Everything People Ask Me Before They Start Therapy
Most people email me with some version of the same handful of questions, and they usually apologize for asking. There is nothing to apologize for. Therapy is expensive, personal, and hard to evaluate from the outside, so here are the answers I give, written out plainly.
What does therapy cost?
My sessions are $225 and I am private pay. Kate Staikos, MHC-LP, on our team is in network with Aetna and Cigna, so if using insurance matters to you, she is often the better fit. If you want to work with me and your plan includes out-of-network benefits, I send you a superbill each month that you submit for reimbursement. Worth knowing before you get your hopes up: not every plan has out-of-network coverage. Most HMO plans, many EPO plans, and Medicaid and Medicare do not reimburse out-of-network therapy at all, so for some people private pay means paying the full fee.
How do I find out what my insurance will actually reimburse?
Call the member services number on the back of your card and ask three things: whether your plan has out-of-network outpatient mental health benefits at all, what the out-of-network deductible is and how much of it you have met, and what percentage of the session fee they reimburse once the deductible is met. If the answer to the first question is no, the other two do not matter. Plans that do reimburse usually land somewhere between fifty and eighty percent after the deductible. The call takes about ten minutes and it is much better to know this at the start than three months in.
Are sessions in person or online?
Every session is by secure video. That means you can do this from your apartment, your office with the door closed, or a hotel room when work sends you somewhere. New Yorkers cancel therapy when it requires crossing town at 6pm, and telehealth removes that problem entirely. I see clients anywhere in New York State.
What actually happens in the first session?
I ask a lot of questions. Some are about what brought you in now rather than a year ago, and many are about everything else: your family, your work, your relationships, your history, what you are like on a good day and on a bad one. I am building a picture of you in full, not just the problem you came in with, because the problem usually makes sense once I can see the whole context around it. You will do most of the talking, and you do not need to prepare anything or arrive with a tidy explanation.
How do I know if we are a good fit?
Every new client starts with a short complimentary consultation, which exists for exactly this question. Sometimes it takes five minutes and sometimes it takes fifteen, depending on what you want to ask. If I am not the right therapist for you, I will say so and point you toward someone who is. Fit matters more than credentials, and most people can feel it within the first two sessions.
How often would we meet, and for how long?
Weekly, at the same time, at least at the start. Momentum matters early on, and every other week tends to turn into catching up rather than working. As for how long, some people come in for a specific problem and finish in a few months, and others stay longer because the work keeps opening into something else. Plenty of clients also stay on at a lighter cadence once the hard part is behind them, the way you would keep seeing a good internist after you feel better. Maintenance is a legitimate reason to be in therapy, not a sign that something is wrong. We talk about all of this openly rather than letting it drift.
What do you actually work on with people?
Anxiety that stays quietly switched on, perfectionism that stopped being useful, relationship patterns that repeat with different people, and the identity shifts that come with a promotion, a breakup, a move, or a baby. I also work with founders and professionals on the strain of building something while trying to keep a life. Kate works with adults with ADHD, people going through infertility and IVF, and new mothers in the first year.
What kind of therapy do you do?
CBT gives the work structure: what you are thinking, what you are doing, and how the two feed each other. Internal Family Systems adds depth, because knowing better rarely stops the reaction that takes over anyway. In practice it is direct. If something happens in session that connects to why you came in, I will say so.
Do you prescribe medication?
No. I am a licensed mental health counselor, not a prescriber. If medication seems worth considering, I will tell you, and I work alongside psychiatrists and nurse practitioners who handle that piece.
Is what I say confidential?
Yes, with the narrow legal exceptions every therapist has, which I go over in the first session so nothing is a surprise.
How do I start?
Use the contact page or call, and we will set up the short consultation. Most people hear back the same day, and there are usually openings within the week.