Therapy at Twilight Psychology — what we offer in Lexington, KY

When people search for a therapist in Lexington, KY, they are usually not looking for a specific modality acronym. They are looking for a provider who understands what they are dealing with, can offer practical help, and will not default to a one-size-fits-all approach. That is the frame Twilight Psychology uses to think about therapy.

Our therapy team now spans ages 3 to adulthood, with specializations in neurodivergent care, ADHD and autism support, childhood and adolescent mental health, anxiety and trauma, couples counseling, substance use recovery, and faith-integrated care. Insurance is accepted for individual therapy through most of our therapists.

Evidence-based modalities we use

Therapy at Twilight is grounded in specific, evidence-based approaches rather than generic “supportive counseling.” The modality varies by clinician and by what a client’s situation calls for.

Cognitive Behavioral Therapy (CBT)

CBT is one of the most extensively researched forms of psychotherapy. At its core, it works by examining the relationships between thoughts, feelings, and behaviors — and learning to interrupt and restructure the patterns that are causing distress.

CBT is used at Twilight for:

• anxiety disorders — generalized anxiety, social anxiety, panic, and phobias
• depression and mood dysregulation
• ADHD-related challenges including procrastination, emotional dysregulation, and planning difficulties
• trauma and PTSD, through trauma-focused CBT adaptations
• OCD and related conditions, through exposure and response prevention (ERP)

Neuro-affirming CBT — adapted for autistic and ADHD clients — is meaningfully different from standard CBT protocols. Traditional CBT can inadvertently push masking by framing the goal as behaving more “neurotypically.” Neuro-affirming CBT instead focuses on distress tolerance, self-advocacy, understanding one’s own patterns, and building a life that fits the actual person.

Our CBT therapy page provides a more detailed breakdown of how CBT is applied to specific concerns.

Acceptance and Commitment Therapy (ACT)

ACT is a third-wave behavioral approach that focuses on psychological flexibility — the ability to stay in contact with the present moment, accept difficult internal experiences, and commit to actions that align with values rather than avoid discomfort.

ACT is particularly effective for:

• anxiety and chronic worry that has not responded to more direct cognitive restructuring
• chronic pain and health-related distress
• depression where avoidance and disconnection from values are central features
• neurodivergent clients who benefit from a defusion-focused rather than thought-restructuring approach

ACT is used by several Twilight clinicians, particularly with younger and neurodivergent clients.

Psychodynamic and integrative therapy

Some Twilight therapists work primarily from a psychodynamic or integrative frame — drawing on the client’s history, relational patterns, and underlying emotional processes rather than structured skill-building. This approach suits clients who are looking for a deeper, more exploratory process and who may not benefit as much from highly structured skill-based work.

Neuro-affirming therapy as a practice stance

Across modalities, neuro-affirming therapy at Twilight means the clinician does not treat autism, ADHD, or other neurodevelopmental differences as problems to correct. The therapeutic goal is not to make a neurodivergent person appear more neurotypical. It is to reduce genuine distress, build coping that fits the person’s actual brain, support self-understanding, and help clients build lives that work for them.

That distinction matters. A neurodivergent person who has received traditional therapy and found it unhelpful may have experienced a modality that was well-designed for neurotypical clients but poorly adapted. Neuro-affirming therapy is explicitly different.

Who our therapists work with

Children (ages 3–18)

Child and adolescent therapy at Twilight is provided primarily by Ethan Puckett, MA and Tiffany Roundtree, MA.Ed. Ethan’s strongest clinical fit is ages 7–16, with play-informed, CBT, and ACT-based approaches for children with ADHD, autism, anxiety, and school-related challenges. Tiffany specializes in adolescent therapy and parenting support.

Our dedicated child and teen therapy page covers the specifics in more depth.

Adults

Several Twilight therapists work primarily or exclusively with adults:

• Stephen Shu, MS — neuro-affirming therapy and ADHD and autism support for adults
• Jonica Davis, Psy.D. — psychodynamic and neurodiverse-affirming therapy for individuals and couples
• Emeli Evans, MS — therapy for autistic, ADHD, and AuDHD adults, with particular expertise in high-masking presentations, PDA, and identity work; also offers intimacy therapy
• Michael Burns, PhD — ADHD and autism support for adults alongside assessment services; dual-licensed in Kentucky and Tennessee
• Tiffany Roundtree, MA.Ed — adolescent and adult therapy focused on anxiety disorders and parenting support

Couples

Couples counseling is offered by Jatana Boggs, MS as a self-pay service. Jatana is dual-licensed in Kentucky and Ohio and is available to see clients in both states via telehealth. Sessions are 75 minutes, priced at $200 per session, with options for weekly work, focused problem-solving, or longer intensives. Our couples counseling page has the full overview.

Insurance and scheduling

Individual therapy is billable to accepted insurance plans for covered mental health diagnoses. Most of our therapy clinicians participate with major commercial plans and Kentucky Medicaid plans.

Couples counseling is self-pay only — insurance does not cover relationship therapy.

Current availability varies meaningfully by clinician. Some therapists have immediate openings; others have 1-month waits. The waitlist times page has current information, and our intake team can tell you specifically which clinicians have openings for your needs.

Twilight Psychology offers weekday appointments in Lexington plus weekend appointments by request — contact our intake team to ask about specific availability.

All therapy services are also available via telehealth across Kentucky. Dr. Burns accepts telehealth therapy clients in Tennessee in addition to Kentucky. Jatana Boggs accepts telehealth clients in Ohio in addition to Kentucky. See our telehealth services page and service area page for details.

When therapy follows an evaluation

If you have recently completed a psychological, ADHD, or autism evaluation at Twilight Psychology — or elsewhere — and therapy is part of the recommended next step, our clinicians experienced in post-evaluation support understand how to work from a diagnostic report and translate recommendations into a therapeutic plan. Our therapy after evaluation page covers that transition in more detail.

How to get started

The best starting point is our therapy services overview or the therapy clinicians page, which lets you compare therapists by specialty, age range, insurance, and current availability.

If you are unsure who is the right fit, the new client guide walks through the intake process, and our intake team can help you match with the right clinician before you schedule.

Related resources

• Therapy Services — full overview of therapy at Twilight
• Child and Teen Therapy — neuro-affirming therapy for children and adolescents
• Cognitive Behavioral Therapy (CBT) — CBT in Lexington, KY
• Couples Counseling — couples and relationship therapy
• Therapy Clinicians — compare therapists by specialty and availability
• FAQ — common questions about therapy, insurance, and scheduling