Secialty & Bio



Minorities (People of Color/POC, LGBTQ+, etc.)

One thing that I really would like to provide is a space where you feel safe to be yourself no matter who you are.  When I was providing counseling (or therapy...they can be used interchangeably) at community mental health clinics, age, race, gender and sexual orientation, disability status, size etc. of my clients were diverse.  It was a surprising and exciting discovery that my status as an immigrant Asian woman can be an advantage to relate to minority clients.  When I started my private pratcice, I was slightly worried I may not attract enough clients because of my Japanese name (an internalized prejudice right there).  While some people probably choose not to work with me, plenty of others told me that they chose me because they were looking for a POC/Asian/Japanese counselor and/or a LGBTQ+ friendly counselor who can relate to them better.  If you are one of them, yes, I can relate to you with my first-hand experience of social oppression (microagression, prejudice, discrimination etc.).  Everyone wants to feel safe, which is crucial for counseling where you became very vulnerable to heal yourself.  However, it can be a challenge for minorities to let their guards down after being treated differently multiple times - even with well-intended acts or statements.  Although I do not expect anyone to feel completely safe with me in the first session, I will do my best to help you to feel so with my respect, knowledge and willingness to learn about you.  I am listed as a LGBTQ+ friendly counselor on the resource of the Rainbow Center in Tacoma, WA.  I am also a member of Multicultural Counselors

( ).  My pronoun is she/her.

Immigrants, Bilingual, Bicultual, Biracial People

I was born and raised in Japan.  My life in the US started as a foreign student in Montana about 20 years ago.  Because of my background, I can establish a special rapport with people from other countries.  Language barrier, cultural adjustment, pressure to succeed and isolated feeling are all common.  I also have knowledge and experience of the draining visa, green card, or naturalization process.  I will be happy to provide emotional support and coping skills to get through it.  In addition, I am part of a bilingual, bicultual and biracial family.  It has unique joys and hardships.  It would be my honor to assist anyone who is in a similar situation.  

"Helpers" - Caregivers, Social Service/Healthcare Workers

My compassion goes toward my fellow social service and/or healthcare workers.  I have worked at Greater Lakes Mental Healthcare and Multicare (formally known as Good Samaritan) Behavioral Health for approximately 15 years total.  Although social service and healthcare are very valuable and rewarding careers, there are common issues such as large caseloads, complex paperwork, maintaining quality services and productivity (at the same time!), time management, dealing with challenging behaviors from clients/patients or their families, dissapointment, sadness or even anger toward "the system" or "the society"...the list goes on.  And, unfortunately, burnout can eventually happen.  We want to make a difference in people's lives, but we need to deal with our emotions and take care of ourselves so that we can keep doing what we believe in.  I would love to assist you, a hard worker who is helping to change people's lives for good, with my deep understanding of light and dark of your important career.

Caregivers always impress me.  I used to provide in-home counseling for them through Family Caregiver Support Program by Pierce County.  You always think of your loved one first, maybe neglect your needs and possibly feel that nobody recognizes your daily heavy load of work and your emotions toward it.  You may feel irritable toward your loved one at times, then guilt kicks in.  It is called compassion fatigue.  You may be afraid how long your duty goes on and also wonder what you would do if anything happens to your loved one.  There is a word called anticipatory grief, which means you are expecting an upcoming loss and are grieving for it.  For instance, seeing someone with dementia and is losing own memory and abilities every day (I have extea knowledge and experience working with dementia clients).  If these describe you, you are not alone.  I have seen many caregivers like you.    

Aging Adults, People with Chronic Medical Conditions

Working with aging adults require extra trainings due to their unique challenges (e.g. chronic medical conditions, grief over health, independence, etc., transition to higher level of care, change in family dynamics especially with children, mild cognitive impairment, dementia, and end of life).  That is why my state Geriatric Mental Health Specialist certification can come in handy.  Throughout my career as a counselor/therapist, an assessor, a case worker and a program lead, I always have been enjoying to assist aging adults in various settings including outpatient clinics, their homes, hospitals, assisted living facilities, adult family homes and skilled nursing facilities. 

Because I have worked with many aging adults with various medical conditions, I have familialized myself with these issues.  Although I am not a doctor/nurse, I have closely worked with medical providers and received trainings for some common illnesses, especially dementia.  In-home counseling for COPES (a county in-home caregiving program) recipients has strengthened my clinical expertise as well since it did not limit my clients based on age.

You, aging adults and/or those who have chronic medical conditions are resilient.  Your rich life experiences including on-going challenges, even grief, have made you wise.  You have lots of accomplishments, capabilities, strengths, values and goals.  I would love to offer you guidance to remember what they are.

I am listed on Center For Chronic Illness' provider list ( ).

Anxiety, Bipolar, Depression and/or Trauma can be experiecned with any populations above.  Please read below for common symptoms:

  - Anxiety (worrying too much, racing mind, trouble focusing, difficulty sleeping, feeling too sensitive, avoiding anxiety-provoking situations suh as crowds, agitation, panic attacks)

- Bipolar (mania - feeling high for no reason, unusual amount of energy, decreased need of sleep, starting multiple projects, grandiosity, hypersexuality, compulsive and/or risky behaviors and depression)

- Depression (depressed mood, hopelessness, sleeping too much or too little, increased or decreased appetite, difficulty focusing, irritability, sense of guilt, moving or speaking too slow or too fast, loss of interest in enjoyable activities, isolation, thought of death or suicidal ideation)

  - Trauma (related to anxiety.  History of experiencing or being exposed to traumatic events, flashbacks, nightmares, being physically and/or emotionally triggered by reminders of past trauma, avoidance of the reminders, feeling jumpy, emotional numbness, inability to recall some or all parts of past trauma, anger outbursts, isolation)

Education, Licensure, Career

  • Bachelor of Arts in Liberal Studies with Women’s Studies emphasis from University of Montana 
  • Masters of Science in Health and Human Development with Marriage and Family Counseling option from Montana State University
  • Licensed Mental Health Counselor (license number: LH60040909) by the State of Washington
  • Certified Geriatric Mental Health Specialist by the State of Washington
  • Post-graduate experience in mental health field since 2004 serving adults and aging adults offering assessments, individual counseling, group counseling, psychoeducation, case management and crisis interventions in outpatient clinics, various residential treatment facilities and individual homes
  • Visited COPES (a county help for in-home services) recipients for counseling at home
  • Visited caregivers for in-home counseling through Pierce County Family Caregiver Support Program
  • Lead a hands-on social service program called HEROS (Helping Elders through Referrals and Outreach Services) for vulnerable aging adults who often had significant medical problems and/or dementia
  • Served as an assessor for a federal and state program called PASRR (Preadmission Screening and Resident Review) for Medicare recipients with mental health care needs to evaluate appropriatesness and provide recommendations for skilled nursing care
  • Provided a grief workshop for a local business
  • Member of Washington Mental Health Counselor Association
  • Member of Pierce County Counselor Association
  • Member of Multicultural Counselors

When I am not at work, I enjoy reading in Japanese, cooking, gardening, appreciating art, re-learning to play the piano, traveling and spending time with my family (including my orange tabby Tama) and friends.  I am also proudly raising my twice exceptioal child.


Ayako Aizawa, MS, LMHC, GMHS

2711 North 21st Street, Tacoma, Washington 98406, United States

(253) 242-2795



09:30 am – 03:00 pm


09:30 am – 03:00 pm


09:30 am – 03:00 pm


09:30 am – 03:00 pm