You’ve done everything right.

You’ve kept your head down. You pushed through the hard days. You carried on—showing up for your work, your responsibilities, your relationships—without asking for much. You didn’t fall apart. You made it through.

But now, something in you is whispering: I need more than just surviving this.

That whisper is important. And it’s why you’re here.

Maybe the last year brought unexpected transitions—changes you had no choice but to navigate. Maybe grief or loss shifted your center. Maybe demands mounted and you barely had space to feel any of it. You stayed in motion because you had to. But now that the dust is starting to settle, the truth is surfacing: you’re tired, emotionally heavy, and yearning for a steadier way forward.

And beneath that? You want to come back to yourself. To your joy. To your capacity to feel your life again—not just manage it.

You are not alone.

It’s Okay to Be the One Who Needs Something Now

So many high-functioning, deeply capable women come to therapy at this very juncture—after seasons of doing what had to be done, of being strong, of carrying the emotional load for others.

But now it’s your turn.

Therapy isn’t just for when things are falling apart. It’s for when you want to stop living like you are. It’s for when you know you’ve been holding your breath for too long. It’s for when you realize that even if you’ve “gotten through it,” you’re still carrying it—inside your body, your nervous system, your sleep, your relationships.

And it’s for when the very tools that helped you survive—work ethic, mental toughness, task-mastery—are now getting in the way of deeper connection, rest, and intimacy.

The Hurt Doesn’t Go Away by Itself

Part of you knows: the hurt doesn’t just fade with time. It morphs. It settles into your daily life. It shows up in irritability, in numbness, in avoidance, in the way you rush through your days without remembering how they even felt.

Left unprocessed, hurt can make your life feel flat—even when good things are happening. It can impact how present you are with your partner. It can mute your desire to be touched or cared for. It can make your body feel like a battlefield instead of a home.

You’re not “broken.” You’re just still healing from things you were too busy surviving to fully feel.

Therapy creates the space for that. For you. Not to wallow—but to metabolize what you’ve been carrying. To clear space for something softer, more connected, more rooted.

You Deserve to Feel Close Again

Even with a loving partner, it might feel hard to slow down, to enjoy intimacy, to feel close.That makes perfect sense. When we’re in survival mode, emotional presence gets replaced by logistics: “What needs to get done?” “What’s the next thing on the list?” Intimacy, spontaneity, and even joy feel like distant luxuries. We become task managers instead of partners. And without meaning to, we begin to drift.

This isn’t about blame. It’s about capacity.

When your system is in overdrive, there’s little left for connection. But that doesn’t mean it can’t be rebuilt.

In therapy, we’ll work together to:

• Understand what you’ve been through—not just intellectually, but emotionally and somatically (in your body), so you can begin to release it.
• Reclaim a sense of emotional stability—so your nervous system feels less flooded, and you’re not always waiting for the next thing to go wrong.
• Reconnect with your inner world—your desires, longings, and limits—so you can make choices that align with you, not just your to-do list.
• Explore your relationship dynamics—why it’s been hard to stay present or intimate, and how to gently move toward more closeness, communication, and softness.
• Learn real-time tools to help you slow down, regulate, and come back to yourself in the moments that matter most.

This isn’t about becoming a “better” partner or doing more—it’s about becoming more available to the love, rest, and connection that already wants to meet you.

Stability Doesn’t Come From Hustling Harder

You’re seeking stability—not the false kind that comes from control or doing everything “right,” but the kind that lives inside you. The groundedness that says: I can meet this moment, and I can care for myself in it.

True emotional stability comes from knowing how to listen to your own needs, how to respond to your anxiety with compassion, how to move through discomfort without abandoning yourself or others.

This work is personal. It’s sacred. And it’s yours to do.

You don’t need to wait until you “have more time,” or until things settle even more. The truth is, life may always be a little busy, a little unpredictable. But you can learn to navigate that busyness with more peace, presence, and grace.

Therapy Is Where You Come Back to Yourself

You already have the courage—you’ve made it this far. You’ve handled life. You’ve kept it all afloat. Now, the work is to re-orient. To soften. To begin tending to the inner world you’ve had to ignore for far too long.

This is your invitation to make space for you again—not as an afterthought, but as a priority.

And if you’re ready, therapy can help you:

• Feel more emotionally grounded.
• Restore joy and connection in your relationship.
• Rebuild self-trust and clarity after a period of survival.
• Shift out of over-functioning and into balance.
• Begin feeling like yourself again—only more empowered, more whole, more present.

It’s time.

Let’s begin.

If you’re ready to explore this next chapter with the support of an experienced, thoughtful therapist, reach out today. You don’t have to hold it all alone anymore.

Why Adult Sibling Relationships Can Feel So Hard—and How Therapy Can Help

Many adults come to therapy feeling confused about how deeply their sibling relationships still affect them. They may say things like, “We’re adults now—why does this still hurt?” or “I thought I was past this.”

The truth is, sibling relationships are rarely just about the present moment. They are layered with history, roles, expectations, and emotional memories that formed long before we had language or choice.

The Invisible Weight of Family Roles

Growing up, most of us unconsciously adapted to our family system. You might have become the responsible one, the caretaker, the achiever, the mediator, or the one who stayed quiet to keep the peace. These roles often helped the family function—but they also shaped how you learned to see yourself.

In adulthood, these patterns can quietly persist. You may notice yourself feeling small, reactive, guilty, or unseen around siblings—even if you’re confident and capable elsewhere in your life.

Why Adult Transitions Reignite Old Dynamics

Sibling tensions often intensify during major life transitions: caring for aging parents, dividing responsibilities, navigating grief, or becoming parents ourselves. These moments activate early attachment wounds and can make long-standing inequalities or emotional injuries feel impossible to ignore.

Strong emotions—anger, sadness, jealousy, grief—are not signs of immaturity. They are signals that something meaningful was never fully processed.

When Distance Feels Safer Than Closeness

Some adults cope by pulling away from siblings altogether. Others stay involved but feel chronically resentful or depleted. Both responses are understandable adaptations to emotional pain.

Therapy helps you slow down and ask deeper questions:

• What did I need back then that I didn’t receive?
• How did my role in my family shape my sense of worth?
• What am I still hoping for—and is it realistic?
• What kind of relationship do I want now?

How Therapy Creates Change

Sibling-focused therapy provides a space to explore these questions without judgment. It helps you understand how family systems shaped your emotional responses and gives you tools to respond differently today.

Over time, therapy can help you:

• Reduce emotional reactivity
• Set boundaries without overwhelming guilt
• Honor grief and anger without shame
• Build self-trust and clarity
• Decide how much closeness feels healthy

For some, healing means repair and reconnection. For others, it means acceptance and peace. Both are forms of growth.

You’re Allowed to Want More Ease

Struggling with sibling relationships doesn’t mean you’re doing something wrong. It means you’re human—and shaped by a system that asked you to adapt early.

With the right support, it’s possible to loosen old patterns and relate from a place of choice rather than obligation.

If sibling dynamics continue to weigh on you, therapy can help you create more space, clarity, and emotional freedom—both within your family and within yourself.

Healing Interactions in Relationships

Healing interactions are necessary when it comes to maintaining satisfying connection. When we lack them—or when they happen too infrequently—the landscape of our relationships can quickly begin to deteriorate. Healing interactions are not about rushing to resolution or checking a box. They are reciprocal, intentional, and designed to tap into the emotional core of an underlying need or conflict. It has often been said that behind every conflict lies a wish. In order to improve your ability to have effective healing interactions with someone you care about, it is necessary to deepen empathy, strengthen curiosity, and practice both consistently.

Healing Interactions and Daily Communication

As a clinician, my mission is to provide high quality, ethical, systemic, and holistic psychotherapy services to individuals, couples, and families. I approach this work with deep curiosity, respect for diverse lived experiences, and a dedication to helping clients move through meaningful growth processes. The ideas in this post are not a substitute for therapy, but rather a set of reflections that you can take into your own relationships and perhaps explore further in your personal work.

Healing interactions are not talked about nearly enough. Yet, understanding how they work can help us better navigate the personal barriers we each bring into relationships. Below is a five-pronged approach to help you feel more grounded, intentional, and competent when it comes to navigating emotionally charged or difficult conversations with those closest to you.

1. Begin with Intention: How Do I Want the Other Person to Feel?

Before initiating a difficult conversation, ask yourself: How do I want my partner, friend, or family member to feel when I approach them? Calm? Soothed? Comfortable? Curious? Ready and willing? By clarifying this intention, you can set the tone for the interaction before it begins.

This reflection often shifts our focus away from anxiety or defensiveness and toward empathy and kindness. For example, if your goal is for your partner to feel safe and open, you might soften your voice, choose a quiet time to talk, or express appreciation before raising a concern. These small adjustments help smooth the path toward repair and reduce the likelihood of conflict escalating.

2. Identify What the Other Person is Seeking

Behind every conflict or point of tension, there is usually a wish. Ask yourself: What is my loved one actually seeking here? Connection? Closeness? Reassurance? The sense of being seen or understood?

It’s natural to fear opening up. You may worry about being dismissed, shut down, or misunderstood. On the other hand, when emotions run high, it can feel tempting to say too much, too fast, in ways that overwhelm the other person. Both extremes can hinder connection.

A helpful alternative is to increase your self-awareness. You might even ask your partner directly: “How am I coming across to you right now?” or “How do you feel in this conversation?” By pausing to check in, you not only learn about their perspective, but you also send the message that you care about their experience as much as your own.

3. Meeting Needs: Balancing Care for the Other with Care for Yourself

One of the central challenges in relationships is learning how to meet another person’s needs without losing yourself in the process. In moments of conflict, ask: What am I actually wanting or needing here?

Sometimes our needs are clear—such as wanting comfort after a long day or asking for help with a responsibility. Other times, our needs are less obvious and harder to articulate. This is where self-reflection becomes critical. The more skilled we become at identifying and naming our needs, the more effectively we can express them to others.

Equally important is recognizing that meeting a partner’s needs does not mean erasing your own. Healing interactions are grounded in reciprocity. Both partners must feel that their wishes and vulnerabilities matter.

4. Showing Care and Concern

When healing interactions are most effective, they are infused with genuine care. Ask yourself: What can I do or say right now that would help the other person feel truly cared for?

This doesn’t require grand gestures. Often, it is the small and thoughtful acts—a validating statement, a gentle touch, a willingness to listen without judgment—that foster safety and closeness.

Many of us did not grow up learning how to communicate in ways that were both openhearted and constructive. It is easy to fall into patterns of criticism or defensiveness. But healing interactions invite us to shift toward speaking from the heart, being genuine without harshness, and assuming there is always more to understand.

When we feel cared for, we naturally become more responsive in return. Even in moments of imperfection or misunderstanding, the commitment to staying connected is what creates lasting trust.

5. Take Meaningful Action

The final step in a healing interaction is taking meaningful action. After listening, empathizing, and understanding, ask: What concrete action could I take that would make a difference for the other person?

This might mean following through on a promise, adjusting a habit that has been hurtful, or showing up more consistently in ways that matter. Research consistently shows that attunement—the ability to check in, confirm understanding, and respond in ways that align with the other person’s lived experience—is a critical component of lasting, satisfying connection.

Healing interactions in relationships are not complete until words are backed by action. When we pair empathy with follow-through, we create tangible evidence that the relationship matters and that both people’s needs are taken seriously.

Closing Reflection

Healing interactions are the lifeblood of resilient, fulfilling relationships. They require intention, empathy, reciprocity, care, and action. While the process can feel uncomfortable at times, it is within these moments of vulnerability that deeper bonds are built.

As an action step, consider this: The next time you find yourself in conflict with someone you care about, pause and ask one simple question—“What is the wish behind this conflict?” Just by identifying that underlying wish, you may find yourself more open to curiosity, empathy, and repair.

Healing interactions are not about perfection; they are about the willingness to stay engaged, to care, and to keep trying. That willingness, practiced over time, is what helps love and connection grow stronger.

For more on this topic, and to hear my complete conversation with the NYMFT network, tune in here!

Sometimes, life hands us more than one major transition at once. A new medical diagnosis. The emotional complexity of trying to conceive. An ever-present undercurrent of anxiety or uncertainty. And even in the midst of love and support, you can find yourself wondering:

How do I hold all of this? How do I stay grounded?

If you’re here, it’s because something inside you knows: it’s time to return to therapy. Not because you’re falling apart—but because you’re ready to care for yourself in a deeper, more intentional way. You’ve done this work before. You know how powerful it can be. And now, in this new chapter, you’re seeking steady support as you move through it all—gracefully, but not alone.

You Are Carrying A Lot (And That Makes Sense)

Getting a new medical diagnosis can tilt your world off center—even when it’s manageable, even when you’re doing “all the right things.” It can bring up fear, grief, confusion, questions about what the future holds. Layer on the emotional process of trying to conceive—and it’s no wonder that anxiety has been louder lately.

Let’s name what’s true: you’re navigating a swirl of hope and fear, of timelines and what-ifs, of medical appointments and emotional weight. You’re holding space for your body’s changing needs, your emotional waves, and your desire to stay open and connected to your partner in the midst of it all.

Of course this feels overwhelming.

You are doing your best to remain calm and present—but the anxiety? It creeps in. It fills the in-between moments. And when you’re already stretched thin, even small things can feel big.

This isn’t about weakness. This is about being human.

Returning to Therapy Isn’t a Step Back — It’s a Step Inward

Therapy isn’t just something we use when we’re in crisis. It’s a tool for returning to ourselves—especially in seasons where everything feels like it’s shifting.

You’ve been here before. You know the kind of relief and insight it can bring. And now, you’re wiser. You’re more ready than ever to approach therapy with clarity about what you want to get from it: stability, resilience, and a better way to manage the anxious moments that are taking up too much space in your head and heart.

You’re not looking for a magic fix. You’re looking for real tools. Emotional grounding. A space to process what’s happening medically, relationally, physically. You want to stay connected to yourself and your partner. You want to stay open, hopeful—and whole.

That’s what therapy can offer you now.

Your Relationship Is A Strength—and a Priority

Going through major transitions that require intense personal strength can challenge even the strongest relationships. A partner who listens, who shows up, who wants to support you through everything. That foundation matters. And it’s worth nurturing—especially in times of stress and uncertainty. Therapy helps to provide clarity, emotional support, and a space to process personal needs so that the relationship doesn’t suffer.

You may have noticed something important: that while your partner is incredibly supportive, he sometimes holds back what’s going on inside of him. And that matters too.

Wanting to be there for him as much as he’s been there for you is not just generous—it’s wise. Because relationships thrive when both people feel seen, heard, and emotionally supported. Especially during seasons of uncertainty and stress.

Returning to therapy can help you to:

• Stay attuned to your own emotional needs without shutting your partner out.
• Develop ways of inviting your partner into gentle, open conversations—even about the hard stuff.
• Explore how to better listen and emotionally engage with his experience, while not losing yourself in the process.
• Keep your connection strong, even as you both navigate the emotional demands of this season.

This is relationship work through the lens of your individual therapy. It’s subtle but powerful—and you’re more than capable of doing it.

Navigating Anxiety in Real Time

The anxious moments you’re feeling now are likely very different from the ones you’ve experienced before. They may come out of nowhere—during a doctor’s visit, in the middle of a workday, late at night when your thoughts are racing. They may be tied to uncertainty about health, fertility, the future. Or they may simply be your body’s way of trying to make sense of all the “unknowns.”

In therapy, we’ll create space for those moments—not to get stuck in them, but to understand what they’re trying to tell you. You’ll learn how to:

• Recognize the early signals of anxious overwhelm.
• Stay with the feeling, instead of fighting it or running from it.
• Use grounding tools and nervous system regulation techniques to return to the present moment.
• Understand how your anxiety shows up in your body, your thoughts, and your patterns—and learn how to disrupt that loop with kindness and clarity.

This is work you don’t have to do alone. And you don’t have to wait until it feels unbearable.

You Deserve Support Now, Not Later

You’ve already made it through so much. You’ve shown up. You’ve stayed strong. But now it’s time to also be soft. To be supported. To stop pushing through without pause.

Therapy gives you room to breathe–to feel, to clarify, to plan with peace instead of panic. To slow down without losing momentum. And to reconnect—to yourself, your body, your desires, and your future.

Whether or not this season unfolds the way you hope, you deserve to move through it with steadiness, with dignity, and with the presence of someone in your corner—someone who’s there to hold space just for you.

You’re ready. Let’s begin.

If this feels like your next right step, reach out today. Therapy can be a powerful companion on your path toward more clarity, calm, and connection—even in life’s most uncertain seasons.

Considerations For Getting Started in Therapy

Many folks might be curious about starting therapy but struggle to know how to select a therapist or even how to consider therapy services. If you do not work in the healthcare field yourself or are new to the idea of investing in therapy, you may be very unfamiliar with how it all works.

This post aims to help people become more familiar with the current landscape of therapy so that you can make informed choices about your care.

Therapy can be life-changing with the right therapist, but it’s also an important investment of your time, energy, and money so it’s wise to be very selective when choosing a therapist.

The decision to start therapy…

Sometimes people start therapy and have a very clear reason for seeking it out and other times, they know something feels off but need some help clarifying their goals and taking meaningful and effective action.

Issues I treat/  My approach…

In my practice, I help people improve the quality of their intimate relationships and their overall emotional well-being. I work equally with individuals and partners, and I enjoy working with folks from all walks of life. My extensive and culturally informed training has allowed me to work effectively with folks across differences. I strive to create a sense of safety, trust, and comfort for my LGBTQIA+ and BIPOC clients. I also work with interracial and interfaith couples as well as expats. I deeply enjoy and value working across difference and consider myself a lifelong learner. 

One my most meaningful professional experiences thus far has been participating as a post graduate student at the Ackerman Institute for the Family here in NYC. Through scholarship, I was able to spend a full postgraduate year studying the art and skill of therapy alongside thoughtful, deeply dedicated, and curious peers and educators. During this time, we shared cases together, consulted as a team, and even participated in the extracurricular Talk Race group, where we unpacked our own intersectional identities more deeply with regard to our intention vs. impact out in the world.

I believe these unique, in-depth, and long-term training opportunities have allowed me to be the most effective, curious, and informed therapist I can be. I deeply value curiosity–both personally and professionally.

Individuals may be struggling with relational challenges, family of origin issues/ trauma (in the form of abuse or neglect), dating/sex, cultivating satisfying connection, and the stress of navigating major life transitions in general.

I often work with partners who are looking to improve their communication, cultivate a more optimal erotic intimacy, or move through the major shift of transition to parenthood. In these sessions, we dive into how to keep their relationship strong through this major life transition. We unpack communication issues, sex/ affection issues, destructive interactional patterns, outside relationships, repair after arguments, and in general — how to nurture a satisfying relationship over the long-term.

Ultimately, I help folks overcome significant barriers and move through individual blocks by providing a personalized approach based on research and my extensive clinical experience. 

Therapy can help you to recognize your interpersonal patterns and understand where you might be struggling so that you’re better equipped to handle life’s diverse challenges. The therapist can collaborate with you in a really personalized way to help you to be more effective. It is this tailored approach and the unique therapeutic relationship that you share with your therapist that makes therapy such a special, effective, and worthwhile endeavor.

Whether you are struggling with some form of self-sabotage, or feelings of loneliness or you are having difficulty in your interpersonal relationships— therapy can be a great way to begin addressing the barriers so that you can ultimately enjoy life more fully, cultivate more meaningful relationships, and experience more pleasure, joy, and satisfaction on a regular basis.

Familiarize yourself with the idea that it is a worthwhile investment of your resources.

Therapy is likely not going to feel convenient—in any way—although it might feel like just the thing you really need, it probably won’t be convenient for you.

It’s the kind of thing where you have to make time for it and really put in the effort to see the results. However, therapy with the right therapist can truly be life-changing.

Tip #1: Understand the present landscape of therapy…

Familiarize yourself with the landscape of therapy so you are informed about what’s available to you and what kind of therapist might be the best fit for you. Most therapists are trained fairly well to handle the common reasons people might come in—anxiety, depression, stress, and relationships, etc. But, based on their professional training, they might take VERY different approaches and that approach can make all the difference.

In addition, level of experience can play a huge role in the quality of your experience. While experience is optimal here, if you are on a very tight financial budget, don’t shy away from asking about sliding scale rates. Often, therapists do reserve some spots in their practice for such circumstances. 

It can also be helpful to view therapy as a time-limited investment and not this ongoing expense that never ends. This can help you contextualize the value of the service. Ideally, you will want to pursue therapy with an experienced and fully licensed clinician who has the skills, knowledge, and experience to help you in an effective and timely manner.

The therapeutic relationship is a very unique one with legal and ethical standards in place. In my practice, I personally provide a four-session diagnostic assessment for partners and a three session assessment for individuals. This approach ensures a quality fit between client and therapist so that we create the right conditions for the work ahead. I believe this is the best way to provide the most appropriate value to clients at this beginning stage.

In completing the assessment period, we gain clarity over what’s happening and what’s bringing you and/or you and your partner in and it also serves to help you assess whether I’m the right fit in a meaningful and in-depth way. 

From there, once we’ve reviewed the findings together and determined a possible course of treatment, I will let you know if I’m not the best therapist for you and will provide thoughtful referrals in this case. If we agree to proceed together, we’ll sort out a schedule based on defined treatment goals. 

While it’s tempting to think you can assess fit over the phone, it’s not the best approach–it’s simply not possible to gain a meaningful sense of therapeutic fit in a brief phone conversation that is focused on logistics of care: i.e.- scheduling, fees, and availability. In my experience, you have to schedule sessions to really see if it’s the best fit. That way, you can get a sense of the therapist’s style, personality, and approach to the work. You can also get a better sense of if you can see yourself building trust with this person. 

Looking at fees…

Let’s briefly touch on fees. In general, experienced and highly trained therapists who are fully licensed and have been practicing independently (not requiring supervision) for at least 6/7 years, will not take insurance and will most likely have higher fees. In NYC, that is generally over $275 per session. However, if you have health insurance with out of network benefits, many insurances will likely reimburse you for a large percentage of the fee. 

So for example, if the therapist charges $300 per session and your insurance covers 50% of the fee, you would receive $150 of the fee back in the form of a check from your insurance company. Sometimes, your plan may cover even more, so it’s worth checking out! In my practice, I’m happy to help you check your benefits ahead of time so you have a clear sense of what’s covered.

I have seen some plans cover up to 80% of the fee, so it’s definitely worth checking out. Many therapists also provide a sliding scale fee structure, so it can be helpful to ask about this during your initial call. 

Do some research and find out what your particular insurance plan covers. I recommend doing this as soon as you have decided to seek treatment. That way, your initial calls to therapists are more productive.

You can say to your insurance company that you’d like to see ____  provider because they specialize in _____ *insert specific issues that you are struggling with; “they have a unique background and training in this area so I feel they will be able to help me best.” You can also mention that you are looking to go to a provider who is experienced. 

Therapy can be extremely helpful if you are looking to improve your relationship to self and others. If you’ve always found your family to be a source of stress/ frustration and there have been troubling experiences in your family of origin while you were growing up, you may find a licensed marriage and family therapist is a nice choice since they will be well-versed in family and relationship dynamics and how to improve them.

Licensed MFTs will be familiar with how to best approach these issues and help you function at your best in all relationships—work, friendships, intimate partners, and of course, relationship to self.

Tip #2 Sort through the different types of trained professionals…

Some terms to help you sort through the options:

Licensed Marriage and Family Therapist – LMFTs are trained to provide high quality therapy and work with individuals, couples, and whole families, so they have a breadth and depth approach to the work. MFTs take a contextual approach to the work so they will be able to take a look at many factors that might be influencing your presenting concerns. Rather than place you into a diagnostic toolbox, they will take a holistic approach to your care. 

Psychiatrists – are medical doctors who are able to prescribe medication. Sometimes, they also provide therapy, however, you will want to look into their approach and therapeutic training to learn more about how they provide psychotherapy. In some cases, a person might have a psychiatrist as well as a therapist whom they see weekly.

Social worker – many social workers pursue a clinical career where they have completed supervised therapy (clinical) hours and clinical supervision so they can provide therapy. Not all social workers pursue this path however. You will want to look for a social worker who has the letters “LCSWR.” This ensures they have the proper clinical experience/ clinical training. 

Psychologist – these providers have completed a PhD or a PsyD and might conduct research, provide therapy, or provide a combination of the two. Again, you will want to learn about their expertise, training, and years in practice to familiarize yourself with their approach to treatment. There is a wide variety of specializations/ modalities within clinical  psychology so you may want to visit their website to learn more about their particular approach and the common issues treated.

Tip #3 Understand the difference in the options…

Here’s a very quick overview: you can receive these services through an outpatient clinic, a hospital, a stand alone clinic, or in a private practice setting. You can also pursue the services through one of those large virtual companies (i.e. Betterhelp for example) where they claim to set you up with the ‘best match for you.’ However, you will want to proceed with caution as these are large, high volume operations. I would be curious to understand how they manage to maintain high quality standards of care at such low costs and what systems are set up and in place to ensure a quality clinical experience. Remember, if it seems too good to be true–it probably is. 

If privacy is most important to you—yep, you guessed it!— A private practice setting is likely the best fit for you.

With so many choices, it would make sense that you might feel overwhelmed. However, I’m going to offer you some inside tips on how to find the best care for you to help make your search easier.

First, understand the landscape. What do I mean by that? Well, when managed care (insurance companies) took over the management of psychotherapy services in the 1980s, many things changed.

Managed care now determines the price of the therapy services, how long they deem care should go on for, and can even influence clinical decisions based on the diagnosis and what they deem is the best path or course of action. In short, the insurance companies have a lot of control over the matters related to your mental health care and what services they choose to cover. This is one of the reasons why many providers opt not be in-network with insurance companies—they would essentially be working for the insurance company instead of for themselves and their client(s).

Level of experience is part of what you are paying for…

At the present time, many experienced therapists opt to accept insurance on an out-of-network basis. Meaning that the client pays for the service up front and the therapist provides the client with a receipt so they can submit it to their insurance company for reimbursement.

This allows the therapist to maintain creative control over the therapy and set their own fees without input from the insurance companies. As a therapist who has been operating this way for a number of years, I can say that this allows for the highest quality care in a private practice setting.

An experienced and fully licensed therapist (of any discipline) has spent many years training and perfecting their craft. In addition to the standard education in graduate school, experienced therapists have likely worked in several different clinical settings and have trained for many years (postgraduate) beyond the minimal requirements of licensure. 

It can be helpful to spend a little time considering what are you looking to change/ heal from or move through in therapy…perhaps you are wrestling with a major life transition, self-image issues or your sense of self-belief.

Maybe you want to act in more confident, self-assured ways. Or, perhaps you are struggling with intimate relationships, dating, communication with a partner, anxiety/ avoidance, or work relationships—there may be many reasons you are seeking out some help and support.

People seek help at different points across the lifespan. 

Looking into low cost options…

If you do not have a job currently or you are on a very tight budget, there are many options for good care. While many experienced therapists who are operating a private practice tend not to take insurance and charge higher fees, there are several very good options that allow you to have quality care at a more budget friendly price. First, it could be helpful to check in with a clinician to see if they are offering an equitable fee structure. Many times, clinicians reserve a portion of their practice for such spots and may have some openings, it’s worth it to ask! Training clinics can also be a great place to start. Many times, the therapists at training clinics have extensive experience already but are seeking some specialized training. As a clinician who has trained at many of them in NYC, I can personally attest that there is good clinical work happening within those spaces and solid supervision. The cost of sessions at these training clinics is often very low because the majority of their revenue is coming from paid trainings that they host for therapists as well as tuition. Therefore, the cost of therapy sessions are able to be kept on the lower end.

The issue of access and affordability is a much larger conversation about our healthcare system in general. It’s a systemic problem and therefore requires a systemic consideration. Certainly, it’s not an easy or simple one to fix. The reimbursement rates to in-network providers are often very low and are not able to cover the cost of offering therapy services–and many of the insurance rates haven’t changed in decades!

In addition, insurance companies do not consider years in practice when setting reimbursement rates–this creates significant inequities across the mental health field in terms of fair and reasonable salaries for therapists. 

It will surely take thoughtful, committed action to bring about meaningful changes to our current healthcare system so that – as a society, we value more deeply the important work of therapists. Once we have a system that truly honors and values mental health across the board, the situation — including access to high quality care and services will begin to look very different.

In the meantime, therapy services vary greatly in quality and are available at different price points depending on a number of factors. 

Key takeaways given our current mental health landscape:

-Go to the most experienced therapist you can afford.

-Feel free to ask the therapist how many years of experience beyond graduate school they have as well as how many years they have been fully licensed in their state. You can also look up how long a therapist has been licensed in a particular state by searching their name on the department of licensed professions website. It will tell you how many years they have had their license.

-Private practice settings will typically offer the most privacy.

-If you are looking for an experienced and fully licensed professional, expect to pay a premium rate for treatment. However, don’t shy away from asking for a sliding scale if you truly need one. If you are curious about the benefits of therapy, you can check out my post here.

-Insurance companies typically reimburse anywhere from 50%-80% of the full fee for out of network providers. So it it worthwhile to call your insurance company and find out your reimbursement rate, deductible, number of sessions covered per year. You can also get a quick check on you out-of-network benefits here.

If you decide to call the number on the back of your card, you can ask them about the reimbursement percentage for 90791 (initial), 90834 (individual), and 90847 (couple/ family).  If they ask for the fee, you can give them $300 per session  rate so you can get an idea of what you’d actually be paying per session. Each geographic area of the country has what insurance calls a “reasonable and customary rate” based on a number of factors. NYC and SF tend to be on the higher end for example since they are more expensive cities.

-Low cost care is accessible at local training clinics, however you may have a short wait to receive the services.

-Local universities can often provide a list of low cost options in the area if you are on a tight budget or unemployed at the moment, it is worth reaching out to inquire.

I hope you have found this post helpful on your journey. I know it might be a lot to take in initially, but once you get started, it will be worthwhile! Feel free to send me an email if you have any questions about this post.

Warmly,

Jennifer