Nell actively collaborates with her clients to identify and clarify the problem that has led them to seek support and examine both what has worked in the past in addressing the problem and what roadblocks are making it difficult to move forward now. 

A good deal of her work involves exploring the "cycle of interaction" between individuals and how those interactions are either maintaining or exacerbating the problem. She is equally dedicated to understanding how past experiences and relationships are informing and influencing the present and exploring the impact of broader family and community systems.

Integral to her approach is her commitment to helping all clients identify, explore, and work through the thoughts and feelings associated with the problem at hand. Her belief that by acknowledging and better understanding the meaning behind the feelings, individuals and couples are more easily able to process painful or challenging experiences and move forward again with greater clarity, confidence, and ease.