Justin Manco, CMHC — Licensed Clinical Mental Health Counselor and co-developer of the RELATE framework for Pathological Demand Avoidance. Telehealth therapy across Utah, Colorado, Montana, and Texas.

I'm a Licensed Clinical Mental Health Counselor based in Utah, and I see clients via telehealth in Utah, Colorado, Montana, and Texas. Over the years I've worked across most of the settings therapy happens in: outpatient private practice, a specialty OCD and anxiety clinic, an adult psychiatric inpatient unit, a PHP/IOP program for co-occurring mental health and substance use, and a few years as a primary therapist in adolescent residential treatment.

That range wasn't really planned. It happened because the people I kept finding myself drawn to didn't fit neatly into one box. Autism shows up with anxiety. ADHD overlaps with executive functioning struggles and shame. OCD shows up alongside demand sensitivity. Depression and substance use layer on top of everything else. Trying to treat one piece while pretending the rest isn't there is usually where things stall, so I learned to sit with the whole picture instead.

The four years I spent in residential treatment for teens with neurodevelopmental disorders is where my work with autism and demand sensitivity really deepened. It's also why I'm comfortable helping families think through higher levels of care when that comes up. I've seen what those settings actually look like from the inside, not from a brochure.

Rachelle Manco, LCSW, and I developed the RELATE framework together, which is a structured way of working with Pathological Demand Avoidance (PDA) that focuses on the nervous system rather than the behavior. There's a clinical manual and a parent book over at relatepda.com if you want to learn more.

Outside of work, I'm a parent doing my best, a runner and triathlete, and someone who heads to the mountains when my own head needs clearing. I value showing up imperfectly and doing hard things on purpose, and that tends to show up in the room with the people I work with too.

CMHC (Utah) Telehealth in 4 states Brainspotting Level II CBT / DBT / IFS / EFT ERP / ACT Motivational Interviewing

Education

Master of Science, Clinical Mental Health Counseling, University of Phoenix
Bachelor of Science, Philosophy / Political Science, University of Utah

Clinical Experience

Outpatient Private Practice (2023 to present)
The OCD and Anxiety Treatment Center, Salt Lake City
Highland Ridge Hospital, Adult Psychiatric Inpatient
Turning Point Centers, PHP/IOP for Co-Occurring Disorders
Discover Seven Stars, Adolescent Residential Treatment (4 years)
Wasatch Crest Recovery, Residential Substance Use Treatment
Benchmark Behavioral Hospital, Psychiatric Unit Management

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Outside the Office

Where I recharge

I tell my clients that doing hard things on purpose is part of how we grow a tolerance for discomfort. I try to live that myself.

Justin Manco on the summit of Kings Peak, the highest point in Utah, holding the summit marker against a blue sky and desert horizon.
Kings Peak, Utah — the highest point in the state. The mountains are where my head clears and the work of being a therapist gets put back in perspective.
Justin Manco riding a road bike along the Great Salt Lake during a triathlon, mountains in the background.
Triathlon season at the Great Salt Lake. Training for long-distance events taught me most of what I know about pacing, patience, and not bailing when things get hard.