Laura Szyikowski

  • Laura Founded River Lily Counseling in 2020. She was working mostly on her own to build her dream of providing compassionate and accessible mental health services. This was up until late 2024, when she began hiring additional people to help her expand her practice. Her goal is to hire additional psychotherapists and increase her outreach into more areas by the end of 2026.

  • Laura currently acts as the Director and Owner of River Lily Counseling. Laura’s vision as Director of River Lily Counseling is to create a safe and known resource for neurodivergent and LGBTQ individuals to receive quality mental health services.

  • Laura specializes in working with people who are non-conforming to mainstream society, especially persons who are queer, or neurodivergent.


    She herself identifies as queer, and ADHD. She is sex positive and body positive, and believes in encouraging positive self-esteem at all times, as self-esteem directly affects mental health.

Treatment Specialization and Methodology


Who?

  • Laura treats humans ages 13 and older with anything they may bring in, with only a few exceptions.

  • Laura specializes with people who are non-conforming to mainstream society, especially persons who are queer or neurodivergent.

    Laura helps people develop identity, self-esteem, self-love, and self-acceptance, even in this political climate.

  • Laura offers telemental health 2 way video conferencing appointments. These appointments are always remote, and currently only offered to residents of Virginia.

Laura believes that therapy goals and methods shouldn’t be based solely off of one diagnostic or therapeutic approach, but a combination of multiple approaches simultaneously. 

Laura utilizes a combined approach to therapy. She believes that therapy goals should be set by the client, and they should be person-centered strategies.

Laura’s sessions are geared around building a sense of agency and joy within the client. The client will always get to choose what is discussed in session, and Laura will not have a set agenda as far as her own goals, she is there to support them.

Laura primarily employs a combination of person-centered and solution-focused strategies.

She feels this gives her clients the freedom to focus on what they are struggling with in the moment, and look for ways to change something about the situation through a strengths-based approach.

How?

In addition, she will use these other research-supported techniques depending on the person and the goal:

  • Motivational Interviewing

  • Gestalt/Existential Therapy

  • Holistic Brain Interventions/Neurobiological Strategies

  • Somatic Therapy

  • Acceptance and Commitment Therapy

  • Holistic Healing

  • Feminist Theory

  • Dialectic Behavioral Therapy

  • Structural Family Therapy

  • Psychodynamic Therapy

  • Narrative Therapy

  • Theories of Development and Psychosocial Development

  • Expressive Arts Techniques

  • Theories Requiring Memory and Learning

  • Jungian Theories of Personality

  • Theories on Adapting to Immigration

  • Culturally Specific Interventions

  • Theories on Gender Identity

  • Gender Development and the WPATH Standards of Care

  • The Stages of Change

ADHD

Testing!

Now Offering…

ADHD is a developmental disorder characterized by a persistent pattern of inattention, hyperactivity, and/or impulsivity that begins in childhood and interferes with functioning and development throughout an individual’s life.

ADHD can present in three forms: predominantly inattentive, predominantly hyperactive-impulsive, or combined presentation. Because of this variability, symptoms and their impact can differ widely among individuals. Despite growing awareness, ADHD remains frequently misunderstood and underdiagnosed, particularly in girls, adults, and people of color.

Individuals with ADHD are more likely than their peers to experience physical injuries and have an increased risk of co-occurring conditions, such as functional disabilities (such as dyslexia or dyscalculia), mental health disorders, and autoimmune conditions. They may also face functional challenges, including difficulties with job stability, managing time, and maintaining relationships.

ADHD is associated with challenges but also linked to creative thinkers, high-energy, spontaneous problem solving, high levels of curiosity, and the ability to multitask or hyperfocus easier compared to others. When provided the right types of support, individuals with ADHD often thrive in dynamic environments and bring unique strengths to personal and professional settings.

About ADHD:

  • The assessment that Laura can provide is appropriate for adults who are typically functioning, but who still struggle in daily life activities, and who want to know if it is because of ADHD.

    You must be a resident of Virginia, over 18, and not in need of an educational profile.

  • Laura cannot provide an educational profile or a neuropsychological assessment.

    Educational profile and neuropsychological assessments can only be completed by a Licensed Psychologist, and are more appropriate for minors attending school, or adults who are looking at different aspects of neurological functioning.

    Some people seek IQ testing and an educational profile in order to determine learning strengths and weaknesses, to determine if they have dyslexia, or other barriers to learning.

    Some people seek neuropsychological assessments to gain a baseline or follow up for pre-or post- head injury, dementia, or head surgery, to determine ability of understanding of language, or to determine their level of intelligence. If you have Parkinson’s Disease, Multiple Sclerosis, Stroke, brain tumor, or any other neurological issue, then you should not utilize this service. It is better to have a neuropsychological assessment to understand how your functioning is changing over time.

  • The test is a multiple step process that will take a minimum of 2 hours over several days. This begins with completion of a written intake form, then your completion of the QBCheck online by having your camera on throughout the test, and finally a 30-45 minute meeting with the psychotherapist to complete your assessment.

    1. A laptop or computer with access to a webcam. The camera is required to track your movement, and a phone or tablet will not work for the testing program. The camera is not recording you, but it is tracking how much movement you are doing, if you have any questions about this feel free to ask.

    2. Reliable Internet

    3. Ideally a chair which doesn’t swivel, rock, and isn’t on wheels.

    4. A quiet, non-distracting room with a blank or mostly blank wall behind you.

  • We utilize a sliding scale pricing model for all services offered at River Lily Counseling.

    A sliding scale is a flexible pricing model that offers multiple rates for the same service. Higher tiers help offset the discounts provided at the lower tiers, ensuring that services remain accessible while also supporting the sustainability of our practice. Sliding Scale pay structures are designed to increase the accessibility of services to lower income households, encourage preventative care, and positively contribute to social equity.
    River Lily Counseling Inc does not require income verification when selecting which price the client selects, we only request that you select the price that feels honest to your financial needs. 

    Tier 1 = The lowest rate offered for our services. 
    Tier 3 = The regular rate of the service if no discount was offered. 
    Tier 5 = The rate which contributes to supporting the continuance of the sliding scale program.

    Sliding Scale:
    Tier 1: $350
    Tier 2: $375
    Tier 3: $400
    Tier 4: $425
    Tier 5: $450

    You will receive two receipts during the assessment process. The first receipt is received when we process the initial payment. You’ll be given the second receipt once the testing process is completed and Laura has determined your diagnosis so she may apply the correct billing codes for insurance. The second receipt is the receipt that you can submit to your insurance provider for reimbursement. If for any reason we are unable to complete the entire testing process, you’ll receive a partial refund based on the amount of steps completed.

    You can use HSA, Debit or Credit Cards.

River Lily Counseling is proud to begin offering Attention-Deficit Hyperactivity Disorder (ADHD) Assessments and is now able to diagnose ADHD in Virginia!

Coming Soon.. Sensory Processing Disorder Testing and Educational Materials!

To Schedule an Appointment…

Laura Szyikowski
Fishersville, Virginia
540-524-2224

support@riverlilycounseling.com

Availability update: As of August 4, 2025, I am accepting 1 new client for individual therapy.

At this time, I reserve 2 spaces per month in my schedule for one-time assessments for letters supporting gender-affirming care, and 2 spots for ADHD assessments.

I am looking for clients for a group therapy for building better boundaries.

Please complete the contact form below if you are interested in any of these services.

Individual Therapy and Group Therapy Experience


Individual Therapy Experience:

Laura has offered individual counseling part-time throughout her career, from peer counseling in high school and college to professional counseling in community-based settings (homes, schools, college), prison, private offices, and state employee offices.

Before opening this practice, she provided individual counseling as a component of the following employment history (typically 5 hours a week):

  • North Carolina Department of Corrections- 2000-2001- Primarily males aged 18-22 using CBT or REBT

  • Salvation Army - 2002-2003 - Pregnant and parenting teens in inner city Syracuse, NY

  • Morrisville State College- 2005- Graduate Intern in Counseling Center

  • Northern Virginia Community College- 2007- Assisting youth transitioning from high school to college

  • New River League of Therapists- 2008-2011- Individual counseling for parents, play therapy for children

  • Minnick Education Center - 2011-2012- Counseling in school for troubled youth - K-12

  • New River Valley Community Services Board- 2012-2015- Non-directive play therapy for children with trauma and ASD.

  • Goochland-Powhatan Community Services Board- 2016- Counseling for adults primarily using MI and brief therapy

  • Northwestern Community Services Board- 2018-2019- Counseling for adults primarily using brief therapy, MI, CBT, or modified DBT.

    Now, it is currently the main focus of her work week.

From 2008-2011 I worked providing Intensive In-home family therapy primarily using the structural family therapy technique, and also behavioral therapy strategies with the New River League of Therapists.

Then from 2012-2014 I worked with children and teens with Autism Spectrum Disorder or combined ID/DD/MH, and their families with New River Community Services Board. This rewarding work also incorporated family therapy and behavioral therapy techniques.

Group Therapy Experience:

Experience as a Training Facilitator:


Throughout my career I have had the honor of facilitating group trainings. Often this effort has been rewarding in many ways, including gaining additional training and developing community relationships.

Specifically, I have facilitated the following group trainings:

  • CIT officer training on the topic of juveniles in crisis for Northwestern Community Services Board, 2019.

  • Meditation Techniques, Festival Workshop, 2019.

  • Therapeutic Options Trainer for Goochland Powhatan Community Services Board, 2016.

  • Parenting Together Separately Instructor for Virginia Courts 2010-2011.

  • Freshmen Orientation for Northern Virginia Community College, 2007.

  • Adjunct Professor, Drugs and Society class, Morrisville State College, 2006.

  • Peer Educator Training, Morrisville State College, 2004.

  • Anger management, NC DOC, 2000-2001.

  • Listening Skills, Big Brothers Big Sisters, monthly 1999-2000.

Laura Szyikowski is an American Counseling Association and SAIGE Member.