How does therapy with you work?

Here’s how it usually goes: you’ll reach out to me via email or the contact form with a little information about you and what you’re coming to therapy for. We’ll then set up a free 15-minute consultation where I can learn more about your goals for therapy and you can learn more about my therapeutic approach. From there, if you feel like we’d be a good fit to work together, we’ll establish a weekly date and time to meet. In our first session, we’ll discuss what’s bringing you to therapy in more depth, and in our second to third sessions, we’ll do a biopsychosocial assessment (BPSA). A BPSA is where we talk about all of your histories (mental health, physical health, family, religious, sexual, platonic, etc.) so that I can get a better, more holistic understanding of who you are in order to be a better therapist to you.

After we complete the BPSA, it’s off to the races! I provide talk therapy using a variety of clinical tools, but figuring out how therapy is most beneficial for you is a collaborative process. Some folks love a lot of structure in sessions, complete with homework assignments, while others prefer to just chat about what’s come up throughout the week—there’s no right or wrong approach. I tend to provide more structure and some homework in couples therapy, as I find it helps us all stay on track, but still everything is up for negotiation on what that looks like.

My therapeutic approach is eclectic—I tend to call on a variety of modalities (types of therapies) to suit each client’s unique needs. Some of my preferred modalities include psychoeducation, polyvagal theory, Exposure & Response Prevention (ERP), Internal Family Systems (IFS), Acceptance & Commitment Therapy (ACT), psychosomatic therapy, Imago dialogue, Gottman, cognitive restructuring, radical feminism, and critical race theory. I also use and welcome a variety of different frameworks to understand behavior, including astrology, humor, storytelling, pop culture references, metaphors, and analogy.

What are your fees?

My rates for weekly 50-minute sessions are:

Individual therapy / Sex therapy: $250

Couples’ therapy (2 people): $300

Couples’ therapy (3+ people): $350+

I also offer sliding scale rates on a limited basis—please feel free to contact me about this! We can discuss how to make therapy financially sustainable for you.

Do you accept insurance?

Unfortunately, I don’t accept insurance at this time. However, I’m happy to provide insurance documentation for folks who have out-of-network benefits, which may cover 50%-100% of my fees. Using out-of-network benefits looks like this: you pay the session fee following our visit, I provide you with a "superbill" (itemized receipt) that you submit to your insurance, then your insurance sends reimbursement for that session. If you’re unsure of your benefits, there should be a member services phone number on the back of your insurance card that you can call for assistance. Here are some helpful questions to ask your insurance provider to learn more about your out-of-network benefits: 

• What is my out of network deductible?

• How much of my out of network deductible has been already met?

• What is my policy period?

• What is my co-insurance?

• (If they ask for a CPT code: Individual Sessions = 90834, Couples/Family Sessions = 90847)

• How do I submit for reimbursement?

• How long do I have to submit my superbill?

I’m also happy to try for a single case agreement (SCA) where possible. An SCA is essentially a contract with your insurance company to have my services count under in-network benefits. Using an SCA looks like this: you contact your insurance company to ask about establishing an SCA, after which point I will connect with your insurance to provide the necessary documentation. Once approved, you pay an in-network co-pay (aka a fraction of the session fee) as dictated by your insurance after each session and your insurance pays me the remainder of the fee. This is possible on a case-by-case basis, as not every insurance company permits SCA’s, but I’m always happy to give it a try.

Why don’t you accept insurance?

Fair question! Insurance companies reimburse therapists at very low rates and are notoriously slow with payments. Your insurance might “pay” the $250 fee, but I would only actually receive $80 at absolute most (it’s often less). You might say “$80 is still a lot,” and you’re not wrong, however I don’t get to keep all 80 of those dollars (see the question below). I get that this is frustrating—the healthcare system is screwed all around!

Why is therapy so expensive?

Capitalism and the privatization of health care aside, there are several reasons. One, social work, as a “helping profession” and one historically done by women, is routinely undervalued. Therefore, the expectations about how much this work “should” cost often belittles the value of such work. Two, the majority of my fees go toward things like group practice fees and taxes, so I’m obligated to charge higher in order to actually make a living. Three, being a therapist is expensive! I did two very expensive years of graduate school to become a therapist and any opportunity to further my learning—like books, workshops, institute trainings—is similarly expensive. In addition to being a therapist, I am also a person, and one who lives in NYC, at that (I too suffer the cost of living crisis). In an ideal world, I’d charge $500 per session, paid for by the government, providing you access to free mental health care—but unfortunately, we are not living in an ideal world.

What are your hours of availability?

I’m available to meet Monday - Friday 9:00 am to 6:00 pm. If this doesn’t work for your schedule, I’m open to meeting outside these times on a case-by-case basis. For virtual sessions, I use Simple Practice, a HIPAA-compliant telehealth platform. I also have in-person availability on Wednesdays at our office in Midtown East, right next to Grand Central.

Triska Psychotherapy
211 E 43rd St #641
New York, NY 10017