Elva 'Julia' Garafola

Compassionate, practical therapy for life’s transitions

LCSW Missouri

Experience: 12 years in practice
Focus areas: Stress, Anxiety, Relationship, Grief
Approaches: Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT)
Languages: English

About Elva

Elva 'Julia' Garafola offers focused support for people facing stress, anxiety, depression, grief, relationship struggles, and major life transitions. She works with those navigating identity and LGBT concerns, caregiving stress, chronic illness, parenting challenges, and the emotional fallout of trauma, abandonment, or separation.

Background and approach

Julia aims to meet individuals where they are and help them move toward clearer thinking and greater emotional balance. With 12 years of clinical experience and an LCSW credential, Julia draws on a mix of evidence-informed methods to tailor therapy to each person’s needs.

Her practice emphasizes collaborative, person-centered work that blends cognitive behavioral techniques with acceptance-based and attachment-focused perspectives. Clients engage in practical coping skills, exploration of patterns in relationships and self-concept, and steps toward sustainable behavior change.

Licensed in Missouri (and also holding a Texas license), she prioritizes a respectful, strengths-based atmosphere where clients can explore grief, career concerns, compassion fatigue, sleep problems, body image, and other complex issues. Julia’s approach is warm and pragmatic, supporting clients as they identify goals, develop resilience, and build healthier ways of relating to themselves and others.

Online Approaches That Support Change

Cognitive Behavioral Therapy (CBT) focuses on identifying and changing unhelpful thinking and behavior patterns. It’s commonly used for anxiety, depression, stress, sleep problems, and coping with life changes by teaching practical skills to shift thoughts and actions.

Acceptance and Commitment Therapy (ACT) encourages noticing difficult thoughts and feelings without getting entangled in them, while clarifying personal values and committed action. This approach is often helpful for grief, chronic stress, body image concerns, and situations where discomfort persists despite efforts to avoid it.

Finding the best therapeutic approach is collaborative; the therapist will work with each client to determine which methods fit their concerns, goals, and preferences. Sessions may blend CBT, ACT, attachment-informed techniques, and client-centered supports so plans reflect real-life needs and strengths.

Online therapy offers flexible ways to engage through video calls, phone sessions, live chat, or text-based messaging. These options make it easier to schedule sessions around work, caregiving, or health limitations while maintaining continuity of care. Licensed professionals can use these formats to teach coping skills, explore relationship patterns, and support behavior change in ways that fit into daily life.

Frequently asked questions

What concerns does she commonly address?

She works with a broad set of issues including stress, anxiety, depression, grief, relationship problems, trauma and abuse, parenting and family challenges, LGBT concerns, sleep disturbances, and compassion fatigue.

How would you describe her therapeutic style?

Her style is collaborative and person-centered, integrating practical cognitive behavioral strategies with acceptance and attachment-informed perspectives to help clients develop coping skills and insight.

What is her professional background?

She brings 12 years of clinical experience working with diverse emotional and relational challenges and blends multiple evidence-informed approaches in her practice.

Which credentials and location apply to this therapist?

She holds an LCSW and is licensed as TX LCSW 56813 and MO LCSW 2024038145, and her practice is based in Missouri.

Can I work with her if I live outside the United States?

She does not accept international clients at this time and works with English-speaking clients located where her licensure allows practice.

What session formats are offered?

Available formats include video calls, phone sessions, live chat, and text-based messaging to accommodate different preferences and schedules.

How are fees and payment handled?

Costs vary by location and therapist availability; sessions are provided through a subscription that can be canceled at any time.

What are the first steps to begin therapy?

Begin by selecting the Start Therapy button, completing a short matching questionnaire, and then scheduling sessions according to the therapist’s availability.

Areas of expertise

Primary focus

Stress, AnxietyRelationship issuesGrief Depression Coping with life changes

Also works with

LGBTFamily conflictsTrauma and abuseSleeping disordersParenting issuesAnger managementSelf esteemCareer difficultiesCompassion fatigue

Additional focus areas

AbandonmentAdoption and foster careAging and geriatric issuesAttachment issuesBlended family issuesBody imageCaregiver issues and stressChronic pain, illness, and disabilityCodependencyCommitment issuesCommunication problemsControl issuesCoping with natural or human-caused disasterDivorce and separationDomestic violenceEating and food-related issuesEmptinessFamily of origin issuesFamily problemsForgivenessGender dysphoriaGuilt and shameHIV / AIDSHoardingHospice and end-of-life counselingImpulsivityInfidelityIsolation / lonelinessJealousyLife purposeMen's issuesMidlife crisisMoney and financial issuesMood disordersMulticultural concernsNarcissismObsessions, compulsions, and OCD Panic disorder and panic attacksPolyamory / non-monogamous relationshipsPostpartum depressionPost-traumatic stressSeasonal Affective Disorder (SAD)Self-loveSexual dysfunctionSexualityWomen's issuesWorkplace issuesYoung adult issues

Therapeutic approaches

Acceptance and Commitment Therapy (ACT)Attachment-Based TherapyClient-Centered TherapyCognitive Behavioral Therapy (CBT)Dialectical Behavior Therapy (DBT)Emotionally-Focused Therapy (EFT)Mindfulness TherapyMotivational InterviewingPsychodynamic TherapySolution-Focused Therapy

Experience

12+ years

Licensed

Texas, Missouri

Languages

English