About Dr. Sierra
Hi there, it's great to have you here. Whatever you're struggling with, healing and change are always possible.
I'm Dr. Sierra Garthwaite, a licensed clinical psychologist who grew up in the San Francisco Bay Area. Below I describe my journey to becoming a therapist.
College: The Psychology Seed Gets Planted
Soccer consumed a large portion of my childhood. I loved it, played constantly, and occasionally forgot which goal belonged to us. Whenever an adult asked me what I wanted to be when I grew up, I had a very practical and achievable answer: "An Olympic gold medalist."
There was no backup plan.
Along the way, psychology entered the picture. As an undergraduate at UC Berkeley, I became fascinated in psychology classes. Eventually, I ventured over to the career center and took a formal career assessment which essentially told me: yes, becoming a psychologist would be a good fit. It made sense, I loved the idea of having a career where I could be a caring, supportive person for people navigating difficult moments in their lives.
Naturally, I then proceeded to do approximately everything except immediately become a psychologist.
While at Berkeley, I created a De-Cal course where I connected with returned Peace Corps volunteers who came and shared their experiences living around the world. I also studied abroad in France and played Division 1 soccer. By graduation, after too many classes, deadlines, and generally operating at full speed, I felt ready to explore life outside the achievement conveyer belt.
Post-College: The
Scenic Route
After college, I moved to New Zealand, where I worked as a waitress. New Zealand showed me how much beauty there is in the natural world to discover. That curiosity eventually led me to hike the entire 211 mile John Muir Trail in California.
My next chapter took me from a lot of walking to a lot of sitting. I lived at Upaya Zen Center in Santa Fe, New Mexico where I practiced sitting meditation three hours a day. Meditation practice taught me the life-changing benefits of mindfulness and eastern philosophy. After a few months teaching English in Thailand, I applied to become a Peace Corps volunteer in West Africa.
While waiting to leave for West Africa, I moved back to San Francisco. In SF I started a Meetup book club, took photography classes, and discovered Rhythm and Motion dance classes at ODC. A new plan developed: I wanted to take dance classes 5 days a week. Dance gave me the opportunity to feel the healing power of being playful and completely in my body. During dance classes, life's stressors melted away because I was fully immersed in the joy of the experience.
As my Peace Corps departure date approached, I found myself genuinely torn. Part of me wanted to leave for West Africa, while another part wanted to stay in San Francisco and pursue this new life I was building. So I did something that would ultimately change the direction of my life: I went to therapy. While working through this decision in therapy, I happened upon a flyer about a psychology graduate school program.
Psychology, the career I had been curious about years earlier at Berkeley suddenly came back into the picture. After a lot of reflection, I made the difficult decision to let go of my Peace Corps plan and pursue a graduate psychology degree. Therapy provided a valuable supportive space that helped clarify what mattered to me and ultimately return to my earlier interest in psychology.
It turns out my path to becoming a psychologist wasn't exactly a straight line. Looking back, I'm so glad I took the scenic route.
From Career Detours to the Therapy Room
Graduate school eventually confirmed that, after several countries, a Zen Buddhist center, 211 miles of hiking, and a brief plan to become a professional dancer, I had in fact landed in the right career.
I've been incredibly fortunate to work in a wide variety of settings over the years, from hospitals and college counseling centers, to community mental health clinics. Each experience shaped the psychologist I am today, although thankfully none required me to demonstrate my dance abilities.
While working with college students at Ohio University, I loved witnessing my therapy clients discover their own, often wonderfully creative, paths toward feeling better. Sometimes healing looked like learning new coping skills in therapy. Sometimes it looked like starting a club on campus, writing music to express an emotion, or finding a community where they finally felt like themselves.
Later, as a therapist in the Santa Clara area, I had the privilege of working alongside talented professionals who expanded my training in evidence-based therapies and helped me grow tremendously as a clinician treating a wide range of concerns including anxiety, depression, trauma, eating disorders, and insomnia.
I have also spent a significant portion of my career supporting seniors living in San Francisco's Tenderloin neighborhood, regularly visiting them in their homes. I had the opportunity to hear stories spanning decades about love, loss, family, resilience, regret, adventure, and everything in between. Many of those conversations have stayed with me and probably always will.
At UCSF, I provided therapy support for the faculty, staff, and medical residents. One of my most valued parts of the experience was the opportunity to co-facilitate a mindfulness and self-compassion course. While teaching this course, I developed an even deeper appreciation for self-compassion which turns out to be considerably more helpful than mentally yelling at yourself to "get it together."
So, What's Therapy
Actually Like?
Today, I enjoy working with adult clients in individual therapy. I continue to be amazed by the resilience, courage, and grace of my clients.
My approach to therapy is warm, collaborative, and holistic. After working with thousands of clients over the years, I've come to appreciate that it's important to treat the whole person: mind, body, and nervous system.
That's why I draw from both traditional top-down approaches, such as Cognitive-Behavioral Therapy (CBT), which helps to work with thoughts, emotions, and behavioral patterns, as well as bottom-up approaches, including somatic strategies and nervous system regulation, which help us learn ways to effectively process stored stress in the body. Combining these approaches (top-down and bottom-up), I tailor therapy to the unique needs and goals of each client.
Therapy with me is also action-oriented. I've noticed how it can be helpful for the insights we uncover during a session to make their way into life outside the virtual screen.
At the end of sessions, clients will often choose a small, manageable action step aligned with their values and therapy goals. We experiment with evidence-based strategies, notice what actually helps improve mood, keep the useful ones, and let go of the ones that aren't a good fit.
Life Outside The
Therapy Room
Being a psychologist can involve spending a lot of time inside my own head thinking about thoughts, feelings, patterns, relationships, nervous systems...and why humans do the things they do.
So outside of work, I make a conscious effort to get out of my head and into the world.
These days, that often means trail running, yoga, sauna sessions, paddle boarding, and hiking.
I also still love traveling and exploring new places. And there is still one bucket list item waiting for me: swimming with giant ocean manta rays.
There is just one minor logistical obstacle:
I'm afraid of sharks.
So my personal growth journey is far from complete. For now, I'll continue practicing what I frequently encourage my clients to do: take things one manageable step at a time, make room for self-compassion, and keep moving toward the things that matter to us.
Licensed Psychologist, California (PSY30672)
Degrees
Clinical Training
Degrees
- Psy.D. and M.A. in Clinical Psychology (California School of Professional Psychology at Alliant International University, San Francisco)
- B.A. University of California Berkeley (Dean's Honor List Student & Division 1 Women's Soccer Player)
Clinical Training
- UCSF Faculty and Staff Assistance Program
- Ohio University Counseling Center (APA Accredited)
- Kaiser Permanente Department of Psychiatry, Santa Clara (APA Accredited)
- Felton Institute, Geriatric Outpatient Services, San Francisco
Education & Training
