Therapy for couples and creatives who want more from life

Good Earth Counseling

Susanna Guarino, LMHC
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Online appointments only 

NY and RI

LGBTQI affirming

(585) 294-4776

Contact Me

or book a free 15 minute consult

Couples: Heal your relationship, communicate effectively, deepen your intimacy.

Creatives: Overcome anxiety and self-doubt, make peace with your past, and become who you truly are.

Why "Good Earth Counseling?" Connecting with nature has been an important part of my own journey and for many of my clients. A long walk in the forest can be as healing as a therapy session (I recommend both!) Unfortunately, a lot of the deep existential angst and ambient anxiety modern people feel is related to the trauma of living in a world filled with environmental degradation as our only home is trashed around us. How would the world change if everyone got reconnected with their own essential goodness, with the goodness of others, and with the good earth we live on? I would love to find out. That's why I love working with couples and individuals as they heal their relationships, learn to manage anxiety, and become who they want to be. As Howard Thurman said, "The world needs people who have come alive."

as seen on...

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For couples...

If you're like me, you started adulthood with an idealistic vision of relationships inspired by images from '90s rom coms and Kay commercials. But now your naïveté is so ten years ago and you're struggling in your real life relationship. It's hard to communicate effectively, compromise, or get through challenges and big life changes without shutting down or escalating. And it's tough to be your best self when your relationship is struggling. You might start to feel depressed, hopeless, on edge. Couples I work with are often intelligent, creative and care about each other and the world, but stuck in negative dynamics.

I spent 3 years teaching Healthy Relationships workshops, and I've also done special trainings to work with couples, including Gottman Levels 1 and 2, and Emotion Focused Therapy. What I've learned is that even relationships that seem to be in real deep sh** can become strong, resilient and healthy if both people are willing to put in the work.

The process is sometimes painful and difficult. But it's also often fun. You will practice communicating in better ways, learn new skills for compromise, and get to know each other on a deeper level. No one is singled out as the "bad guy" or reason for the problems. Rather, we explore what's happening between you and in the context of your lives.

Investing in your relationship is an investment in your own health and happiness as well as your partner's. Feel free to reach out to schedule a free 15 minute consultation.



"all suffering prepares one for vision" - martin buber

"you are the music while the music lasts" - ts eliot

"be grateful, though you have considered all the facts" - wendell berry

For individuals...


Are you struggling with difficult relationships, anxiety or self-doubt, feeling like you have more to offer the world but not sure how to make that happen?


Other reasons you might be seeking therapy include

  • You grew up in a conservative culture that prevented you from expressing your authentic self

  • You're so smart that you're often in your head but you have trouble getting in touch with what you're feeling, and it's impacting your relationships negatively

  • You're struggling with existential malaise and you're not sure what your purpose is

  • Self-doubt keeps you from speaking up or showing up fully in your life

  • You had a parent who made it all about them, all the time. Now you're an adult and still struggling with that relationship

  • You feel like an outsider or don't know where you fit in

  • You just want more for your life

You deserve to have space to be seen, heard, heal from what's hurt you, and vision the future you want. You can learn how to navigate those difficult family relationships, figure out why you feel anxious and how to manage that, get un-stuck creatively and work through self-doubt. You can also find a way to live an authentic and meaningful life in this crazy world. Your voice matters. 

I would love to hear from you. Contact me so we can chat about what you're looking for and whether working together is a good fit.

About me...


I'm a zen practicing therapist+musician who loves working with people on their journeys to healthier relationships and becoming their most authentic selves. Trees, books, stringed instruments and meditating outside make me really happy. I also have a cute though somewhat misbehaved dog who hangs out during therapy sessions (she will be quiet, but you might hear her drinking water or playing with a toy once in awhile).

I was raised fundamentalist (Reformed Baptist, Calvinist) and spent a lot of my childhood learning fire and brimstone theology and memorizing verses from the King James Bible. Needless to say I chose to leave the "sinners in the hands of an angry God" mentality behind when I grew up. The truth is, being hard on ourselves doesn't help us or anyone else. But compassion, love, acceptance and presence connect us to who we really are, and who we can become.

Along the journey, I've played a lot of music (with friends, in bands and on my own) and become a therapist. I wrote an album while in grad school and took a year off after grad school to play shows and work at a record store. I believe it's OK to have multiple passions, to want to do a lot of things, to use your voice, and to take your time figuring it all out.


Ok, onto the "resume facts."


I'm a licensed mental health counselor in NY and RI with a MS in Mental Health Counseling from St. John Fisher College and a B.A. in English Literature from SUNY Geneseo.

My work is LGBTQI affirming, multiculturally oriented, and open relationship/polyamory friendly.

I'm constantly learning so that I can bring more knowledge to our work together and help you reach your goals. To that end, I've completed special training in:

  • ACT w/ Russ Harris

  • CBT Essentials from the Beck Institute

  • CBT for Anxiety from the Beck Institute

  • Perinatal Mental Health from Postpartum Support International

  • Gottman Levels 1, 2 and 3 through Gottman Institute

  • Treating Affairs and Trauma in Couples - Gottman Institute

  • Couples and Addiction Recovery - Gottman Institute

  • Emotion Focused Therapy from Sue Johnson

  • Mindfulness Based Stress Reduction from East Coast Mindfulness

  • Dialectical Behavior Therapy Skills from Marsha Linehan/Behavioral Tech

  • Narrative Therapy from St. Joseph's Neighborhood Center

In our work together, I want to help you tap into your own creativity and inner wisdom while also drawing from these evidence-based modalities to help you live a purposeful life, strengthen your relationships, get to know yourself in a deeper way, and reach your goals as a couple or an individual.

I look forward to working with you!


Puedo hablar contigo un poco de español, pero no puedo hablar con fluencia.


Contact Me

Reaching out to a therapist can feel like a big step. I get it. I don't bite! Feel free to call if you want to chat a bit and see if this might be a good fit for you.

You can contact me through the form below, or you can book a free 15 minute consult.

160 Allens Creek Rd

Suite 160

Rochester, NY 14618

Tel: 585-294-4776

Thanks for submitting! I will respond within 48 hours.


"wherever you go, there you are" - jon kabat-zinn