fell in love with the Northwest and my now husband. We have been married for twelve years and have two elementary school-age children. I love being in nature, a good workout or yoga class, and ice cream.

Dandelion Parachute Seed

June 2022 Update: I am full and not accepting new clients.



Have you (and your partner if seeking couples counseling) both read my website and think I could be a good fit for you? Wonderful, I look forward to hearing from you. The best way to inquire about my availability is e-mail (below). Next, we will schedule a free 20 minute consultation by phone or video. If you are interested in couples counseling this can be with just one of you or both of you. In this brief consult I will ask more about what brings you to counseling, any of your initial hopes/goals/fears about counseling, and I can tell you a little about how I might work with you and your specific issues. You can also ask me any questions you have. This way we can each have a chance to determine if we might be a good fit working together and if we'd like to schedule a first session.


I use the first 3-4 sessions as an assessment phase, in which I am learning a lot about you and your history, mental health, relationships, and hopes and goals for counseling. If I don't believe I can meet your needs at the end of this time or at another point in our working together, I will explain this to you and find you appropriate referrals. 



I am available for sessions Mondays and Wednesdays during business hours. I am available for in-person office sessions on Mondays, and I am available for walking or telehealth sessions only on Wednesdays. I make every effort to respond to emails and phone calls within 24-48 hours Monday - Friday.


Email (preferred): sarah@madronacounseling.info

Phone: (206) 339-3641


I am located at 1126 34th Ave, Suite 206, Seattle 98122. This is the Madrona Refuge building, with Vendemmia Restaurant on the ground floor, in the Madrona neighborhood. It is an ADA-accessible building. There is usually plenty of free street parking within 1-2 blocks. See the building's green and rust-colored doorway tucked back a little from the street, just one door south of Vendemmia's door. The front door will be locked, but please just call me at the number above and I will come down and let you in, or you can find my name listed in the directory call box under "Crane-O'Neill, Sarah," push "Call" and I will buzz you in. Come up the stairs or elevator to the second floor and to your left you'll see suite #206, which says "Lisa Hake Counseling" on the door (I sublet this suite from a colleague).