About Hiroko
Hiroko Makiyama is a licensed clinical social worker in California who helps people facing addictions, stress, anxiety, relationship and intimacy concerns, and work-related strain. She speaks English and offers sessions using video calls, phone, live chat, or text messaging. Hiroko emphasizes clients' own strengths and works alongside them as they make changes.
Hiroko brings ten years of clinical experience and practical focus to each session. She centers the client's voice and life story when setting goals.
Background and approach
Sessions are aimed at small, manageable steps rather than big, sudden shifts. This helps people feel less overwhelmed while they practice new ways of coping. Addictions and drug or alcohol concerns are a clear focus in her practice.
She helps people identify triggers, build healthier routines, and strengthen motivation for change. Conversations are direct but supportive, with attention to both setbacks and progress. When stress, anxiety, or compassion fatigue are present, Hiroko works on day-to-day strategies.
These include breathing and grounding techniques, planning for stressful situations, and creating realistic self-care plans. Her approach aims to reduce symptoms while keeping goals tied to daily life. For relationship, family, intimacy, self-esteem, and career worries she helps people clarify what matters most.
Together they look at communication patterns, personal boundaries, and steps to improve confidence. The pace is set by the client so change feels doable and rooted in real life.
How therapeutic approaches translate to online care
Evidence-based techniques focus on clear skills people can practice between sessions. One common approach emphasizes building coping skills and routines to address stress and anxiety. It teaches simple tools like breathing, grounding, and planning that help reduce daily symptoms and improve functioning.Another approach centers on change work for addictions and substance use. This involves identifying triggers, strengthening motivation, and setting small goals to support safer choices and healthier habits. The work is practical and aimed at measurable steps forward.
Finding the right approach is part of the therapy process. The therapist collaborates with each person to choose techniques that match their needs, goals, and preferences. Together they review what helps most and adjust the plan over time.
Online formats make it easier to fit therapy into a busy life. Video calls allow face-to-face conversation when visual cues matter. Phone sessions use less bandwidth and can be easier during a short break. Live chat and text-based messaging offer short check-ins, written reflections, and flexible contact between longer sessions. These options increase access and let people pick what works best for their schedule and comfort.
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Specialties and expertise
Top specialties
Also works with
- Career difficulties
- Compassion fatigue
- Coping with life changes
- Drug and alcohol addiction
- Family conflicts
- Intimacy-related issues
- Relationship issues
- Self esteem
- Stress, Anxiety
- Experience
- 10 years
- Licensed
- California
- Languages
- English