Starting therapy in New York City usually means making a decision with very little information. You’ve read a few profiles, compared a few photos, and now you’re being asked to sit down with a stranger and talk about the parts of your life you’ve spent years managing under the surface.
Most of the difficulty in that first step comes from not knowing what the process involves. So here is what actually happens, from the first call through the first few months.
Before the First Session: The Free Therapy Consultation
Every client relationship at WorthyTherapy begins with a fifteen-minute consultation, before anything is booked.
It exists to answer one question: is this the right fit? Not whether you’re “ready,” and not whether your concerns are serious enough to bring in. Fit is practical. It covers what’s bringing you to therapy now, what you’ve tried before, whether our approach matches what you’re looking for, and whether the logistics work – scheduling, frequency, and how payment and insurance function in an out-of-network practice.
Insurance is part of that conversation. Dr. Worthy works on an out-of-network basis, with session fees between $250 and $400. Our LMSW clinicians are in-network with Aetna and Cigna. Verification of your benefits happens immediately after the consultation, so you know what you’re working with before an intake is scheduled rather than after.
Ask us anything on that call. People want to know how we work with your concerns specifically, or what happens if therapy doesn’t feel useful after a few sessions. Those are better asked before an intake than three sessions in.
We’ll also tell you if we’re not the right fit. If what you need falls outside our clinical focus, we’d rather say so in fifteen minutes than have you spend weeks discovering it. Sometimes the better fit is another clinician within the practice.
Nothing gets scheduled unless you want it to be. If it does, the next step is the intake.
What Our Intake Session Actually Looks Like
Once the consultation is done, we create your account in our Therapy Portal and send an invitation link. Intake paperwork lives there. We recommend completing the forms at least 48 hours before your scheduled intake, particularly the informed consent, confidentiality, and HIPAA documents, so that the session itself isn’t spent on administration.
The intake runs between 50 and 60 minutes depending on whether you’re using insurance or paying out of network. It’s longer than a standard session because it’s doing a different job. Regular sessions build on what’s already understood. The intake is where that understanding gets built in the first place.
It’s a conversation, though a conversation with a direction. We’re listening for patterns – what tends to set things off, what you do in response, what that response costs you.
By the time people get to intake, they usually know exactly what brought them in. “I get anxious before I present at work.” That’s the symptom. What most people haven’t thought about yet is what that presentation actually represents: being seen, being judged, being wrong in front of people who matter. The anxiety isn’t random. At some point it had a job, probably keeping you safe from criticism or failure. Intake is where that starts getting traced, not to diagnose someone in one session, but to start asking what the body is actually responding to, and whether that threat is still the one you’re living in now.
The History We Ask About
We’ll ask about your current concerns and how long they’ve been present. We’ll ask about your family. Not out of obligation to a script, but because the way emotion was handled in the home you grew up in tends to explain a great deal about how you handle it now. We’ll ask about relationships, work and your relationship to achievement, sleep, and any previous experience with therapy, including what worked and what didn’t.
We’ll also ask about the context you move through: culture, identity, community, and the expectations attached to them. For many of our clients, those factors aren’t background detail. They’re central to the pressure being described.
None of it has to be answered completely in one sitting. If something is too raw to open in a first meeting, say so. That’s information too, and we’ll come back to it when there’s more ground underneath it.
What We Don’t Ask You to Perform
Plenty of people arrive at therapy already good at it. They know the vocabulary. They can narrate their own patterns fluently, in complete paragraphs, with insight – and still leave every session having disclosed nothing that costs them anything. Others arrive having spent years in environments where emotional expression carried a price, and have learned to present a composed version of themselves as a matter of survival. Code-switching doesn’t stop at the door of a therapist’s office just because the office is supposed to be safe.
Whatever you bring to the first hour is enough to start with. Over time, we’ll pay attention to the distance between what’s being described and what’s actually moving underneath it, and when that distance shows up, we’ll name it – directly, and without judgment. That directness is the point. It’s the difference Dr. Keoshia Worthy, Ph.D., built this practice around after watching too many clients spend years in therapy still editing themselves.
By the end of the intake, you should leave with a clearer sense of what you’re working on and how we intend to approach it. That becomes the plan.
Building Your Personalized Treatment Plan
A practice can be trained in half a dozen modalities and still run every client through the same one, because that’s the one the clinician is most comfortable in. The training becomes a line on a website rather than something the client experiences.
Dr. Worthy is trained in Relational Psychodynamic Therapy, Cognitive Behavioral Therapy (CBT), Emotionally Focused Couples Therapy (EFCT), Internal Family Systems (IFS), and narrative approaches. In practice, those get combined rather than chosen between. A client working through anxiety tied to an old relational pattern might do cognitive work on the thought loops keeping them up at night while the relational work runs underneath it. A couple might do EFCT together while one partner does individual work on a family history that keeps surfacing in the room.
Our clinical staff extends that range further. The clinicians here come from different training routes, different disciplines, and different lived contexts, which is deliberate rather than incidental. Cultural background, immigration history, language, family structure, and community expectation shape what a client is able to say out loud and how quickly. When a client is spending energy translating their context before they can describe their problem, the work slows down.
What stays constant across everyone here is the frame. Our work is relational and trauma-informed, which means we’re consistently asking why a pattern exists rather than only how to interrupt it. Understanding the origin of a response tends to be what makes the practical tools hold once you’re outside the session and no one is coaching you through it. Every clinician in the practice works under Dr. Worthy’s supervision, so the approach stays consistent regardless of who you sit with.
The plan is also written to be revised. What surfaces in month four is rarely what you described in week one, and a plan that can’t accommodate that isn’t a plan. If a modality doesn’t sit right with you, say so. Some people want structure and homework between sessions. Others want space to think out loud without being handed an exercise. Both are workable.
What the plan draws on depends partly on which parts of the practice fit.
Start Your Therapy Journey With Confidence
How Our Counseling Services in NYC Fit Together
Individual weekly sessions are the center of the practice, though they aren’t the whole of it.
Individual therapy covers most of what brings people in – anxiety, trauma, grief, identity, perfectionism, relationship patterns that keep repeating. Couples and family work runs on a different structure and a longer session length. Some clients start individually and add couples work later. Some do the reverse.
Alongside that, we run therapy groups and workshops. Group work does something individual therapy structurally can’t: it puts you in a room with people navigating something similar. For clients whose pattern involves isolation, or the belief that their particular version of a problem is uniquely theirs, that room reaches something no amount of one-on-one conversation does.
We also operate as a training practice. Dr. Worthy supervises doctoral, master’s, undergraduate, pre-licensed, and licensed clinicians. For clients, that has a practical effect: cases here get discussed and examined in supervision rather than living entirely inside one clinician’s head. A fuller breakdown of what we treat sits on our services page, and the reasoning behind how the practice was built is in Dr. Worthy’s own account.
Our therapy services in NYC are delivered virtually across New York State. For clients managing demanding schedules or long commutes, remote sessions are frequently what makes weekly consistency possible at all.
Whichever format you’re in, the rhythm is the same.
Session Cadence and What Comes Next
Standard cadence is weekly. Session length depends on who you’re seeing and how you’re paying. Sessions with Dr. Worthy run 45 minutes for individuals. Sessions with our LMSW clinicians run 45 to 53 minutes, which varies with insurance requirements. Clinical trainees see individual clients for 45 minutes. Couples and family sessions run 60 to 75 minutes, since more people in the room means more ground to cover.
The early sessions usually go slower than people expect. There’s a common assumption that session two is where solutions start. In practice, sessions two through four are still mapping – testing whether the pattern identified in the intake holds up under closer examination, and where it came from. Progress at this stage looks like recognition. You start catching a reaction while it’s happening instead of three hours later. Relief comes after that.
We check in on progress periodically against the goals set during intake. Sometimes the plan holds. Sometimes what you came in for turns out to be sitting on top of something else, and the focus shifts. What we want to avoid is drifting for months without either of us naming that the work has moved somewhere different. You can raise this yourself at any point. If a session felt useless, saying so directly is useful information and won’t be received as a complaint.
A Note on Fit
Not every clinician is right for every client, and the first session is as much your assessment of us as ours of you. Pay attention to whether you felt able to say the true version of things or the presentable one. That’s the most reliable early signal there is.
If what you’ve read here matches what you’re looking for, starting is just a fifteen-minute call.