Logistics

It is common in the field to meet weekly for 45- to 50-minute appointments. Early in my training I had the opportunity to participate in a couple therapy research study structured instead around 90-minute appointments. I was immediately struck by the depth of exploration and understanding that this facilitated, and enthusiastically revived it a few years later when the opportunity arose. 

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This choice was cemented further when I took a training through the Gottman Institute. In this training, Dr. John Gottman cited research that confirmed my experience - fewer, longer appointments produce greater gains, and those gains last much longer. To this day I have preserved this as a foundation of my practice - I begin work with couples meeting weekly for 80-90 minute appointments. Once initial gains have been made, I am open to reducing frequency and duration if it is preferred, and will generally recommend this during a taper-down phase at the end of our work together.

Longer appointments, of course, cost more per visit. However, that does not mean that the total course of therapy must necessarily cost more. Indeed, research has shown that longer, more intensive sessions facilitate deeper work and longer-lasting gains than the same number of hours spent in shorter, less-intensive therapy visits.

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When finances are tight, I prefer to do blocks of weekly appointments rather than spacing appointments out. In my experience, reducing frequency (e.g., bi-weekly) can dilute focus and allow growth to whither before it has taken root. I prefer a minimum of an 8-session block to start, and a minimum of a 4-session block when continuing. The length of gap between active blocks of therapy can vary widely based on needs and circumstances, and is at your discretion. Interestingly, when there is a cap on the number of visits, it can create increased motivation to squeeze what one can from each visit, amplifying the benefit of the work.

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As for specific rates, I charge $175 for a 50-minute appointment, and $280 for an 80-minute appointment.

As of Jan 1, 2022, the "No Surprises Act" went into effect, requiring that anyone not using insurance to pay for medical services receive a "Good Faith Estimate" (see https://www.cms.gov/nosurprises for details). While the sections above will hopefully give you the information you need to gauge cost, a formal Good Faith Estimate is also available upon request (and will be provided to all clients who initiate therapy).  

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Additional language I am required by law to post:

• You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost. Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
• Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
• If you receive a bill that is at least $400 more than your Good Faith
Estimate, you can dispute the bill.

• Make sure to save a copy or picture of your Good Faith Estimate.