# Turning Leaf Therapy: Full Site Text > Full readable text of every page in the sitemap. Index version: https://turningleaftherapyservices.com/llms.txt ===================================================================== URL: https://turningleaftherapyservices.com/ ===================================================================== Now accepting new clients Deeper Work. Lasting Change. Therapy in Old City, Philadelphia. Turning Leaf Therapy is a relational, trauma-informed group practice of twenty-six clinicians across sixteen focus areas, in Old City, Philadelphia, and online across Pennsylvania and New Jersey. One conviction: change comes from being known, not from being fixed. Request your match → The sixteen specialties ↓ THE ROOM · SUITE 304, OLD CITY EST. 2017 · PHILADELPHIA IN-NETWORK Aetna Blue Cross Blue Shield United Healthcare Optum + Horizon, Highmark, Capital, Anthem, Empire & FEP Blue plans Copays & self-pay ↓ OUT-OF-NETWORK Independence Blue Cross Cigna Medicare You can still work with us. We provide superbills and most PPOs reimburse 50 to 80 percent after your deductible. Out-of-network guide → i · THE APPROACH The relationship is the work. M ost of what brings people to therapy is not a list of symptoms. It is a pattern, laid down early, carried into every room, every relationship, every quiet hour. Pills and protocols can quiet the alarm, but the fire underneath still burns. We treat that fire. Turning Leaf is a relational psychodynamic practice: the therapeutic relationship is the instrument of change, not a setting where techniques get delivered. Your symptoms are treated as signals of what needs attention, not problems to eliminate. i. Symptoms are signals, not defects. Anxiety , depression , grief : adaptive responses to circumstances that demanded them. We listen to what they point toward. ii. Trauma-informed, everywhere. Every clinician works from a trauma-informed frame; several are additionally trained in EMDR, IFS, and PE. Trauma therapy in Philadelphia is what this practice was built on. iii. Depth work, insurance prices. Most specialty practices refuse insurance. We are in-network with the plans Philadelphia actually uses, and provide superbills for everyone else. ii · WHAT WE TREAT Sixteen focus areas. One clinical frame. Not a checklist of issues we will consider. Each area is staffed by clinicians who work in it every week, inside the same relational, trauma-informed frame. Not sure which fits? Start your intake → MOOD & ANXIETY 01 Anxiety Therapy → 02 Depression Therapy → 03 Grief Therapy → TRAUMA & PTSD 04 PTSD & Complex PTSD → 05 Trauma Therapy → RELATIONAL & ATTACHMENT 06 Relationship Therapy → 07 Attachment Therapy → 08 Childhood Emotional Neglect → IDENTITY & LGBTQIA+ 09 LGBTQIA+ Affirming Therapy → 10 Identity Exploration → TEENS 11 Teen Therapy ages 13 to 17 → EATING & BODY IMAGE 12 Eating Disorder Therapy → LIFE TRANSITIONS 13 Life Transitions → MODALITIES 14 EMDR Therapy → 15 IFS Therapy → 16 Relational Therapy → ❧ Things that grow slowly tend to grow well. FROM THE PRACTICE ETHOS iii · WHERE WE MEET Therapy in our space, or yours. Same therapist, same care plan. The room just changes: in person above Chestnut Street, or HIPAA-secure video anywhere in Pennsylvania and New Jersey. N° 01 · IN PERSON Connect in person A quiet room two flights up from Chestnut. A closed door, and time that is only yours. Address 123 Chestnut St, Suite 304 Transit 2nd St MFL · PATCO Franklin Sq Hours Mon to Fri, 8 AM to 9 PM About the neighborhood → N° 02 · ONLINE Meet online From your couch, your office, or your car between meetings. Same therapist, same care, fewer miles. Coverage PA residents · select NJ Platform HIPAA-secure video Sessions 53 minutes More on telehealth → iv · HOW IT STARTS Three steps to the right therapist. No phone tag, no referral roulette. A short adaptive intake, coordinators who read it personally and verify your benefits, and a match with a clinician who has availability. Most people have a first session within about a week. Now accepting new clients 01 Share what is bringing you in. An adaptive form that asks only what applies. Self-pay? The insurance section disappears. 5 MIN 02 We match you, personally. A coordinator reviews every response, verifies your benefits, and pairs you with the clinician who fits your concern, insurance, and schedule. 1 TO 2 BUSINESS DAYS 03 Meet your therapist. Your first session is a clinical consultation, scheduled directly with the right fit. 53 MIN Begin your intake. About five minutes. Reviewed personally by our coordinator team and answered within one to two business days. Est. 2017 · 26 clinicians · Psychology Today verified Start your intake → Or call (215) 399-4128 v · THE CLINICIANS Clinicians who do this kind of work. Twenty-six clinicians, each practicing relational, depth-oriented therapy as their primary frame, not a method picked off a list. ‹ › N° 01 Psychology Resident Dr. Brian Matlaga Trauma & Attachment N° 02 Psychology Resident Dr. Taylor Dunn Trauma & Anxiety N° 03 LAPC Karla Martin González Grief & Identity, Bilingual N° 04 LAPC Annie Hawks Eating, Body Image & Identity N° 05 LSW Christine Meusz Trauma & PTSD N° 06 LSW Esha Dev Trauma & Identity N° 07 LAPC Rebecca Ewing Trauma & Life Transitions N° 08 LPC Luke Romano Relationships & Transitions N° 09 LSW Isabelle Dewyngaert Perinatal & Postpartum THE FULL TEAM All 26 clinicians → Bios, photos & specialties. vi · COVERAGE & FEES In-network with the insurance Philadelphia actually uses. Most specialized practices are out-of-network only. We are not. Work with a relational, trauma-trained clinician for a copay. Aetna All plans United Healthcare All plans Optum Behavioral & EAP Highmark BCBS Blue Cross, PA Horizon BCBSNJ Blue Cross, NJ Capital BCBS Blue Cross Anthem BCBS Blue Cross Empire BCBS Blue Cross FEP BCBS Federal employees PA VCAP Victims compensation Independence Blue Cross (IBX) , Cigna , and Medicare & Medicaid are out-of-network, with a clear superbill path. Most in-network clients pay a $15 to $50 copay after deductible. Every plan, explained → Full fee & insurance details → Out-of-network & self-pay. Self-pay session $130 to $200 In-network copay $15 to $50 OON reimbursement 50 to 80% after deductible HSA / FSA Accepted Superbills provided after every session on request. Your PPO does the rest. Self-pay rates are shared during intake, before scheduling. vii · QUESTIONS Before the first call. Everything else lives in the full FAQ and policies & forms . How much does therapy cost? + Self-pay runs $130 to $200 per 53-minute session depending on the clinician. With in-network insurance through Aetna, BCBS, United, or Optum, most clients pay a $15 to $50 copay after deductible. What insurance do you accept? + In-network: Aetna, Horizon BCBSNJ, Highmark, Capital, Anthem, Empire and FEP Blue plans, United Healthcare, Optum, and PA VCAP. IBX, Cigna, Medicare, and Medicaid are out-of-network; superbills are provided after every session on request, and most PPOs reimburse 50 to 80 percent after your out-of-network deductible. Can I do therapy online, or do I have to come in? + Both. We see clients in person at our Old City office and by HIPAA-secure video anywhere in Pennsylvania , with select clinicians also licensed in New Jersey. You work with the same therapist on the same care plan either way, and the plans we accept cover telehealth at parity with in-person sessions. Many clients alternate between the two as life requires. How long does therapy last, and how often will I meet? + Most clients begin weekly, and some move to every other week as the work progresses. Length depends on what you are working through: a focused concern may take a few months, while depth work around trauma or long-standing patterns often unfolds over a year or more. You are never signing up forever, and you and your therapist revisit the plan together. What if I'm not sure what kind of therapy I need? + That is the most common place to start, and it is exactly what our matching is built for. The short intake asks what is bringing you in, our coordinators pair you with the clinician whose focus and openings fit, and your first session is a consultation to feel out the fit. You do not need a diagnosis or a plan before reaching out. Is Turning Leaf LGBTQIA+ affirming? + Yes. LGBTQIA+ and trans-affirming therapy is one of our core specialties. Much of the team works with trans, nonbinary, queer, polyamorous, and relationship-diverse clients, with several clinicians focused on identity exploration across gender, sexuality, faith, and culture. How do I get started? + Fill out the short adaptive intake, about five minutes. Coordinators review every response personally and match you within 1 to 2 business days. Not a crisis service: if you are in crisis, call 988 or the Philadelphia Crisis Line at 215-685-6440. ❧ Begin when you are ready. Five minutes to reach out. A real person reads it. An answer within two business days. Request your match → (215) 399-4128 Not a crisis service. In crisis, call or text 988, or the Philadelphia Crisis Line at 215-685-6440. ===================================================================== URL: https://turningleaftherapyservices.com/about/ ===================================================================== Home / About old city, philadelphia About Turning Leaf Therapy Turning Leaf Therapy is a group psychotherapy practice in Old City Philadelphia, founded in 2017 by Dr. Kaycee Beglau, a clinical psychologist. Twenty-six clinicians practice here now, in a quiet suite two flights up from Chestnut Street and over secure video across Pennsylvania and, with select clinicians, New Jersey. One idea holds the practice together: the relationship is the work. What we believe Most of what brings people to therapy began in relationship, so we believe it heals in relationship too. Every clinician here practices from a relational psychodynamic foundation, with trauma-informed thinking threaded through all sixteen of our clinical focus areas, from anxiety and depression to complex trauma, attachment, and LGBTQIA+ affirming care. We treat symptoms as signals, not defects. We are not a coping-skills dispensary, and we do not promise transformation in six sessions. Things that grow slowly tend to grow well. What makes us different Three things, mostly. First, depth: our clinicians do this kind of work as their primary frame, not a method picked off a list. Second, matching: a short adaptive intake, coordinators who review it personally, and a match within 1 to 2 business days. No bots. Third, access: we are in-network with the insurance Philadelphia actually uses, including Aetna, the Blue Cross Blue Shield family, United Healthcare, and Optum, coverage most specialty practices refuse. Leadership Dr. Kaycee Beglau , Clinical Psychologist, Founder. Kaycee founded Turning Leaf in 2017 and leads the practice's clinical direction. Anne Miller-Uueda, LCSW , Executive Director. Anne oversees the daily life of the practice and maintains a clinical caseload focused on trauma and perinatal mental health. Dr. John Machalaba , Clinical Psychologist, Director of Clinical Services. John oversees the quality and consistency of clinical care across the team, and maintains a caseload focused on relationships and men's issues. Dr. Alison Tripptree , Clinical Psychologist, Director of Supervision, who leads training and supervision for our early-career clinicians. Where to find us Turning Leaf Therapy, 123 Chestnut Street, Suite 304, Philadelphia, PA 19106. (215) 399-4128 . Monday to Friday, 8 AM to 9 PM. In-person in Old City, or telehealth anywhere in Pennsylvania. keep exploring Meet the team Our sixteen specialties Fees and insurance request an appointment Request your match. A five-minute intake, a personal review, and a clinician who fits. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/team/ ===================================================================== Home / Our Team the clinicians, old city philadelphia Twenty-six clinicians. One clinical spine. Each clinician here practices relational, depth-oriented therapy as their primary frame, not a method picked off a list. All are licensed in Pennsylvania; several also serve clients in New Jersey. Filter by what brings you in. If insurance is your first filter, our guide to finding a therapist in Philadelphia who takes your insurance explains what to check before you book. All 26 All 26 Trauma & PTSD Trauma & PTSD Mood & anxiety Mood & anxiety Relationships Relationships Identity & LGBTQIA+ Identity & LGBTQIA+ Grief & loss Grief & loss Teens Teens Perinatal Perinatal EMDR & parts work EMDR & parts work Supervision Supervision n° 01 Clinical Psychologist Dr. Kaycee Beglau Founder PA n° 02 LCSW Anne Miller-Uueda Executive Director PA & NJ n° 03 Clinical Psychologist Dr. John Machalaba Director of Clinical Services PA n° 04 Clinical Psychologist Dr. Alison Tripptree Director of Supervision PA n° 05 LPC Ellis Matthews Senior Operations and Client Manager PA n° 06 LCSW Tara Bailey Clinical Supervisor PA & NJ n° 07 Clinical Psychologist Dr. Katelyn Vala Clinical Supervisor PA n° 08 Psychology Resident Dr. Brian Matlaga Therapist PA n° 09 Psychology Resident Dr. Taylor Dunn Therapist PA n° 10 LPC Luke Romano Therapist PA n° 11 LPC Samara Perez Therapist PA n° 12 LCSW Tori Mittelman Therapist PA & NJ n° 13 LCSW Laura Kochman Therapist PA n° 14 LAPC Kaitlin Battiste Therapist PA n° 15 LCSW Aldis Gamble Therapist PA n° 16 LCSW Emily Sullivan Therapist PA, DE & MA n° 17 LCSW Krista Smith-Hanke Therapist PA n° 18 LSW Leah Fogel Therapist PA n° 19 LSW Mallory Moore Therapist PA n° 20 LSW Christine Meusz Therapist PA n° 21 LSW Blake Macko Therapist PA n° 22 LSW Isabelle Dewyngaert Therapist PA & NJ n° 23 LSW Esha Dev Therapist PA n° 24 LAPC Annie Hawks Therapist PA n° 25 LAPC Rebecca Ewing Therapist PA n° 26 LAPC Karla Martin González Therapist PA Not sure who fits? Our intake coordinators review every request personally and match you within 1 to 2 business days. Start your intake or call (215) 399-4128 . ===================================================================== URL: https://turningleaftherapyservices.com/team/kaycee-beglau/ ===================================================================== Home / Our Team / Dr. Kaycee Beglau Founder Dr. Kaycee Beglau Clinical Psychologist, Founder · She/Her Leading the practice and its clinical team. No longer accepting new clients. FROM THE FOUNDER K aycee Beglau is the founder of Turning Leaf Therapy. She is no longer accepting new clients and now focuses her work on leading the practice, supporting the clinical team, and continuing to develop Turning Leaf as a place where meaningful, relational, and trauma-informed therapy can thrive. Her background Kaycee's clinical roots began in Marriage and Family Therapy, where she was drawn to the profound importance of relationships in shaping emotional health, identity, and wellbeing. From the beginning of her career, she was interested in working with children, families, and relational systems, and she came to understand healing as something that happens not only within individuals, but also through connection, safety, and attunement. As her training deepened, Kaycee became increasingly interested in health psychology and behavioral medicine. This work expanded her understanding of the mind-body connection and the many ways our lived experiences shape how we feel in our bodies, in our relationships, and in the world. Through clinical training in hospital and inpatient settings, she began to recognize the central role that trauma often plays in emotional suffering, physical symptoms, dissociation, and patterns of survival that can be deeply misunderstood. This led Kaycee to pursue specialized training in complex trauma and dissociative disorders, including advanced postdoctoral training at Sheppard Pratt's Trauma Disorders Unit, a nationally recognized program serving individuals with complex trauma and dissociative symptoms. There, she developed a deep appreciation for the careful, skilled, and profoundly human work required to support people whose experiences have often been missed, minimized, or inadequately treated. Why Turning Leaf exists When Kaycee returned home to Philadelphia, she found that it was difficult to locate a strong community of clinicians doing this kind of specialized, depth-oriented trauma work. She also experienced how painful it could be to have a full caseload and nowhere trusted to refer people who needed this level of care. That gap ultimately inspired the creation of Turning Leaf Therapy. Kaycee founded Turning Leaf to be more than a collection of individual therapists. Her vision was to create a clinical home: a place where therapists could come together around shared values, thoughtful training, strong supervision, and a commitment to doing meaningful work with depth, integrity, and care. Over time, Turning Leaf has grown into a practice of specialized clinicians serving children, adults, families, and people navigating trauma, relational pain, and complex emotional experiences. Her work with the team today More than ten years later, Kaycee remains deeply proud of what Turning Leaf has become. The practice continues to evolve as a home for relational, depth-oriented, and trauma-focused therapy, as well as a training environment for clinicians who want to develop this work with seriousness and heart. While Kaycee is no longer seeing clients directly, her ongoing work is centered on protecting and strengthening the mission that led her to begin the practice in the first place: expanding access to thoughtful, specialized therapy and creating a community where both clients and clinicians can feel held, supported, and deeply seen. Meet the clinical team → About the practice ===================================================================== URL: https://turningleaftherapyservices.com/team/anne-miller-uueda/ ===================================================================== Home / Our Team / Anne Miller-Uueda LCSW Anne Miller-Uueda I believe that healing occurs in therapy when there is a safe and trusting connection between the therapist and client. I strive to support the person sitting with me through listening with empathy and no judgments. Request your match → She/Her IV Specialties Anxiety Childhood Trauma Clinical Supervision Life Transitions Parenting Perinatal & Postpartum Sexual Violence Trauma & PTSD My Approach Relational Prolonged Exposure (PE) Trauma-Focused CBT Trauma Art Narrative Therapy Mindfulness Location In-Person / Virtual (PA, NJ & DE residents) Rate $180 per session Licensure LCSW, licensed in Pennsylvania and New Jersey, with telehealth registration in Delaware Insurance In-network with Aetna, BCBS plans (not IBX), United Healthcare, Optum, and PA VCAP. Superbills provided after every session on request. I 'm continually honored to walk alongside people as they heal, grow, and reconnect with themselves and the people they care about. With more than ten years of experience as a Licensed Clinical Social Worker, I've seen that healing happens in a safe, trusting relationship in which you can feel understood, supported, and not judged. My hope is that our sessions offer a space where you can feel less alone, open up space for curiosity, and move toward the life and relationships you're longing for. If you're carrying the weight of trauma, anxiety, or the transition to parenthood, you don't have to navigate it alone. I work with many forms of trauma, including childhood sexual abuse, sexual assault, interpersonal violence, birth trauma, and the lingering effects of parental misattunement. I also support people experiencing relational struggles, self-esteem challenges, the challenges of pregnancy and postpartum, and the day-to-day stresses that can feel overwhelming. I work with both adults and adolescents, and I also offer clinical supervision for LSWs pursuing their LCSW. My approach is relational and collaborative. We'll work together to find what feels most supportive for you, both moment by moment and over time. I draw primarily from relational and psychodynamic approaches, though I bring in mindfulness, body awareness practices, and cognitive behavioral therapies as needed. I also hold the impact of systemic oppression and intersectional identities with care. My intention is to create a trauma-informed space that affirms all identities, including LGBTQ+, and is grounded in social justice. I stand with the Black Lives Matter movement. I'm trained in several trauma-specific interventions, including Eye Movement Desensitization and Reprocessing (EMDR), Prolonged Exposure Therapy (PE), Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), and Trauma Art Narrative Therapy (TANT). Reaching out for therapy can feel vulnerable. If something here speaks to you, I'd be glad to connect. Together, we can be curious about how your past is influencing your present, and explore what healing and possibility might look like for you moving forward. See Anne’s full bio on Psychology Today request an appointment Request Anne. Our intake coordinators review every request personally. Mention Anne in the intake and we will check openings and fit, or suggest the closest match. Request Anne → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/team/john-machalaba/ ===================================================================== Home / Our Team / Dr. John Machalaba Clinical Psychologist Dr. John Machalaba I want my clients to feel empowered and free to explore themselves and grow into the person they wish to become. Request your match → He/Him IV Specialties Chronic Illness Clinical Supervision Men's Issues Relationships My Approach Relational Psychoanalytic Psychodynamic Location In-Person / Virtual (PA residents) Rate $195 per session Licensure Clinical Psychologist, licensed in Pennsylvania Insurance In-network with Aetna, BCBS plans (not IBX), United Healthcare, Optum, and PA VCAP. Superbills provided after every session on request. M y approach to therapy is one that prioritizes the creation of a relationship that is safe, mutual, and honest. My presence is calm, warm, and active. I offer my clients feedback and challenge them in ways that encourage growth, often with some levity and humor. I value knowing my clients as a person first and foremost and prioritize gaining an understanding and appreciation of their perspective. I work together with my clients to identify negative patterns in their life and provide the opportunity to create new, healthy experiences. My therapeutic approach is generally grounded in psychodynamic, existential, and humanistic theories. However, I believe that no two clients are alike and that no one approach works for everyone. For this reason, I tailor my approach to each client's unique needs through collaboration and feedback. As a licensed clinical psychologist, I have considerable experience treating depression, anxiety, trauma, and difficulties in interpersonal or romantic relationships. I am also committed to working with issues concerning identity development, diversity, and sexuality. The focus of my practice is in treating individuals from late adolescence through adulthood. I have extensive expertise working with university students and medical professionals. I also have broad experience and training in facilitating interpersonal process groups that help clients improve their relationships with others and gain a better understanding of their interpersonal interactions. See John’s full bio on Psychology Today request an appointment Request John. Our intake coordinators review every request personally. Mention John in the intake and we will check openings and fit, or suggest the closest match. Request John → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/team/alison-tripptree/ ===================================================================== Home / Our Team / Dr. Alison Tripptree Clinical Psychologist Dr. Alison Tripptree From the beginning of therapy, I want to establish a relationship that feels as comfortable and safe as possible so that we can work collaboratively to decide the direction of therapy. Request your match → She/Her IV Specialties Childhood Trauma Eating & Body Image Identity Exploration LGBTQIA+ OCD Relationships Trauma & PTSD My Approach Psychodynamic Location In-Person / Virtual (PA residents) Rate $200 per session Licensure Clinical Psychologist, licensed in Pennsylvania Insurance In-network with Aetna, BCBS plans (not IBX), United Healthcare, Optum, and PA VCAP. Superbills provided after every session on request. I seek to provide you with the flexibility and agency to choose for yourself if you would like to accept or change certain patterns within your life. I bring a gentle, calming presence to the relationship, which I balance with active challenge and feedback in order to create the possibility for new behaviors, emotions, and relationship dynamics. I work from a relational, emotion-focused psychodynamic therapy approach, which emphasizes understanding relationship patterns in the past and present in order to process the emotions related to these experiences. When we are young, we learn ways to cope with our feelings and usually these strategies were helpful at the time. However, these ways of coping frequently do not serve us anymore and in fact, disrupt our growth. We will aim to broaden these strategies so you have more options when responding to a situation. We will try to understand the meaning behind these behaviors and what it might represent. I have specialized experience working with individuals who present with developmental and relationship trauma, eating concerns and eating disorders, as well as self-injurious behavior. I also work with individuals experiencing a variety of concerns, including depression, anxiety, identity development, and attachment/relationship concerns. I have significant experience working with individuals who are exploring or have concerns related to their sexual orientation and/or gender identity. I have written letters for my clients in support of gender-affirming surgery. We can focus on your identity development and how you want to incorporate this part of yourself into your life. We can also discuss conflicts that have arisen within yourself, important others, and how you are treated in the world since questioning and/or acknowledging this part of your identity. See Alison’s full bio on Psychology Today request an appointment Request Alison. Our intake coordinators review every request personally. Mention Alison in the intake and we will check openings and fit, or suggest the closest match. Request Alison → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/team/ellis-matthews/ ===================================================================== Home / Our Team / Ellis Matthews LPC Ellis Matthews Healing happens in relationship, and the shared journey of building safety and power in ours will embolden you to move differently in yours. Request your match → They/Them IV Specialties Attachment Childhood Trauma Dissociative Disorders Eating & Body Image EMDR LGBTQIA+ Relationships Self-Harm & Suicidal Ideation My Approach Psychodynamic Integrative (EMDR) Parts Work / Ego State Ecotherapy & Somatic Practices Location In-Person / Virtual (PA residents) Rate $160 per session Licensure LPC, licensed in Pennsylvania Insurance In-network with Aetna, BCBS plans (not IBX), United Healthcare, and PA VCAP. Superbills provided after every session on request. I highly value the depth of your subjective experience, knowing there is more than one truth and certainly a myriad of dimensions to your lived experience. Using warmth, gentle challenging, and humor, we will explore, give language to and better understand the meaning behind the 'who', 'why', and 'how' of you. I believe the core of my role is connection and relationship. I work from a relational psychodynamic lens, though I draw on a variety of models including parts work/ego state, EMDR, ecotherapy & other somatic practices to collaboratively build a space that works best for your needs. Healing happens in relationship and the shared journey of building safety & power in ours will embolden you to move differently in yours. I have experience and training working with folks 14yrs & up who present with developmental and relationship trauma, dissociative disorders, eating disorders, and self-injurious behavior. As a queer and trans clinician, I have an additional focus on serving my LGBTQIA+ community. I hold a commitment to using therapy as an anti-oppressive space where you can understand and manage the impact of racism, sexism, fatphobia, ableism, homophobia, transphobia, and other forms of systemic oppression. Clients who "hate therapy" or "don't see the point" often find their way into my office, and though my teens would call me "cringe", I'm honored to hold a space that centers your autonomy while inviting even the most protected parts in. See Ellis’s full bio on Psychology Today request an appointment Request Ellis. Our intake coordinators review every request personally. Mention Ellis in the intake and we will check openings and fit, or suggest the closest match. Request Ellis → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/team/tara-bailey/ ===================================================================== Home / Our Team / Tara Bailey LCSW Tara Bailey My goal is to create a secure therapeutic relationship in which you feel seen, heard, valued, and empowered. Request your match → She/Her IV Specialties Anxiety Clinical Supervision Dissociative Disorders Parts Work Relationships Trauma & PTSD My Approach Relational Psychoanalytic Psychodynamic Attachment-Focused Integrative (IFS, EMDR, Deep Brain Reorienting, Somatic strategies & EFT) Location In-Person / Virtual (PA & NJ residents) Rate $200 per session Licensure LCSW, licensed in Pennsylvania and New Jersey Insurance In-network with Aetna, BCBS plans (not IBX), United Healthcare, and PA VCAP. Superbills provided after every session on request. M any people choose to enter therapy to gain a deeper understanding of themselves, their thoughts, feelings, and behaviors in addition to reducing distressing symptoms, and resolving problems in their personal relationships. Oftentimes, the issues we face in the present stem from painful experiences in the past. As a result of these experiences, we develop ways of coping in the world, some continue to serve us well and others may get in the way of us living a more satisfying and fulfilling life. I offer a warm, non-judgmental, and safe environment for exploration, healing, and growth. I work with individuals and couples who are dealing with a variety of concerns including anxiety, depression, grief, shame, and relationship issues. I also specialize in the treatment of complex trauma and have extensive training, supervision, and experience working with dissociative disorders. My goal is to create a secure therapeutic relationship in which you feel seen, heard, valued, and empowered. I take a collaborative approach and will work with you on identifying your goals in the present and for your future self. I am trained in EMDR, Clinical Hypnosis, IFS/Ego State/"parts of self" work, and Deep Brain Reorienting. I am a certified Relational Psychoanalyst through the Institute of Relational Psychoanalysis of Philadelphia. See Tara’s full bio on Psychology Today request an appointment Request Tara. Our intake coordinators review every request personally. Mention Tara in the intake and we will check openings and fit, or suggest the closest match. Request Tara → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/team/katelyn-vala/ ===================================================================== Home / Our Team / Dr. Katelyn Vala Clinical Psychologist Dr. Katelyn Vala The therapeutic relationship itself has the power to transform your life in ways you may have never imagined. Request your match → She/Her IV Specialties Anxiety Depression LGBTQIA+ Attachment Childhood Emotional Neglect Perfectionism & Shame Relationships Trauma & PTSD My Approach Psychodynamic Attachment-Focused Internal Family Systems (IFS) / Parts Work CBT & DBT Prolonged Exposure (PE) Cognitive Processing Therapy (CPT) Location In-Person / Virtual (PA residents) Rate $200 per session Licensure Clinical Psychologist, licensed in Pennsylvania Insurance In-network with Aetna, BCBS plans (not IBX), United Healthcare, Optum, and PA VCAP. Superbills provided after every session on request. Y ou may be surprised by how deeply childhood experiences continue to shape your daily life, relationships, and sense of self. Anxiety, depression, perfectionism, relationship issues, or difficulty with boundaries are often manifestations of deeper emotional pain and ways you learned to cope or protect yourself. If you struggle with shame, attachment concerns, people-pleasing, or feeling disconnected from yourself, I aim to provide a space where you can slow down, be vulnerable, and feel genuinely understood. I specialize in trauma, particularly complex trauma and experiences of emotional neglect or emotionally immature environments. My approach blends parts work within a deeply relational and psychodynamic lens to make sense of your inner world. Through inner child and attachment-focused work, I help clients deepen self-understanding and build more authentic, connected relationships, both internally and externally. In our sessions, I strive to create a compassionate environment where you can explore past experiences and make small yet impactful changes in your life. I balance empathy with directness, offering both support and clarity, and I incorporate a touch of humor to what might seem like a daunting process. So much can change when you let the right person in. Therapy is about more than just addressing symptoms; it’s about helping you build a more fulfilling and balanced life through a relationship that is truly therapeutic. See Katelyn’s full bio on Psychology Today request an appointment Request Katelyn. Our intake coordinators review every request personally. Mention Katelyn in the intake and we will check openings and fit, or suggest the closest match. Request Katelyn → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/team/luke-romano/ ===================================================================== Home / Our Team / Luke Romano LPC Luke Romano I am committed to fostering a warm experience and collaborative process tailored to fit your needs. Request your match → He/Him IV Specialties Anxiety Depression Identity Exploration LGBTQIA+ Life Transitions Relationships My Approach Relational Psychoanalytic Psychodynamic Location In-Person / Virtual (PA residents) Rate $150 per session Licensure LPC, licensed in Pennsylvania Insurance In-network with Aetna, BCBS plans (not IBX), United Healthcare, Optum, and PA VCAP. Superbills provided after every session on request. I support my clients as they navigate relationship challenges and life transitions, cope with traumatic experiences, and grapple with complex family dynamics. With advanced training in relational psychodynamic therapy, I specialize in trauma informed mental health treatment based on the development of a strong therapeutic relationship. My work with LGBTQ+ individuals rests on affirming principles, and all of my work considers the impacts of structural harms. My sessions are grounded in compassion and curious listening. I provide warm guidance as my clients get to know their inner, emotional world with greater depth. This approach is rooted in the belief that the more we understand ourselves, the clearer the path to change becomes. My aim is to create a comfortable space for you to explore, heal, and grow. I am committed to fostering a collaborative process tailored to fit your needs, and I appreciate that the fit is critical in finding a therapist with whom you feel comfortable and can trust. Please feel free to reach out for a free consultation prior to making an initial appointment. I’m here to discuss any questions you may have. See Luke’s full bio on Psychology Today request an appointment Request Luke. Our intake coordinators review every request personally. Mention Luke in the intake and we will check openings and fit, or suggest the closest match. Request Luke → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/team/samara-perez/ ===================================================================== Home / Our Team / Samara Perez LPC Samara Perez I believe therapy can be a beneficial tool for any person that choses it, and I am honored when I am allowed to be a part of someone’s healing journey. Request your match → She/Her IV Specialties Anxiety Childhood Trauma Chronic Illness Depression Grief & Loss Life Transitions Parts Work Relationships My Approach Psychodynamic Person-Centered Attachment-focused Internal Family Systems (IFS) Somatic & Mindfulness-Based Approaches Location In-Person / Virtual (PA residents) Rate $150 per session Licensure LPC, licensed in Pennsylvania Insurance In-network with Aetna, BCBS plans (not IBX), United Healthcare, Optum, and PA VCAP. Superbills provided after every session on request. A re you feeling overwhelmed and stuck but are nervous to ask for help? I'm glad you're here. My approach to therapy is largely Person-Centered, meaning I respect what feels most important to you and will follow your lead. We will work in a non-directive manner with curiosity and compassion, as I recognize that you are a person with unique qualities and experiences. I strive to learn about you as a full person and become familiar with all of your parts, the happy, the sad, the angry, the scared, at a pace that works for you. Together, we will work collaboratively to achieve your goals and create the life that you want. I work with adults of all ages experiencing a variety of issues related to depression, anxiety, relationship and attachment issues, life stressors/adjustments, grief/loss, chronic illness and the effects of all kinds of traumas. I tend to use humor and empathy to connect with and support you through your journey of healing and discovery. My role is to support you through this journey of healing, discovery, and self-improvement, to help provide some perspective, or to ask questions to help build greater insight, understanding, and self-compassion. Most importantly, my role is to hold space for you and with you. I value the client's needs and building a strong therapeutic relationship, where you can feel heard, seen, and accepted. I have completed my Master's degree at Thomas Jefferson University's program in Community and Trauma Counseling. I am specializing in trauma-informed therapy, and my work is extensively focused on understanding the effects of childhood trauma on individuals in later life when left untreated. I encourage you to listen to your gut but also, to take a chance. Imagine what it might feel like to put yourself first. Although the work is hard and can be uncomfortable, I am here to empathize with you and support you in ways that are unique to you. I look forward to walking with you in this journey! See Samara’s full bio on Psychology Today request an appointment Request Samara. Our intake coordinators review every request personally. Mention Samara in the intake and we will check openings and fit, or suggest the closest match. Request Samara → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/team/tori-mittelman/ ===================================================================== Home / Our Team / Tori Mittelman LCSW Tori Mittelman For me, therapy isn’t about being “fixed” - it’s about being found. Request your match → She/Her IV Specialties ADHD Anxiety Creatives & Artists Depression First Responders Identity Exploration LGBTQIA+ Trauma & PTSD Women's Issues My Approach Relational & Psychodynamic Play Therapy Integrative CBT & CBT-I EMDR Location In-Person / Virtual (PA & NJ residents) Rate $150 per session Licensure LCSW, licensed in Pennsylvania and New Jersey Insurance In-network with Aetna, BCBS plans (not IBX), United Healthcare, Optum, and PA VCAP. Superbills provided after every session on request. B efore becoming a therapist, I spent years in the theatre, helping people tell their stories, find their voices, and sit in the beautiful chaos of being seen. That same creative spirit guides my work in the therapy room. Together, we'll explore what's working, what's not, and gently (or not-so-gently) challenge the stories that keep you feeling stuck. My background includes trauma and crisis work in the Emergency Department at the Children's Hospital of Philadelphia, where I supported children, teens, and families through some of their hardest moments. I blend evidence-based approaches, including CBT, CBT-I, EMDR training, and narrative therapy, with a psychodynamic and relational lens. At the heart of my work is connection: I want you to feel safe showing up as your whole self, messy, brilliant, funny, heartbroken, healing, or all of the above. As a lifelong military brat, I bring an appreciation for diverse cultures, identities, and life experiences into every session. I enjoy working across age ranges and especially love supporting young adults and college-aged clients navigating transition, identity, and the big emotional shifts that come with growing into yourself. When I'm not in session, you can usually find me baking bread, playing with my dogs, or dreaming up new ways to over-plant my (slightly shady) backyard garden. For me, therapy isn't about being "fixed", it's about being found. See Tori’s full bio on Psychology Today request an appointment Request Tori. Our intake coordinators review every request personally. Mention Tori in the intake and we will check openings and fit, or suggest the closest match. Request Tori → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/team/laura-kochman/ ===================================================================== Home / Our Team / Laura Kochman LCSW Laura Kochman I think of therapy as a space where we can explore not only what is difficult or distressing, but also what is joyful, connective, warm, and creative. Request your match → She/Her IV Specialties Anxiety Creatives & Artists Eating & Body Image Grief & Loss Identity Exploration Intergenerational Trauma LGBTQIA+ Neurodivergence Trauma & PTSD My Approach Relational Psychodynamic Location In-Person / Virtual (PA residents) Rate $150 per session Licensure LCSW, licensed in Pennsylvania Insurance In-network with Aetna, BCBS plans (not IBX), United Healthcare, Optum, and PA VCAP. Superbills provided after every session on request. I believe that noticing what goes unspoken is just as important as recognizing the patterns in your life, and that not-knowing is just as valuable as curiosity. My approach is primarily relational and psychodynamic, meaning that our work is rooted in the relationship that unfolds between us and how it may illuminate aspects of your relationships to yourself, to others, and to the systems around us. I view mental health through the lens of intersectionality, keeping in mind the impact of histories both personal and collective. At the same time, I believe that you know yourself deeply, and that it is essential to listen without making assumptions about your experiences and what might feel most pressing for you. While I work with clients of all identities and areas of concern, I have a specific background in working with people under the LGBTQ+ umbrella, people exploring their relationships to their bodies, people who identify as neurodivergent and/or disabled, and people with complex, intergenerational, and/or cultural trauma histories. I also have experience with adults of all ages, particularly those whose lives are in transition, and I have worked with groups as well as individuals. My hope is that we can collaborate in creating a safe-enough space for your whole self to emerge; I'm honored to meet you there. See Laura’s full bio on Psychology Today request an appointment Request Laura. Our intake coordinators review every request personally. Mention Laura in the intake and we will check openings and fit, or suggest the closest match. Request Laura → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/team/kaitlin-battiste/ ===================================================================== Home / Our Team / Kaitlin Battiste LAPC Kaitlin Battiste I strive to honor each client’s unique story, strengths, and values while helping them build greater clarity and self-understanding. Request your match → She/Her IV Specialties Anxiety Childhood Trauma Depression Grief & Loss Life Transitions Relationships Women's Issues My Approach Person-Centered Psychodynamic Relational Cognitive Behavioral Therapy (CBT) Acceptance and Commitment Therapy (ACT) Internal Family Systems (IFS) Somatic & Mindfulness-Based Approaches Location In-Person / Virtual (PA residents) Rate $130 per session Licensure LAPC, licensed in Pennsylvania Insurance In-network with Aetna, BCBS plans (not IBX), and PA VCAP. Superbills provided after every session on request. M y therapeutic approach is grounded in Person-Centered, Psychodynamic, and Relational frameworks, and I often integrate Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and parts of Internal Family Systems (IFS), though I am not formally trained in IFS at this time. I also incorporate somatic and mindfulness-based approaches, drawing on my background as a yoga teacher to support clients in understanding their nervous system states and cultivating deeper mind-body awareness. I am deeply passionate about walking alongside individuals as they engage in self-exploration, heal from past experiences, and navigate the stressors and transitions of daily life. My work is trauma-informed and person-centered, and I strive to honor each client's unique story, strengths, and values while helping them build greater clarity and self-understanding. I aim to create a warm, grounding, and non-judgmental space where clients feel safe to explore themselves with curiosity and warmth. I hope to support individuals in developing self-compassion, strengthening their inner resources, and reconnecting with a more authentic, aligned sense of self. See Kaitlin’s full bio on Psychology Today request an appointment Request Kaitlin. Our intake coordinators review every request personally. Mention Kaitlin in the intake and we will check openings and fit, or suggest the closest match. Request Kaitlin → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/team/aldis-gamble/ ===================================================================== Home / Our Team / Aldis Gamble LCSW Aldis Gamble I believe that every individual client is unique, and no single approach will be universally effective. Request your match → He/Him IV Specialties Anxiety Attachment Childhood Emotional Neglect Childhood Trauma Dissociative Disorders Identity Exploration Intergenerational Trauma Relationships My Approach Psychodynamic Relational Body-Based Mindfulness Location In-Person / Virtual (PA residents) Rate $150 per session Licensure LCSW, licensed in Pennsylvania Insurance In-network with Aetna, BCBS plans (not IBX), United Healthcare, Optum, and PA VCAP. Superbills provided after every session on request. M y approach to therapy begins by creating welcoming and honest space in which I can get to know my clients as people. I strive to collaboratively explore their challenges and difficulties, as well as their joys and successes. I believe deeply in each person's capacity for resilience and healing. I believe that healing happens in supportive relationships. I enjoy building such connections with clients to support them working towards becoming the version of themselves they want to be. My work is grounded in relational and psychodynamic theories. I believe that exploring past and current relationships can provide opportunities for growth, healing, and positive experiences. I believe that every individual client is unique, and that no single approach will be universally effective. Because of this, I shape my approach to each client's needs. My areas of clinical interest and experience include navigating relationship challenges, making sense of painful or difficult childhood experiences, anxiety, depression, body image issues, trauma, abuse, and neglect. I have experience working with clients of all genders around issues related to gender, sexuality, and sexual health. See Aldis’s full bio on Psychology Today request an appointment Request Aldis. Our intake coordinators review every request personally. Mention Aldis in the intake and we will check openings and fit, or suggest the closest match. Request Aldis → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/team/emily-sullivan/ ===================================================================== Home / Our Team / Emily Sullivan LCSW Emily Sullivan My priority as a clinician is to co-construct an environment that feels affirming, warm, and responsive to the needs of clients managing various life challenges and traumas including sudden deaths. Request your match → She/Her IV Specialties Anxiety Creatives & Artists Depression Grief & Loss Identity Exploration Intergenerational Trauma Neurodivergence Relationships Trauma & PTSD My Approach Relational Psychodynamic Existential Internal Family Systems (IFS) EMDR Emotion-Focused Location In-Person / Virtual (PA, DE & MA residents) Rate $150 per session Licensure LCSW, licensed in Pennsylvania and Delaware; LICSW in Massachusetts. Insurance In-network with Aetna, BCBS plans (not IBX), United Healthcare, Optum, and PA VCAP. Superbills provided after every session on request. M y priority as a clinician is to co-construct an environment that feels affirming, warm, and responsive to the needs of clients managing various life challenges and traumas including sudden deaths. My therapy style incorporates relational, psychodynamic, and existential frameworks that invite clients to build awareness of their inner systems, claim their autonomy, and move toward meaningful change, at a pace that feels right for them. I blend modalities such as Internal Family Systems (IFS), Eye Movement Desensitization and Reprocessing (EMDR), and emotion-focused approaches with my clients, and my practice is always informed by grief and loss, even if a client's feelings are not associated with a death. I hold precious the opportunity to practice humility as I walk alongside clients who are willing to generously share their stories, and I will never pretend to know more about a client's experiences than them, as I believe they are the true experts. I hold a master's degree in social work from the University of Pennsylvania and have worked in community, hospital, and group practice settings. As a clinical social worker, my perspectives are informed by intersectionality and harm reduction, and I highly value learning about the strengths of clients as well as what helps them to keep going when things feel impossible. I love to connect, human to human, with clients while learning about them as whole people and collaborating with them to ensure our work best honors their desires, goals, and agency. I currently offer psychotherapy for people of all ages, particularly teens, young adults, and people grieving suicides or other traumatic deaths of loved ones; I also volunteer in several capacities outside of work with bereaved people, as informed by my own loss experiences. See Emily’s full bio on Psychology Today request an appointment Request Emily. Our intake coordinators review every request personally. Mention Emily in the intake and we will check openings and fit, or suggest the closest match. Request Emily → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/team/krista-smith-hanke/ ===================================================================== Home / Our Team / Krista Smith-Hanke LCSW Krista Smith-Hanke I believe that healing is available to all individuals, and that when we commit to individual healing, we take steps toward collective healing. Request your match → She/They IV Specialties Anxiety BPD Depression Intergenerational Trauma LGBTQIA+ Life Transitions Parenting Relationships Trauma & PTSD Women's Issues My Approach Relational & Psychodynamic Internal Family Systems (IFS) & Parts-Work Experiential Therapy Art Therapy Play Therapy Mindfulness-Informed Body Awareness & Somatic-Informed Person-in-Environment Framework Location In-Person / Virtual (PA residents) Rate $150 per session Licensure LCSW, licensed in Pennsylvania Insurance In-network with Aetna, BCBS plans (not IBX), United Healthcare, Optum, and PA VCAP. Superbills provided after every session on request. F oundational relationships and childhood experiences shape who we are, what we think, and how we behave. I approach therapy with curiosity about how the impacts of these relationships and experiences show up across your life. I’m interested in identifying patterns, exploring the ways trauma manifests in your life, looking at how relationships and systems impact your identity, and noticing the connections between past and present. I work with children, adolescents, and young adults around themes of identity development, life transitions, complex trauma, abuse and neglect, gender & sexuality, attachment issues, and relationship challenges. My practice is centered around our therapeutic relationship and incorporates elements of parts work and experiential/creative arts therapies. It is important to me to create an approach that is tailored specifically to what you want and need. My style is playful, challenging, and grounded in curiosity - above all, I want you to feel understood. I specialize in working with people who have experienced childhood trauma, parental mis-attunement, attachment trauma, and complicated familial dynamics. I ground our work in the relationship between us, focusing on connection and understanding. Together we will make note of patterns, feelings, and dynamics playing out between us. I believe that, ultimately, you are the expert of your own experience. Through our relationship, I hope to give you the space you need to be your whole self. I look forward to co-creating that space together, and supporting you through reflection, healing, and growth! See Krista’s full bio on Psychology Today request an appointment Request Krista. Our intake coordinators review every request personally. Mention Krista in the intake and we will check openings and fit, or suggest the closest match. Request Krista → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/team/leah-fogel/ ===================================================================== Home / Our Team / Leah Fogel LSW Leah Fogel Therapy is an opportunity to find compassion for yourself, to heal, and to celebrate the successes. Request your match → She/Her IV Specialties Anxiety Depression Grief & Loss Life Transitions Neurodivergence Trauma & PTSD My Approach Holistic Psychodynamic Strengths-based Trauma-informed Internal family systems informed Location In-Person / Virtual (PA residents) Rate $130 per session Licensure LSW, licensed in Pennsylvania Insurance In-network with Aetna, BCBS plans (not IBX), and PA VCAP. Superbills provided after every session on request. S tarting therapy can feel like a big step in asking yourself to delve deep into self-exploration and vulnerability, but it's not a process you need to take on alone. My role is to walk alongside you, to offer a safe, caring space built on trust, honesty, authenticity and humor for you to explore your story. I work with adults who are moving through experiences of trauma or complex trauma, depression, anxiety, grief and loss, neurodivergence, and times of transition. In our sessions, I draw from strengths-based, psychodynamic, trauma-informed, and Internal Family Systems approaches. What this means is that while we look at the challenges you're facing, we'll also recognize the strengths you already carry, which are powerful building blocks for growth and healing. Our past experiences shape so much of how we move through the world, where we feel safe, how we cope, what drives us, and what brings us joy. Together, we'll explore the different parts of you in ways that feel supportive and tailored to your needs. Before joining Turning Leaf Therapy, I worked with people who were incarcerated. That experience, both meaningful and difficult, opened my eyes even more to the systemic barriers that many people face. I'm dedicated to seeing each person as more than their circumstances, and to working collaboratively and holistically. I also hold a deep commitment to anti-racism, advocacy, and amplifying voices that too often go unheard. I believe that healing as an individual is another step towards healing as a collective. If you're ready to begin this journey, I'm here to walk with you. See Leah’s full bio on Psychology Today request an appointment Request Leah. Our intake coordinators review every request personally. Mention Leah in the intake and we will check openings and fit, or suggest the closest match. Request Leah → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/team/mallory-moore/ ===================================================================== Home / Our Team / Mallory Moore LSW Mallory Moore Together, we can work to build emotional insight, address limiting beliefs, and explore new possibilities. Request your match → She/Her IV Specialties Anxiety Grief & Loss Identity Exploration LGBTQIA+ OCD Self-Harm Trauma & PTSD My Approach CBT and DBT Informed Integrative Mindfulness Informed Narrative and Expressive Arts Relational Location In-Person / Virtual (PA residents) Rate $130 per session Licensure LSW, licensed in Pennsylvania Insurance In-network with Aetna, BCBS plans (not IBX), and PA VCAP. Superbills provided after every session on request. P eople often seek therapy during times of overwhelming transition or times when they feel agonizingly stuck. As a licensed social worker, I collaborate with my clients to move beyond shame and develop curiosity about their symptoms of distress. My professional background includes inpatient psychiatric care and school counseling, settings where I developed strong crisis management skills and a profound appreciation for the way childhood experiences impact our development across the life course. Everyone has their own story, and I take a trauma-informed, client-centered approach to therapy, supporting each individual in defining what healing means to them. In the early stages of therapy, I often incorporate cognitive-behavioral strategies and mindfulness skills in order to provide concrete symptom relief, especially for those experiencing acute anxiety, obsessive compulsive tendencies, or body-focused repetitive behaviors. As trust develops, we may examine deeper relational patterns shaped by early childhood, trauma, and identity. I pay special attention to the ways in which oppressive systems and intergenerational family dynamics impact personal suffering. Nothing exists in a vacuum, and situating pain within context can be a powerful step towards increasing self-compassion and identifying opportunities to enhance agency. During my graduate studies at the University of Pennsylvania, I learned to take a person-in-environment approach to care, completed training in cognitive behavioral therapy for suicide prevention through the Center for Deployment Psychology, and earned a certificate in LGBTQ+ policy and practice. I also conducted original research on stigma and body-focused repetitive behaviors, presenting my work at Oxford University. In my free time, I enjoy making collages, going on picnics, and reading library books. I strive to keep creativity, humility, and sensitivity at the center of my practice. Together, we can work to build emotional insight, address limiting beliefs, and explore new possibilities. I would be honored to meet you. See Mallory’s full bio on Psychology Today request an appointment Request Mallory. Our intake coordinators review every request personally. Mention Mallory in the intake and we will check openings and fit, or suggest the closest match. Request Mallory → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/team/christine-meusz/ ===================================================================== Home / Our Team / Christine Meusz LSW Christine Meusz No matter what brings you into this work, I will meet you with respect, care, and genuine commitment to supporting your growth on your own terms. Request your match → She/Her IV Specialties Anxiety Depression Dissociative Disorders Grief & Loss Identity Exploration Immigrant & Refugee Life Transitions Relationships Trauma & PTSD My Approach Relational & Psychodynamic Internal Family Systems (IFS) and Parts Work Existential Artistic and Creative Expression Body/Somatic Informed Location In-Person / Virtual (PA residents) Rate $130 per session Licensure LSW, licensed in Pennsylvania Insurance In-network with Aetna, BCBS plans (not IBX), and PA VCAP. Superbills provided after every session on request. T ending to a relationship with yourself is a continuous practice, shaping the way you show up in all areas of life. With ongoing attention and care, I am dedicated to understanding how you experience your own story and your relationships, the complex history and challenges that shape your inner life, and the unique ways you navigate a world where change is constant. Being vulnerable can be an act of courage, and I endeavor to listen with empathy and non-judgmental curiosity, walking alongside you as we explore what matters most. My approach is rooted in psychodynamic, client-centered, and existential theories. I attend to each individual's unique needs and strengths while cultivating a space of safety that allows for honest reflection and new inner truths and experiences to surface. I have experience working with teens and young adults facing a wide range of concerns, including depression and life stressors, the impacts of complex trauma, identity exploration and integration, and acculturation stressors faced by multicultural and minoritized identities. I also have specific background in working with survivors of relational and domestic violence, as well as individuals who have caused harm. I incorporate elements of Internal Family Systems (IFS), ACT, along with creative expression, as pathways to support healing. No matter what brings you to this work, I will meet you with respect, care, and a genuine commitment to supporting your growth on your own terms. It would be an honor to walk with you towards the life you envision. See Christine’s full bio on Psychology Today request an appointment Request Christine. Our intake coordinators review every request personally. Mention Christine in the intake and we will check openings and fit, or suggest the closest match. Request Christine → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/team/blake-macko/ ===================================================================== Home / Our Team / Blake Macko LSW Blake Macko My goal is to support you in facing and embracing all aspects of yourself, especially the ones that feel most unworthy of love. Request your match → He/They IV Specialties Anxiety Depression Grief & Loss Identity Exploration LGBTQIA+ Relationships Trauma & PTSD My Approach Relational Psychodynamic Attachment-Focused "Parts of Self" Work Integrative (CBT, DBT, IFS) Mindfulness Somatic Awareness Strengths-Based Location In-Person / Virtual (PA residents) Rate $130 per session Licensure LSW, licensed in Pennsylvania Insurance In-network with Aetna, BCBS plans (not IBX), and PA VCAP. Superbills provided after every session on request. I view therapy as a collaborative process centered around the co-creation of a safe environment for self-discovery. The relationship between therapist and client is the most important aspect of the work, as it creates the container for insight and growth to occur. Therapy is not one person fixing the problems of another, but rather two people coming together in compassion and respect to learn more about the human condition from one another and discover new paths forward. My work is rooted in relational therapy, focusing on the "here-and-now" of our dynamic as a way to explore patterns and uncover the influence of early experiences. I pay attention not just to symptoms, but to the emotional and relational contexts that give rise to them, including how you navigate trust, vulnerability, boundaries, and connection. My approach is integrative and trauma-informed, drawing from psychodynamic theory alongside evidence-based practices like CBT, DBT, and IFS parts work. My clinical work is informed by my background in yoga, meditation, and bodywork, supporting clients in developing deeper mind-body awareness as a natural aspect of the healing process. I'm especially passionate about working with LGBTQIA+ folks navigating identity, trauma, anxiety, and relationship challenges. My clinical experience includes university counseling, refugee resettlement, and LGBTQIA+ community care. Above all, I strive to offer a warm, affirming space where all parts of you are welcome. See Blake’s full bio on Psychology Today request an appointment Request Blake. Our intake coordinators review every request personally. Mention Blake in the intake and we will check openings and fit, or suggest the closest match. Request Blake → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/team/isabelle-dewyngaert/ ===================================================================== Home / Our Team / Isabelle Dewyngaert LSW Isabelle Dewyngaert I believe therapy starts with a safe and supportive partnership between client and therapist. Request your match → She/Her IV Specialties Anxiety Depression Grief & Loss Identity Exploration Infertility Life Transitions OCD Perinatal & Postpartum My Approach Relational & Psychodynamic Internal Family Systems (IFS) and Parts Work Existential Artistic and Creative Expression Body/Somatic Informed Location In-Person / Virtual (PA & NJ residents) Rate $130 per session Licensure LSW, licensed in Pennsylvania and New Jersey Insurance In-network with Aetna, BCBS plans (not IBX), and PA VCAP. Superbills provided after every session on request. W hether you're considering starting therapy for the first time or returning after a break, it's normal to have questions about what the process might look and feel like. That is completely understandable. I'm here to help you explore and clarify how therapy could support you, whether you're dealing with a recent life event or something you've been carrying for a long time. I believe therapy works best when it begins with a partnership between us that will serve as the foundation of our work together. Once we meet, we will decide what our work will look like and what approach will best serve you and your individual needs. Generally, my approach is relational and psychodynamic, which just means I pay attention to what happens in our sessions to better understand how you relate to others and yourself. We might explore patterns in your history and present, gently questioning old ones that no longer work and discovering new possibilities. I also incorporate evidence-based practices (such as CBT or DBT techniques) when appropriate. Above all, I am committed to a trauma-informed and individualized approach, considering how to make our work together feel safe and supportive for you. I support people going through a broad range of challenges, like anxiety, depression, big life changes, or relationship struggles. I have experience in a range of clinical settings, including university and college counseling. My goal is to create a space where you can bring your full self, your thoughts, your feelings, your questions, without judgment. Together, we'll build a trusting relationship and work toward meaningful change, both inside and outside of therapy. I look forward to meeting you and starting from wherever you are. We can figure out the next step together. See Isabelle’s full bio on Psychology Today request an appointment Request Isabelle. Our intake coordinators review every request personally. Mention Isabelle in the intake and we will check openings and fit, or suggest the closest match. Request Isabelle → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/team/esha-dev/ ===================================================================== Home / Our Team / Esha Dev LSW Esha Dev Helping clients find acceptance and belonging within themselves is at the heart of why I do this work. Request your match → She/Her IV Specialties Anxiety Childhood Trauma Depression Grief & Loss Identity Exploration IFS & Parts Work LGBTQIA+ Life Transitions Relationships Trauma & PTSD Women's Issues My Approach Relational Psychodynamic Internal Family Systems (IFS) Acceptance & Commitment Therapy (ACT) Narrative Therapy Location In-Person / Virtual (PA residents) Rate $130 per session Licensure LSW, licensed in Pennsylvania Insurance In-network with Aetna, BCBS plans (not IBX), and PA VCAP. Superbills provided after every session on request. W hether a recent event has brought you here or you’ve been carrying something difficult for a long time, therapy can be a space to slow down and give it the attention it deserves. Together, we’ll explore what feels most important to you, at your pace. I work with adults navigating trauma, anxiety, depression, grief and loss, identity questions, difficult family dynamics, and substance use. Whatever you’re carrying, you’re welcome here. This includes adult children of immigrants, people from multicultural backgrounds, and people of color. As a South Asian daughter of immigrants, questions of belonging, obligation, and identity are ones I’ve navigated myself. The ways we’ve learned to move through the world and keep ourselves safe tend to stay with us, often in ways we don’t recognize. That can be where the work begins, and where a better sense of belonging starts to become possible. Central to that process is the therapeutic relationship, which I build on safety and trust. This creates a space to better understand what you want and need, apart from others’ expectations. My approach is relational and trauma-informed, and I bring warmth and levity into the room. I draw on IFS to help make sense of different parts of you that can feel in conflict, ACT to reconnect with what actually matters to you, and Motivational Interviewing for when you’re unsure about change. Before joining private practice, I worked in university counseling settings and with immigrant and refugee communities. That work deepened my understanding of how trauma and systemic inequity shape a person’s inner life, and reinforced social justice as foundational to my clinical work. I am a Licensed Social Worker working toward my LCSW. I’m glad you’re taking this step, and I look forward to meeting you. See Esha’s full bio on Psychology Today request an appointment Request Esha. Our intake coordinators review every request personally. Mention Esha in the intake and we will check openings and fit, or suggest the closest match. Request Esha → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/team/annie-hawks/ ===================================================================== Home / Our Team / Annie Hawks LAPC Annie Hawks This is a space where you can show up as you are, without feeling judged or shamed. Request your match → She/Her IV Specialties Eating & Body Image Identity Exploration Relationships Trauma & PTSD Women's Issues My Approach Person-Centered Psychodynamic Relational Strengths-Based Acceptance & Commitment Therapy (ACT) Holistic Integrative Location In-Person / Virtual (PA residents) Rate $130 per session Licensure LAPC, licensed in Pennsylvania Insurance In-network with Aetna, BCBS plans (not IBX), and PA VCAP. Superbills provided after every session on request. M aking the decision to begin therapy and allow yourself to be vulnerable is not easy. It takes courage, trust, and a willingness to explore parts of yourself that may feel painful or uncertain. Many of us who choose to begin this journey are unsure if we should open up or if it is even "worth it" to share our pain. My therapeutic approach focuses on establishing a sense of safety before anything else. From there, we work collaboratively to tailor therapy to your unique needs as an individual. Regardless of which approaches I may pull from (CBT, DBT, ACT, etc.), my work is informed by intersectionality, a strengths-based perspective, and a relational psychodynamic lens. I believe we are shaped by our past experiences, our relationships, and the environments we are a part of. Therapy can offer the space to explore these patterns with curiosity and compassion. I also recognize that our experiences don't exist in a vacuum. Race, culture, identity, and broader societal structures all leave their mark on who we are, shaping our sense of self, our relational patterns, and the ways we've learned to cope or simply survive. As an Asian American and queer clinician, these are themes I hold close in my own life as well as in my work, and I am able to work with Mandarin-speaking individuals. That context matters, and it's always part of the conversation. This is a space where you can show up as you are, without feeling judged or shamed. I'm warm and strive to provide a validating experience, but I also provide gentle challenges when it'll help you grow. The relationship we build together is something I take seriously, and my goal is for you to feel truly seen and supported throughout the process. I have experience working with individuals struggling with anxiety, depression, PTSD, interpersonal difficulties, body image concerns, and a broad range of other presenting issues. Whatever brings you here, you do not have to face it alone. I would be honored to walk alongside you through this process whenever you feel ready to reach out. See Annie’s full bio on Psychology Today request an appointment Request Annie. Our intake coordinators review every request personally. Mention Annie in the intake and we will check openings and fit, or suggest the closest match. Request Annie → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/team/rebecca-ewing/ ===================================================================== Home / Our Team / Rebecca Ewing LAPC Rebecca Ewing Meaningful change happens through a relationship that is genuine, thoughtful, and emotionally honest. Request your match → She/Her IV Specialties Anxiety Attachment Childhood Emotional Neglect Childhood Trauma Depression IFS & Parts Work Life Transitions Trauma & PTSD My Approach Relational Psychodynamic Trauma-Informed Integrative Acceptance & Commitment Therapy (ACT) Attachment-Focused DBT (Dialectical Behavior Therapy) Psychoanalytic Location In-Person / Virtual (PA residents) Rate $130 per session Licensure LAPC, licensed in Pennsylvania Insurance In-network with Aetna, BCBS plans (not IBX), and PA VCAP. Superbills provided after every session on request. I f you’re exhausted from carrying more than anyone seems to see, stuck in patterns that no longer serve you, or frustrated by therapy that felt too surface-level or disconnected from your lived experience, you are not alone. Together, we can make sense of the impact of trauma, burnout, fear, and painful relationships while creating space for meaningful and lasting change. I believe that true change happens through a relationship that is genuine and emotionally honest. I aim to create a space where clients feel understood and cared about, while also challenged in ways that promote growth and deeper self-awareness. I value candor, curiosity, and humor in the therapy room, and I sometimes use levity to help clients feel more human and less alone in the difficult parts of their experience. My work is based primarily on the evidence-based approach of relational psychodynamic, attachment-based, and mentalization-oriented therapy with the integration of parts work, Acceptance and Commitment Therapy (ACT), and Rational Emotive Behavioral Therapy (REBT). This modality allows us to work together to better understand long-standing emotional and relational patterns, the ways they developed, and how they may now be limiting a fuller and more satisfying life. My goal is to help you better understand yourself at the root level, develop greater flexibility and self-awareness, and build a life that feels more connected, sustainable and genuinely your own. My own background as a former lawyer, large law firm associate, and senior government official informs the way I understand the emotional costs of high-functioning identities as well as pressure, ambition, and institutional environments. I bring that perspective into my clinical work with clients from all paths of life who are navigating trauma, loss, demanding careers, life transitions, identity questions, and the often painful gap between external success and internal wellbeing. See Rebecca’s full bio on Psychology Today request an appointment Request Rebecca. Our intake coordinators review every request personally. Mention Rebecca in the intake and we will check openings and fit, or suggest the closest match. Request Rebecca → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/specialties/ ===================================================================== Home / Specialties the sixteen, old city philadelphia Our Sixteen Clinical Focus Areas Sixteen focus areas, one clinical spine: relational psychodynamic, trauma-informed care, delivered by the clinicians who specialize in each. Filter by what brings you in. All sixteen All sixteen Trauma and PTSD Trauma and PTSD Mood and anxiety Mood and anxiety Relational and attachment Relational and attachment Identity and LGBTQIA+ Identity and LGBTQIA+ Teens Teens Life transitions Life transitions Modalities Modalities 01 / 16 mood and anxiety Anxiety therapy that goes beyond coping skills A relational, psychodynamic, and trauma-informed approach for adults whose worry, racing thoughts, or panic are not resolved by coping skills alone. 02 / 16 mood and anxiety Depression therapy that goes beyond symptom management We treat depression as a signal, not a symptom checklist, for adults navigating major, persistent, or treatment-resistant depression. 03 / 16 trauma and PTSD PTSD and Complex PTSD Therapy That Treats the Whole Person Phase-based, relational, trauma-informed care for single-incident, developmental, and relational trauma. Every clinician works from a trauma-informed frame; several are additionally trained in EMDR, IFS, and PE. 04 / 16 trauma and PTSD Trauma Therapy That Treats the Root, Not the Label The clinical lens through which all of our work is conducted: we ask "what happened to you?" rather than "what is wrong with you?" 05 / 16 life transitions Grief Therapy That Honors the Full Weight of Your Loss Care for every kind of loss: death, traumatic loss, perinatal loss, relational endings, and the losses the world does not recognize as grief. 06 / 16 relational and attachment Relationship Therapy That Rewrites the Blueprint, Not Just the Ending Individual, relational psychodynamic work on the patterns you carry into every connection. 07 / 16 relational and attachment Attachment Therapy That Gets to the Root of Your Relational Patterns Work on the anxious, avoidant, and disorganized patterns formed in your earliest relationships, toward earned secure attachment. 08 / 16 relational and attachment Therapy for the Childhood That Looked Fine From the Outside Relational care for the adult consequences of childhood emotional neglect: chronic emptiness, people-pleasing, perfectionism, a harsh inner critic. 09 / 16 identity and LGBTQIA+ LGBTQIA+ Affirming Therapy Where You Don't Have to Explain Yourself Affirming, trauma-informed care from 11 clinicians who specialize in it, including gender-affirming care letters. 10 / 16 identity and LGBTQIA+ Identity Exploration Therapy for When the Question Is "Who Am I?" Support across gender, sexuality, faith, cultural identity, career, and life direction. 11 / 16 eating and body image Eating Disorder & Body Image Therapy Depth-oriented, relational care for restriction, bingeing, purging, ARFID, and body preoccupation. For teens and adults, all bodies and all genders. 12 / 16 teens Therapy for Teens Who Are Going Through Something They Cannot Put Into Words Individual therapy for ages 13 to 17, grounded in relational psychodynamic and trauma-informed care. 13 / 16 life transitions Life Transitions Therapy for When Everything Is Changing and Nothing Feels Settled Support for career change, divorce, new parenthood, empty nest, retirement, relocation, and the identity questions they expose. 14 / 16 modalities EMDR Therapy That Does Not Stop at the Memory EMDR integrated within a relational psychodynamic frame rather than offered as a standalone protocol. 15 / 16 modalities IFS Therapy for the System You Built to Survive Parts-based work from nine clinicians, integrated within our relational psychodynamic frame. 16 / 16 modalities Relational Psychodynamic Therapy in Philadelphia The clinical foundation of our entire practice: depth-oriented, open-ended psychotherapy where the relationship itself is the engine of change. ===================================================================== URL: https://turningleaftherapyservices.com/anxiety-therapy-philadelphia/ ===================================================================== Home / Specialties / Anxiety Therapy old city, philadelphia Anxiety therapy in Philadelphia that goes beyond coping skills We treat anxiety, panic, social anxiety, and chronic worry in adults and teens, in person in Old City, Philadelphia, and by telehealth across Pennsylvania (and in New Jersey through our NJ-licensed clinicians), in network with Aetna, Blue Cross plans, United Healthcare, and Optum. Anxiety therapy at Turning Leaf in Old City Philadelphia is a relational, psychodynamic, and trauma-informed approach for adults whose worry, racing thoughts, or panic are not resolved by coping skills alone. Sessions are 53 minutes; clinicians treat the underlying patterns, not just the symptoms. In-network with Aetna, BCBS, United, and Optum; self-pay $130 to $200. We are a relational psychodynamic and trauma-informed practice with therapists who specialize in anxiety. We do not just help you manage the alarm. We help you understand the fire. mood and anxiety WHAT WE TREAT HERE Anxiety, panic, social anxiety, perfectionism, and chronic worry INSURANCE In-network with Aetna, Blue Cross plans, United Healthcare, Optum, PA VCAP Typical copay $15 to $50. See all plans SELF-PAY $130 to $200 per session Superbills provided for out-of-network reimbursement. Rates SESSIONS 53 minutes, usually weekly FORMAT In person in Old City Philadelphia, or telehealth Across Pennsylvania, and New Jersey with select clinicians. Telehealth AGES Teens (13 to 17) and adults APPROACH Relational, trauma-informed EMDR, IFS, and somatic work as needed NEW CLIENTS We are accepting new clients After your intake form, a coordinator reviews it and verifies your benefits; most people have a first session within about a week. Start your intake → ON THIS PAGE It Is Rarely Just Anxiety What Anxiety Actually Looks Like The Connection Between Anxiety, Shame, and Attachment How Your Nervous System Creates and Sustains Anxiety Why Our Approach Produces Lasting Change How We Treat Anxiety in Philadelphia Anxiety and Depression Often Travel Together What Relief Looks Like What to Expect From Anxiety Treatment at Turning Leaf Getting started Using your insurance Frequently Asked Questions Take the First Step Anxiety is the surface. Underneath is a pattern, laid down long before you had words for it. It Is Rarely Just Anxiety The racing thoughts, the tightness in your chest, the sleepless nights, the worst-case scenarios on a loop. Those experiences are real and deserve relief. But anxiety is almost always the surface expression of patterns that run much deeper, patterns that started long before you had language to describe them. Think of anxiety like a smoke alarm. You can take the battery out, and the noise stops. But the fire is still burning. Anxiety disorders are the most common mental health condition in the United States, affecting approximately 40 million adults, or 19.1 percent of the population, in any given year ( NIMH ). In Philadelphia, the picture is sharper: the city's Community Health Assessment found that 24 percent of adults reported experiencing frequent mental distress, and Philadelphia County records one of the highest ratios of mental health need to provider availability in the state. Yet despite how common anxiety is, the majority of people with anxiety disorders do not receive treatment that goes beyond surface-level symptom management. From a relational and psychodynamic perspective, anxiety frequently develops in response to early relational experiences that shaped how you learned to feel safe in the world. When the people you depended on as a child were unpredictable, emotionally unavailable, or critical, your nervous system learned to stay on alert. That alertness was adaptive then. It kept you attuned to danger signals in an environment that was not reliably safe. But it does not shut off just because the environment changes. You carry it into adulthood, into your relationships, into your work, into the quiet moments when everything is objectively fine but your body will not stop scanning for what might go wrong. What looks like Type A efficiency is often an anxious system trying to keep the unpredictable from happening. What Anxiety Actually Looks Like Most people recognize the obvious presentations: panic attacks, chronic worry, social anxiety, phobias. But anxiety shows up in ways that often go unrecognized because they do not match what people expect anxiety to look like. Perfectionism The relentless need to get it right, to avoid mistakes, to produce work that cannot be criticized. Perfectionism is not a personality trait. It is an anxiety management strategy. The unconscious logic: if I am perfect enough, I will be safe from the judgment, rejection, or abandonment that my nervous system is bracing for. People-pleasing Automatic prioritization of everyone else's needs. Saying yes when you mean no. Difficulty setting boundaries. The inability to tolerate someone being disappointed in you. This is anxiety wearing a mask of agreeableness. Underneath it is a nervous system that learned early: keeping others comfortable is how you stay safe. Control The need to plan, organize, anticipate, and manage every variable. Difficulty delegating. Discomfort with uncertainty. What looks like Type A efficiency is often an anxious system trying to prevent the unpredictable from happening, because the unpredictable was once dangerous. Avoidance Procrastination that looks like laziness but is actually a terror of failure or exposure. Declining invitations. Not applying for the job. Not having the conversation. Avoidance shrinks your life incrementally until you realize the boundaries of your world have been drawn by your anxiety, not by your choices. Physical symptoms Chronic muscle tension, jaw clenching, headaches, digestive issues, fatigue that sleep does not fix. Research shows that up to 30 percent of patients presenting to primary care with unexplained physical symptoms are experiencing anxiety as the underlying cause (Kroenke, Archives of Internal Medicine). Your body is carrying what your mind has not processed. Irritability and anger Anxiety does not always present as fear. It can present as a short fuse, as snapping at people you care about, as a constant low-grade agitation that makes everything feel like too much. When your nervous system is chronically activated, your threshold for additional stimulation drops. What looks like anger is often an overwhelmed system that has run out of bandwidth. Dissociation and numbness When anxiety becomes chronic enough, some nervous systems stop producing the alarm and start shutting down instead. You feel disconnected from your body, from your emotions, from the world around you. Things feel unreal. This is not the absence of anxiety. It is anxiety that has exceeded your system's capacity to process it. The Connection Between Anxiety, Shame, and Attachment Shame is different from guilt. Guilt says, "I did something wrong." Shame says, "I am something wrong." Most of the time, shame operates beneath conscious awareness. You do not walk around thinking about it. You walk around feeling anxious, hypervigilant, perfectionistic, or terrified of judgment. When a child's emotional needs are consistently met with rejection, dismissal, or simply go unnoticed, the child concludes: "Something about me is too much, or not enough." That belief becomes shame. And because it forms before language and conscious memory fully develop, it gets stored not as a thought but as a felt sense that something is fundamentally wrong with you. If this description resonates, our Childhood Emotional Neglect page may be relevant to your experience. Anxiety becomes one of the primary ways the psyche protects you from that shame. The constant vigilance, the need to control, the people-pleasing, the avoidance that looks like laziness but is actually a terror of failure. These are all ways of managing an unconscious belief that you are not okay. This is not something you can think your way out of. It requires a therapeutic relationship where those patterns can surface safely and gradually shift. Research supports this directly. A meta-analysis of 64 studies found a significant positive association between insecure attachment and anxiety, with the strongest links found in anxious-preoccupied attachment (Colonnesi et al., Clinical Psychology Review). People with anxious attachment show heightened amygdala reactivity to social threat cues, meaning their brains are literally wired to detect danger in relationships (Vrticka and Vuilleumier, 2012). This is not a cognitive error. It is a nervous system that learned, through lived experience, that relationships are not safe. Our Attachment Therapy page addresses these patterns in depth. You can take the battery out of the alarm. The fire underneath still burns. How Your Nervous System Creates and Sustains Anxiety Understanding what is happening in your body helps explain why anxiety does not respond to logic. When your brain perceives a threat, whether real or remembered, it activates the sympathetic nervous system: heart rate increases, muscles tense, breathing becomes shallow, cortisol and adrenaline flood the system. This is the fight-or-flight response, and it evolved to keep you alive. The problem is that after prolonged or early exposure to stress, the system does not recalibrate to baseline. It stays activated. Your amygdala, the brain’s threat detection center, becomes hypersensitive, firing alarm signals at stimuli that are not actually dangerous: a delayed text message, an ambiguous facial expression, a change in plans, silence. Dan Siegel's concept of the window of tolerance describes the zone of arousal where you can function, think clearly, and engage with the world. Anxiety narrows this window. When you are above it (hyperarousal), you feel panicked, wired, unable to settle. When you drop below it (hypoarousal), you feel numb, shut down, disconnected. Many anxious people oscillate between both states within the same day. The good news, supported by decades of neuroscience research, is that the brain is plastic. Neuroplasticity means that repeated experiences of safety, particularly in a consistent relational context, can gradually retrain the nervous system. The therapeutic relationship provides exactly this: a reliable, attuned, non-threatening relational experience that, over time, expands the window of tolerance and reduces the amygdala’s hair-trigger reactivity. This is why relational therapy works for anxiety in a way that purely cognitive approaches often do not. You cannot think your way to a feeling of safety. You have to experience it. Why Our Approach Produces Lasting Change Many of our clients have tried therapy before. Some found it helpful in the short term but noticed the relief did not last. Others felt like they were learning coping skills without ever getting to the thing that needed coping with. Research helps explain why. CBT for anxiety is effective at reducing symptoms in the short term, with response rates of approximately 50 to 60 percent (Hofmann and Smits, 2008). But relapse rates after CBT are significant: a meta-analysis in Behaviour Research and Therapy found that approximately 50 percent of patients who responded to CBT for anxiety experienced a return of symptoms within one to five years. The skills work. They just do not address the relational and developmental roots that keep generating the anxiety. Psychodynamic therapy takes a different path. Jonathan Shedler's landmark 2010 review in the American Psychologist found that psychodynamic therapy produces effect sizes of 0.97 at the end of treatment, growing to 1.51 at long-term follow-up. This sleeper effect, where patients continue to improve after therapy ends, is the signature finding of psychodynamic research, and it has not been consistently replicated in studies of symptom-focused treatments. Steinert et al. (2017, American Journal of Psychiatry) confirmed through a formal equivalence test across 23 randomized trials that psychodynamic therapy is statistically equivalent to CBT. The 2023 Leichsenring umbrella review in World Psychiatry concluded that psychodynamic therapy warrants a strong recommendation for anxiety disorders. The difference is not that one approach works and the other does not. The difference is in what each approach targets. CBT targets the alarm. Psychodynamic therapy targets the fire. For anxiety that is rooted in attachment disruption, relational trauma, or unconscious shame, getting to the fire is what produces change that sticks. How We Treat Anxiety in Philadelphia Our clinical approach is grounded in relational psychodynamic and psychoanalytic theory, with trauma-informed care woven into everything we do. We pay close attention to the therapeutic relationship itself, because the patterns that create anxiety in your life will eventually show up in the therapy room too. That is not a problem. That is the work. When the client who manages everyone else’s emotions begins to manage the therapist’s, that is material. When the client who avoids conflict goes along with a treatment direction that does not feel right, that is material. When the client who fears abandonment cancels sessions after a moment of vulnerability, that is material. These moments are where relational psychodynamic therapy does its most important work: not by analyzing the pattern from the outside, but by living through it together in real time, in a relationship where a different outcome is possible. We are not a practice that hands you a worksheet and sends you home. We sit with you in the complexity of your experience. We are curious about your history, your relationships, and the things that feel too big to say out loud. Our therapists also draw from EMDR, IFS, ACT, DBT, somatic approaches, and cognitive behavioral techniques when they serve the work. But these are tools we incorporate as needed. The foundation is always the relationship and the deeper inquiry into what the anxiety is protecting you from. Anxiety and Depression Often Travel Together If you are experiencing anxiety alongside depression, you are not alone. Research shows that approximately 60 percent of people with an anxiety disorder also experience depression (NAMI), and in clinical settings that number climbs to over 70 percent. The two conditions share common relational roots, particularly early attachment disruption and environments where emotional safety was inconsistent. From our perspective, treating one without addressing the other often produces incomplete results. Our team is trained to work with both simultaneously, understanding them as different expressions of the same underlying relational and emotional patterns. If depression is also a concern, our Depression Therapy page outlines how we approach that work. Relief is not the absence of the alarm. It is a nervous system that finally learns it is safe. What Relief Looks Like Within the first several weeks, most clients develop a different relationship with their anxiety. The panic may not disappear overnight, but the way you understand and respond to it starts to change. That alone brings meaningful relief. But we specialize in something beyond symptom relief. Anxiety rooted in early attachment disruption, relational trauma, or unconscious shame did not develop in a few weeks, and it will not fully resolve in a few weeks either. Many of our clients have done shorter-term therapy before and found that it helped temporarily but did not stick. That is usually because it addressed the alarm without getting to the fire. Our approach goes to the fire. What to Expect From Anxiety Treatment at Turning Leaf Your first sessions are about getting to know each other. You will not be asked to dive into anything you are not ready for. Treatment is collaborative, and your perspective, instincts, and pace matter. Many of our therapists use validated screening tools to establish a baseline so we can track your progress over time. fees & insurance frequency Weekly sessions, with twice-weekly available for intensive work. format In-person at our Old City Philadelphia office (123 Chestnut St) or telehealth for anyone located in Pennsylvania. insurance Aetna, BCBS plans, United Healthcare, and Optum Behavioral Health. (Note: We do not accept Independence Blue Cross) . self-pay $130 to $200 per session depending on the therapist. Superbills provided after every session on request. related Depression Therapy Attachment Therapy Childhood Emotional Neglect Fees & insurance Getting Started 01 Complete our short intake A short adaptive form. It asks only what applies to you. 02 We match you, personally Our intake coordinator reviews your response and matches you with the clinician who fits your concern, insurance, and schedule. 03 Meet your therapist Your first session is a clinical consultation, scheduled directly with the right fit. Start your intake → Or call (215) 399-4128 Using Your Insurance for Anxiety Therapy Anxiety treatment is covered as a standard outpatient behavioral health benefit under every plan we participate in, which means you do not need a special rider or a separate mental health policy to begin. Turning Leaf is in-network with Aetna , with the Blue Cross family including Highmark , Capital Blue Cross , Anthem , Empire , the Federal Employee Program and Horizon in New Jersey , along with United Healthcare , Optum , and Pennsylvania VCAP . Most in-network clients pay between $15 and $50 per session once any deductible is satisfied. You will not have to guess at that number: after you send the intake form, a coordinator verifies your benefits and tells you your expected per-session cost before your first appointment. If your card reads Independence Blue Cross, Cigna, Medicare, or Medicaid, we are out of network. That does not close the door. Sessions are $130 to $200, and we provide a superbill after every session that you can submit for out-of-network reimbursement. The insurance page walks through how that works and what to ask your plan. Frequently Asked Questions How do I know if I need anxiety therapy or counseling? + If anxiety is getting in the way of your ability to work, sleep, be present in your relationships, or enjoy your life, therapy is worth exploring. You do not need a formal diagnosis to benefit from treatment. If you are asking the question, the answer is probably yes. How long does anxiety therapy take? + You can expect to feel some relief within the first several weeks. Deeper, lasting change takes longer. For anxiety rooted in early life experiences, attachment patterns, or trauma, we typically recommend longer-term treatment. The timeline is always a conversation between you and your therapist. Therapy can also feel harder before it feels better, which is often a sign of the work deepening rather than failing. Does insurance cover anxiety therapy? + Yes. Turning Leaf is in-network with Aetna, United Healthcare, Optum, Pennsylvania VCAP, and these Blue Cross plans: Highmark, Capital Blue Cross, Anthem, Empire, the Federal Employee Program, and Horizon BCBS of New Jersey. Most in-network clients pay a copay of $15 to $50 after any deductible. We are out-of-network with Independence Blue Cross, Cigna, Medicare, and Medicaid; those sessions are $130 to $200, and for plans with out-of-network benefits we provide a superbill after every session on request. Can I do anxiety therapy online? + Yes. We offer online anxiety therapy by secure video to anyone located in Pennsylvania, and to New Jersey residents through our NJ-licensed clinicians. Research shows telehealth therapy produces outcomes comparable to in-person treatment for most concerns. What happens in the first session? + Your first session is about beginning a relationship with your therapist. They will ask about your history, what is bringing you in, and what you are hoping for. You set the pace. The goal is to build enough safety and trust to do meaningful work together. What makes your approach different? + Most anxiety treatment focuses on managing symptoms through coping skills and thought restructuring. Our primary approach is relational, psychodynamic, and trauma-informed, which means we go deeper. We work with you to understand where your anxiety comes from, how it connects to your history and your relationships, and what it is trying to protect you from. Research shows that this depth-oriented approach produces gains that continue to grow after therapy ends (Shedler, American Psychologist, 2010). How much does anxiety therapy cost? + Session fees range from $130 to $200 depending on the therapist. Many clients use insurance, which typically covers anxiety therapy with a copay. We are in-network with Aetna, BCBS, United Healthcare, and Optum, and we offer out-of-network reimbursement support. Is anxiety a sign of something deeper? + Often, yes. Anxiety frequently coexists with depression, attachment difficulties, unresolved trauma, and patterns rooted in childhood emotional neglect. In our experience, treating anxiety without exploring these connections produces results that do not last. Our approach addresses the full picture. Do I need medication for anxiety? + Therapy alone is effective for many people, and for some, medication helps, especially early on. We do not prescribe, but we collaborate with your prescriber or refer you to trusted psychiatric providers. Therapy works on what medication cannot reach: the pattern underneath the anxiety. Do you take my insurance for anxiety therapy? + We are in-network with Aetna, the Blue Cross plans including Highmark, Capital, Anthem, Empire, the Federal Employee Program and Horizon of New Jersey, along with United Healthcare, Optum, and Pennsylvania VCAP. Most in-network clients pay a copay of $15 to $50 per session after any deductible. Independence Blue Cross, Cigna, Medicare, and Medicaid are out of network. Sessions are then $130 to $200 and we provide a superbill after every session for out-of-network reimbursement. Either way, a coordinator verifies your benefits before your first appointment. How soon can I be seen for anxiety? + After you submit the intake form, a coordinator reviews it, verifies your insurance benefits, and matches you with a clinician who has availability. Most people have a first session within about a week. Do I have to have tried therapy before? + No. Many people who come here are starting therapy for the first time, and this approach works as well for first-timers as it does for people who have been in therapy before. You do not need any vocabulary for what you are feeling, and you do not need to arrive with a theory about where it came from. If you have tried therapy and it did not hold, that is useful information rather than a strike against you. Your therapist will want to hear what helped and what did not. Take the First Step You do not have to keep managing anxiety alone. You do not have to keep white-knuckling through days that other people seem to navigate effortlessly. The patterns that drive your anxiety are not character flaws. They are adaptations that served you once and are now running your life. They can change. But they change in relationship, not in isolation. request an appointment Take the first step. You do not have to keep managing anxiety alone. The patterns that drive it are not character flaws; they are adaptations that served you once and can change, in relationship. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/depression-therapy-philadelphia/ ===================================================================== Home / Specialties / Depression Therapy old city, philadelphia Depression therapy in Philadelphia that goes beyond symptom management We treat depression, low mood, burnout, and the exhaustion that follows long-term stress, for adults and teens, in person in Old City, Philadelphia, and by telehealth across Pennsylvania (and in New Jersey through our NJ-licensed clinicians), in network with Aetna, Blue Cross plans, United Healthcare, and Optum. An estimated 21 million American adults had at least one major depressive episode in a single year, about 8.3 percent of the adult population (NIMH) . Depression is common. That does not make it something to manage alone. Depression therapy at Turning Leaf in Old City Philadelphia is delivered by therapists trained in relational, psychodynamic, and trauma-informed care for adults navigating major depression, persistent low mood, or treatment-resistant depression. We treat depression as a signal, not a symptom checklist. In-network with Aetna, BCBS, United, Optum; self-pay $130 to $200. At Turning Leaf Therapy in Old City Philadelphia, our clinical team includes 13 therapists who specialize in treating depression. We are a relational, psychodynamic, and trauma-informed practice, which means we do not treat depression as a set of symptoms to manage. We treat it as a signal that something in your emotional and relational life needs attention, and we help you understand what that something is. mood and anxiety WHAT WE TREAT HERE Depression, persistent low mood, burnout, and long-term exhaustion INSURANCE In-network with Aetna, Blue Cross plans, United Healthcare, Optum, PA VCAP Typical copay $15 to $50. See all plans SELF-PAY $130 to $200 per session Superbills provided for out-of-network reimbursement. Rates SESSIONS 53 minutes, usually weekly FORMAT In person in Old City Philadelphia, or telehealth Across Pennsylvania, and New Jersey with select clinicians. Telehealth AGES Teens (13 to 17) and adults APPROACH Relational, psychodynamic Depth-oriented, not symptom management alone NEW CLIENTS We are accepting new clients After your intake form, a coordinator reviews it and verifies your benefits; most people have a first session within about a week. Start your intake → ON THIS PAGE When Depression Feels Like More Than Sadness Depression as a Relational and Emotional Pattern The Inner Critic and the Shame Beneath Depression How We Treat Depression in Philadelphia: Why Our Approach Produces Lasting Change Therapy Versus Medication for Depression Depression and Grief Are Not the Same Thing Depression and Anxiety Often Travel Together What to Expect in Depression Therapy at Turning Leaf Getting started Using your insurance Frequently Asked Questions About Depression Therapy Take the First Step The gap between how a life looks and how it feels. Depression affects more than 21 million adults in the United States each year, making it one of the leading causes of disability in the country (National Institute of Mental Health). Recent CDC data shows that 13.1 percent of U.S. adults now report symptoms of depression in any given two-week period, a 60 percent increase from a decade ago. If you have been searching for a depression therapist in Philadelphia, the difficulty of finding one is part of the problem. Philadelphia County recorded over 94,000 adult depression cases in 2023, and the city’s provider-to-resident ratio sits at roughly 1 mental health provider per 290 residents. Nearly half of adults in the city report experiencing poor mental health on a recurring basis. The need is enormous. The availability of therapists who do more than surface-level work is not. That is what our practice was built for. When Depression Feels Like More Than Sadness Most people describe depression as sadness, but that description rarely captures the full experience. Depression can feel like heaviness, like everything requires more effort than it should. It can feel like numbness, like emotions that used to be accessible have gone quiet. It can show up as irritability, as a short fuse that surprises you. It can look like withdrawal, canceling plans, not returning messages, pulling away from people you care about. It can feel like exhaustion that sleep does not fix, or like a fog that makes it hard to think clearly, make decisions, or imagine a future that feels different from right now. Sometimes the most confusing part is that nothing obviously "wrong" is happening in your life. You may have a stable job, good relationships, a life that looks fine from the outside. And yet something inside feels flat, depleted, or stuck. That gap between how your life looks and how it feels is one of the hallmarks of depression, and it is also one of the reasons people wait so long to seek help. It is hard to explain what is wrong when you cannot point to a clear cause. From a relational and psychodynamic perspective, the cause is often not a single event. It is a pattern. Depression frequently develops out of early relational experiences that shaped how you learned to process emotions, tolerate vulnerability, and relate to yourself and others. The roots may run much deeper than the present moment, even when the present moment is where the pain shows up. So much of depression begins in relationship, long before we have words for it. Depression as a Relational and Emotional Pattern Our approach to depression starts from a fundamentally different premise than most therapy practices. We do not view depression primarily as a chemical imbalance or a collection of cognitive distortions. We understand it as a relational and emotional condition, one that develops in the context of your history, your attachments, and the ways you learned to survive in environments that may not have been emotionally safe. Here is what that looks like in practice. When a child grows up in an environment where certain emotions are not welcome, the child learns to suppress them. If expressing anger was met with punishment or withdrawal, the child learns that anger is dangerous. If expressing need was met with dismissal or ridicule, the child learns that needing anything from another person is shameful. Over time, these emotional responses do not disappear. They get redirected. Anger that cannot be expressed outward gets turned inward. Need that cannot be voiced becomes a quiet conviction that you are too much, or not enough. This is one of the oldest and most well-supported insights in psychodynamic theory. Depression often involves the redirection of feelings that originally belonged in a relationship, feelings like anger, grief, disappointment, or longing, back toward the self. What looks like low self-esteem, self-blame, or the persistent feeling that you are fundamentally flawed is frequently the residue of relational experiences where those feelings had nowhere safe to go. Research supports this connection directly. A meta-analysis of 55 studies found that insecure attachment patterns developed in childhood are significantly associated with depressive symptoms in adulthood. The link is strongest among people with histories of early adversity, including emotional neglect, inconsistent caregiving, and environments where the child had to suppress their needs to maintain the relationship with the parent. The Inner Critic and the Shame Beneath Depression If anxiety is the mind’s alarm system, depression is often its shutdown system. When the emotional world becomes too painful, too threatening, or too overwhelming, the psyche protects itself by going quiet. Energy drops. Motivation disappears. Feelings flatten. On the surface it looks like apathy or laziness. Underneath it is often a kind of emotional hibernation, a protective response to conditions that once felt unbearable. One of the most powerful engines of depression is the inner critic, the voice inside that tells you that you are not good enough, that you should be further along, that other people manage life better than you do. That voice can feel like yours. It can feel like objective reality. But in our work, we often discover that the inner critic is not your voice at all. It is an internalized version of someone else’s, a parent, a caregiver, or a culture that taught you early on that your worth was conditional. The psychoanalytic researcher Sidney Blatt identified two patterns that underlie most depression. The first is organized around fear of abandonment and loss. The second is organized around self-criticism and the relentless pursuit of achievement. Both patterns share a common root: the belief, formed early and reinforced often, that something about you is fundamentally inadequate. That belief is shame. And shame is one of the most difficult emotions to access in therapy because its primary function is to stay hidden. Depression keeps shame hidden by making everything feel like your fault. If you believe you are the problem, you never have to confront the more painful truth, which is that the people you depended on may have let you down in ways that were not your fault and were never yours to fix. This is the work that relational, psychodynamic therapy is designed to do. Not to assign blame, but to help you see the full picture of how you got here, so you can begin to build a different relationship with yourself. Change here happens in relationship, not in isolation. How We Treat Depression in Philadelphia: Why Our Approach Produces Lasting Change Many of our clients have tried therapy before. Some found it helpful in the short term but noticed the relief did not last. Others felt like they were learning coping skills without ever getting to the thing that needed coping with. Some tried medication and found it took the edge off but left the underlying emptiness untouched. These are not failures of effort. They are often the result of approaches that focus on symptom management without addressing the relational and emotional roots of the depression. Research consistently supports this distinction. Jonathan Shedler’s landmark review in the American Psychologist found that patients who receive psychodynamic therapy not only maintain their gains after treatment ends but appear to continue improving. Effect sizes grew from 0.97 at the end of treatment to 1.51 at long-term follow-up, a pattern not consistently seen with other approaches. A meta-analysis of 54 studies with nearly 4,000 participants found psychodynamic therapy equally effective to other evidence-based treatments for depression, with effect sizes of 0.49 to 0.69 compared to controls (Driessen et al., Clinical Psychology Review). Perhaps the most compelling evidence comes from the Tavistock Adult Depression Study, which treated patients whose depression had not responded to any previous treatment, including medication and other forms of therapy. After 18 months of weekly psychoanalytic psychotherapy, 30 percent of patients in the treatment group achieved partial remission compared to just 4 percent in the control group. For people who have tried everything else, this kind of deep, relational work may be the first approach that reaches what other treatments could not. We are not opposed to other modalities. Our therapists incorporate techniques from EMDR, IFS, ACT, DBT, somatic approaches, and cognitive behavioral methods when they serve the work. But these are tools we draw from as needed. The foundation is always relational, psychodynamic, and trauma-informed. We believe that lasting change requires understanding not just what you think, but why you think it, where that pattern came from, and what it has been protecting you from. Therapy Versus Medication for Depression If you are considering therapy as an alternative to antidepressants, or wondering whether therapy could allow you to reduce or eventually stop medication, you are asking a question the research has a lot to say about. Short-term, both therapy and antidepressants can be effective at reducing depressive symptoms. The difference shows up over time. A 2024 systematic review published in Frontiers in Psychiatry found that psychotherapy is superior to medication for preventing depression relapse, reducing the risk by approximately 40 percent. In one of the most cited studies on this question, patients who completed therapy relapsed at a rate of about 31 percent, compared to 76 percent of patients who discontinued medication (Hollon et al., 2005). This does not mean medication is wrong or unnecessary. For some people, particularly those with severe depression, medication can provide the stabilization needed to engage meaningfully in therapy. We work collaboratively with prescribers and support clients who choose to use medication as part of their treatment. Our position is not anti-medication. It is that medication alone rarely addresses the emotional and relational patterns that keep depression coming back. Therapy does. A 2022 review published in Molecular Psychiatry, which was downloaded over one million times, found no convincing evidence that depression is caused by low serotonin levels, challenging the "chemical imbalance" model that has dominated public understanding for decades. This does not mean antidepressants are ineffective. It means the mechanism is more complex than we were told, and that treating depression as a purely biological condition misses the psychological and relational dimensions that therapy is uniquely positioned to address. Grief comes in waves. Depression can flatten the whole sea. Depression and Grief Are Not the Same Thing People sometimes confuse depression with grief, and the distinction matters because the path through each is different. Grief is a response to loss. It is painful, sometimes devastating, but it preserves your sense of who you are. You may feel broken by what happened, but you do not feel broken as a person. Grief comes in waves. There are moments of intense pain and moments of reprieve. The world may feel emptier, but you can still locate yourself within it. Depression collapses something different. In depression, it is not just the world that feels diminished. It is you. Your sense of your own value, your own goodness, your own right to exist and take up space. Depression often involves a pervasive self-blame that grief does not. The depressed person does not just feel sad about what happened. They feel, often without being able to articulate it, that they are what is wrong. This distinction comes directly from psychoanalytic theory, and it has held up remarkably well across a century of clinical work. It also explains why depression so often develops in the aftermath of losses that seem disproportionately devastating, a breakup that levels you, a job loss that sends you into freefall, a friendship that ends and takes part of your identity with it. Present-day losses have a way of reopening older, deeper wounds from earlier in life. If the original wound was never fully processed, the current loss can trigger a depressive response that feels far bigger than the event itself. Our therapists are trained to hold both layers simultaneously, the grief of what is happening now and the deeper relational injuries it connects to. If you are navigating grief that has tipped into something heavier, our Grief and Loss Therapy page may also be relevant. Depression and Anxiety Often Travel Together If you are experiencing depression alongside anxiety, you are not alone. Research shows that approximately 60 percent of people with an anxiety disorder also experience depression (NAMI), and in clinical settings that number climbs to over 70 percent. The two conditions share common relational roots, particularly early attachment disruption and environments where emotional safety was inconsistent. From our perspective, treating one without addressing the other often produces incomplete results. Our team is trained to work with both simultaneously, understanding them as different expressions of the same underlying relational and emotional patterns. If anxiety is also a concern, our Anxiety Therapy page outlines how we approach that work. Things that grow slowly tend to grow well. What to Expect in Depression Therapy at Turning Leaf Starting therapy when you are depressed can feel like one more thing you do not have the energy for. We understand that. Here is what the process looks like so you can make an informed decision about whether this is the right step. Your first sessions are about getting to know each other. Your therapist will ask about your history, what brought you in, and what your life looks like right now. You will not be asked to perform or produce insights. The goal of early sessions is to build enough trust and safety to begin the deeper work. Many of our therapists use validated screening tools to establish a baseline so we can track your progress over time. You should expect some relief relatively quickly. Within the first several weeks, most clients begin to feel less alone in their experience. The act of being heard, understood, and not judged by a trained clinician produces real neurobiological and emotional shifts. That is not nothing. It matters. But we specialize in going further. What we provide is intensive, longer-term therapy designed to address the relational and emotional patterns that keep depression returning. Depression that has its roots in early attachment, relational trauma, or unconscious shame did not develop quickly, and resolving it at the root takes sustained, committed work. Many of our clients have done shorter-term therapy before and found that the relief did not stick. That is usually not because the therapy was bad. It is because it did not go deep enough. fees & insurance frequency Typically weekly. For clients doing intensive work, twice-weekly sessions are sometimes recommended. format In-person at our Old City Philadelphia office or telehealth for anyone located in Pennsylvania. insurance Aetna, BCBS plans, United Healthcare, and Optum. Out-of-network support offered. self-pay $130 to $200 per session depending on the therapist related Anxiety Therapy Grief Therapy Relational Therapy Fees & insurance Getting Started 01 Complete our short intake A short adaptive form. It asks only what applies to you. 02 We match you, personally Our intake coordinator reviews your response and matches you with the clinician who fits your concern, insurance, and schedule. 03 Meet your therapist Your first session is a clinical consultation, scheduled directly with the right fit. Start your intake → Or call (215) 399-4128 Using Your Insurance for Depression Therapy Therapy for depression is covered as a standard outpatient behavioral health benefit under every plan we participate in. Turning Leaf is in-network with Aetna , Highmark Blue Cross , Capital Blue Cross , Anthem , Empire , the Federal Employee Program , Horizon BCBS of New Jersey , United Healthcare , Optum , and Pennsylvania VCAP . Most in-network clients pay a copay of $15 to $50 per session once any deductible is met, and a number of plans waive the deductible for behavioral health so the copay applies from the first visit. We verify your benefits before that first session and tell you the expected cost per appointment. Independence Blue Cross, Cigna, Medicare, and Medicaid are out of network with our practice. Sessions in that case are $130 to $200, and we provide a superbill after every session so you can seek out-of-network reimbursement. The insurance page explains the path in plain terms. Frequently Asked Questions About Depression Therapy How do I know if I need depression therapy or counseling? + If you have been feeling persistently low, empty, exhausted, or disconnected from things you used to enjoy, and it has been going on for more than a couple of weeks, therapy is worth exploring. You do not need a formal diagnosis. If something feels off and it is not getting better on its own, that is enough of a reason to reach out. What is psychodynamic therapy for depression? + Psychodynamic therapy explores how your emotional history, early relationships, and unconscious patterns contribute to your depression. Rather than focusing primarily on changing thoughts or behaviors, it helps you understand where your depression comes from and what it is connected to, so that change happens at the root level rather than the surface. Is psychodynamic therapy evidence-based for depression? + Yes. A meta-analysis of 54 studies found psychodynamic therapy produces significant reductions in depressive symptoms with effect sizes comparable to other established treatments (Driessen et al., 2015). A landmark review in the American Psychologist found that gains from psychodynamic therapy not only persist after treatment ends but continue to grow at long-term follow-up (Shedler, 2010). How long does depression therapy take? + You can expect to feel some relief within the first several weeks. Deeper, lasting change takes longer. For depression rooted in early life experiences, attachment patterns, or trauma, we typically recommend longer-term treatment. The timeline depends on your situation and is always a conversation between you and your therapist. Therapy can also feel harder before it feels better, which is often a sign of the work deepening rather than failing. Is therapy or medication better for depression? + Both can be effective in the short term. The key difference is durability. Research shows therapy is superior to medication for long-term relapse prevention, reducing the risk of depression returning by approximately 40 percent (Nature Mental Health, 2024). We support clients who use medication and work collaboratively with prescribers. Our view is that therapy addresses the relational and emotional roots that medication alone does not reach. Can therapy help if antidepressants have not worked for me? + Yes. The Tavistock Adult Depression Study found that 30 percent of patients with treatment-resistant depression achieved meaningful improvement after weekly psychoanalytic psychotherapy, compared to just 4 percent receiving usual care (Fonagy et al., 2015). For people who have not responded to medication or shorter-term therapy, deeper relational work may reach what other approaches could not. What if I have tried therapy before and it did not help? + That is more common than you might think, and it does not mean therapy cannot help you. It often means the previous approach did not go deep enough or was not the right fit for what your depression actually needed. Our relational, psychodynamic approach is specifically designed for the kind of depression that does not resolve with coping skills or thought restructuring alone. Can you treat depression and anxiety at the same time? + Yes. Depression and anxiety co-occur in roughly 60 percent of cases, and we view them as connected expressions of deeper relational and emotional patterns. Our therapists are trained to work with both simultaneously rather than treating them as separate conditions. Does insurance cover depression therapy in Philadelphia? + Yes. Turning Leaf is in-network with Aetna, United Healthcare, Optum, Pennsylvania VCAP, and these Blue Cross plans: Highmark, Capital Blue Cross, Anthem, Empire, the Federal Employee Program, and Horizon BCBS of New Jersey. Most in-network clients pay a copay of $15 to $50 after any deductible. We are out-of-network with Independence Blue Cross, Cigna, Medicare, and Medicaid; those sessions are $130 to $200, and for plans with out-of-network benefits we provide a superbill after every session on request. How much does depression therapy cost in Philadelphia? + Session fees at Turning Leaf Therapy range from $130 to $200 depending on the therapist. Many clients use insurance, which typically covers therapy for depression with a copay. We are in-network with Aetna, the Blue Cross plans other than Independence Blue Cross, United Healthcare, and Optum, and we provide superbills for out-of-network reimbursement with other plans. Do you take my insurance for depression therapy? + Yes for most major plans. We are in-network with Aetna, Highmark, Capital Blue Cross, Anthem, Empire, the Federal Employee Program, Horizon BCBS of New Jersey, United Healthcare, Optum, and Pennsylvania VCAP. In-network clients typically pay $15 to $50 per session once any deductible is met. We are out of network with Independence Blue Cross, Cigna, Medicare, and Medicaid. Those sessions are $130 to $200 with a superbill provided each time for reimbursement. Your benefits are verified before your first session. How soon can I be seen for depression? + After you submit the intake form, a coordinator reviews it, verifies your insurance benefits, and matches you with a clinician who has availability. Most people have a first session within about a week. Can therapy help if I am also on medication? + Yes, and the two are not in competition. We do not prescribe, and we do not ask anyone to choose between medication and therapy. Where you have a prescriber, we coordinate with them; where you want one, we can refer you to psychiatric providers we trust. Medication can lift the floor enough to make the work possible. Therapy addresses what medication does not reach: the patterns, relationships, and history that keep producing the depression in the first place. Take the First Step Depression makes it hard to believe that anything can help. That doubt is part of the condition, not evidence that it is true. Our team at Turning Leaf Therapy specializes in helping people understand where their depression comes from, what it has been protecting them from, and how to build a life that feels like theirs again. request an appointment Take the first step. Depression makes it hard to believe that anything can help. That doubt is part of the condition, not evidence that it is true. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/ptsd-therapy-philadelphia/ ===================================================================== Home / Specialties / PTSD & Complex PTSD old city, philadelphia PTSD and Complex PTSD Therapy in Philadelphia That Treats the Whole Person PTSD and Complex PTSD therapy at Turning Leaf in Old City, Philadelphia, is phase-based, relational, trauma-informed treatment for single-incident, developmental, and relational trauma, with select clinicians trained in EMDR, IFS, and PE. Sessions are 53 minutes, in person at 123 Chestnut Street or by secure video across Pennsylvania, and in New Jersey through our NJ-licensed clinicians. In-network with Aetna, BCBS, United, Optum, and PA VCAP; self-pay $130 to $200. About 6.8 percent of American adults (NIMH) will meet criteria for PTSD at some point in their lives, and far more carry trauma that never gets a diagnosis. Approximately 13 million Americans are living with PTSD in any given year, and research suggests that Complex PTSD may be even more prevalent, affecting an estimated 3.8 percent of the U.S. population (National Institute of Mental Health; Cloitre et al., 2019). At Turning Leaf Therapy in Old City Philadelphia, treating trauma is not one of the things we do. It is the thing we were built to do. Our practice was founded on a relational, psychodynamic, and trauma-informed approach to PTSD and Complex PTSD, and the majority of our clinical team holds advanced training in trauma treatment. trauma and PTSD WHAT WE TREAT HERE PTSD and complex PTSD, including developmental and relational trauma INSURANCE In-network with Aetna, Blue Cross plans, United Healthcare, Optum, PA VCAP Typical copay $15 to $50. See all plans SELF-PAY $130 to $200 per session Superbills provided for out-of-network reimbursement. Rates SESSIONS 53 minutes, usually weekly FORMAT In person in Old City Philadelphia, or telehealth Across Pennsylvania, and New Jersey with select clinicians. Telehealth AGES Teens (13 to 17) and adults APPROACH Phase-based, relational trauma care EMDR, IFS, PE, and somatic work NEW CLIENTS We are accepting new clients After your intake form, a coordinator reviews it and verifies your benefits; most people have a first session within about a week. Start your intake → ON THIS PAGE Understanding PTSD and Complex PTSD Why Complex PTSD Is Not in the DSM (and Why That Does Not Matter) How Complex Trauma Shapes the Nervous System Where Complex PTSD Comes From How We Treat PTSD and Complex PTSD in Philadelphia The Tools Within Our Framework Why Short-Term Protocols Often Fall Short for Complex Trauma What to Expect in PTSD and C-PTSD Therapy at Turning Leaf Getting started Using your insurance Frequently Asked Questions About PTSD and C-PTSD Therapy Take the First Step Healing from trauma begins with the body learning, slowly, that it is safe again. We specialize in the kind of trauma that does not resolve in 12 sessions. The kind that started early, lasted long, and shaped who you became. The kind that lives not just in your memories but in your body, your relationships, your sense of self, and your ability to trust. If that is what brought you here, you are in the right place. Understanding PTSD and Complex PTSD PTSD and Complex PTSD are related conditions, but they are not the same thing. Understanding the difference matters because it changes what treatment needs to look like. PTSD develops in response to a specific traumatic event or set of events: an accident, an assault, combat, a natural disaster, witnessing violence. The hallmark symptoms include intrusive re-experiencing of the trauma (flashbacks, nightmares, unwanted memories), avoidance of reminders, changes in mood and thinking, and a heightened state of alertness or reactivity. Roughly 6 to 7 percent of U.S. adults will develop PTSD at some point in their lives, and women are two to three times more likely to develop it than men (NIMH). Complex PTSD develops in response to prolonged, repeated trauma, particularly trauma that occurs in the context of relationships where escape is difficult or impossible. Judith Herman, the Harvard psychiatrist who first named the condition in 1992, described it as arising from situations of captivity, whether physical or psychological: childhood abuse and neglect, domestic violence, narcissistic abuse, trafficking, cult involvement, or any environment where a person’s autonomy and safety are chronically violated by someone they depend on. Complex PTSD includes all the core symptoms of PTSD plus three additional areas of disruption that Herman and later researchers call disturbances in self-organization: Difficulty regulating emotions. This can look like intense emotional reactions that seem disproportionate to the trigger, or the opposite: a flatness or numbness where emotions that should be accessible simply are not. It can look like rage that comes out of nowhere, or a chronic inability to calm down once activated. A deeply negative sense of self. Not ordinary self-doubt, but a pervasive, persistent belief that something about you is fundamentally broken, defective, or unworthy. Shame that does not attach to a specific behavior but to your existence. The feeling that if people really knew you, they would confirm what you have always suspected about yourself. Difficulty in relationships. Trouble trusting, trouble staying close, trouble feeling safe with other people even when they have given you no reason to feel unsafe. Patterns of either avoiding intimacy entirely or becoming so enmeshed in relationships that you lose track of where you end and the other person begins. A cycle of reaching for connection and then pulling away from it. If you recognize yourself in that description, you are not broken. You adapted to conditions that required adaptation. The problem is that the adaptations that protected you then are now running your life in ways that no longer serve you. Why Complex PTSD Is Not in the DSM (and Why That Does Not Matter) Complex PTSD is recognized by the World Health Organization in the ICD-11, the international diagnostic system adopted in 2022. It is not, however, included in the DSM-5-TR, the diagnostic manual used by most clinicians in the United States. This is a bureaucratic gap, not a clinical one. The research supporting C-PTSD as a distinct condition is robust and growing. Population-based studies confirm that PTSD and C-PTSD have different symptom profiles, different risk factors, different treatment needs, and different prevalence rates. The International Society for Traumatic Stress Studies recognizes C-PTSD and recommends phase-based treatment for it. Clinicians across the country use ICD-11 criteria to conceptualize and treat it, even when the formal DSM code on the insurance claim reads "PTSD." We raise this because many of our clients arrive having been told they have PTSD, depression, anxiety, or a personality disorder, sometimes all of them at once, without anyone connecting the dots to the underlying developmental trauma. When you understand C-PTSD as a single coherent condition rather than a collection of separate diagnoses, the path forward becomes clearer. A nervous system shaped by danger can learn, in time, to feel calm again. How Complex Trauma Shapes the Nervous System To understand why C-PTSD affects so much more than memory, it helps to understand what trauma does to the nervous system. Your autonomic nervous system operates in three basic modes. When you feel safe and connected, you are in what researchers call a ventral vagal state: calm, socially engaged, able to think clearly and relate to others. When you perceive threat, your system shifts into sympathetic activation: fight or flight, increased heart rate, mobilized energy, narrowed focus. When the threat feels overwhelming and inescapable, the system drops into a dorsal vagal state: freeze, shutdown, collapse, dissociation. The body essentially plays dead because fighting and fleeing have both failed. In a healthy nervous system, these states are flexible. You shift into activation when needed and return to baseline when the threat passes. In someone with C-PTSD, the system has been shaped by prolonged exposure to threat, often beginning in childhood when the nervous system was still developing. The result is a nervous system that is biased toward defense. You may live in a near-constant state of sympathetic activation (hypervigilance, anxiety, difficulty relaxing, scanning for danger) or dorsal vagal shutdown (numbness, fatigue, disconnection, depression), or you may swing between the two with very little access to the calm, connected state in between. This is not a character flaw. It is the predictable result of a nervous system that learned, through repeated experience, that the world is not safe and that other people cannot be relied on. That learning happened below conscious awareness, in your body, before you had any say in the matter. There is also a fourth adaptive response that does not get named often enough: fawning . If you grew up in an environment where fighting back was dangerous and leaving was impossible, you may have learned to survive by reading other people’s emotional states and giving them what they needed in order to stay safe. People-pleasing, conflict avoidance, shapeshifting to match whoever you are with. Fawning is a survival strategy, and it is one of the most common presentations we see in our clients with C-PTSD. Where Complex PTSD Comes From Complex PTSD develops most frequently in the context of early, repeated, interpersonal trauma. The most common origins include: Childhood Abuse and Neglect This includes physical, sexual, and emotional abuse, but it also includes emotional neglect, which can be harder to identify because it is defined by what did not happen rather than what did. A child who was not seen, not responded to, not comforted, not allowed to have emotions, grew up without the attuned caregiving that the developing nervous system requires. The CDC reports that nearly 64 percent of U.S. adults experienced at least one adverse childhood experience, and 17 percent experienced four or more. In Philadelphia specifically, the landmark Philadelphia Expanded ACE Survey found even higher rates, with nearly half of respondents reporting both household and community-level adversity. Domestic Violence and Intimate Partner Abuse Herman specifically identified domestic violence as a context of captivity. The victim is held not by physical restraints but by psychological control, financial dependence, threats, and the erosion of autonomy and self-worth. Studies show that C-PTSD is roughly twice as prevalent as standard PTSD among intimate partner violence survivors. Narcissistic Abuse Prolonged exposure to a partner, parent, or authority figure who alternates between idealization and devaluation, who gaslights, controls, and systematically undermines your reality, produces the same nervous system adaptations as other forms of captivity. The confusion, self-doubt, and identity erosion that result are hallmarks of C-PTSD. Community Violence and Systemic Trauma Philadelphia has a specific relationship with community-level trauma. While gun violence has decreased significantly in recent years, the cumulative impact of decades of concentrated violence in specific neighborhoods has produced widespread traumatic stress. A Penn LDI study found that a 14-year-old Black male in Philadelphia has a 1 in 8 chance of being shot or killed before age 25. This kind of systemic, community-level exposure produces complex trauma responses that standard PTSD frameworks were not designed to capture. Recovery moves in phases: safety first, then processing, then reconnection. How We Treat PTSD and Complex PTSD in Philadelphia Our approach follows the phase-based treatment model developed by Judith Herman and endorsed by the International Society for Traumatic Stress Studies as the standard of care for complex trauma. It unfolds in three overlapping phases, though the work is not strictly linear. You may move between phases as your needs evolve. Phase One: Safety and Stabilization Before any trauma can be processed, you need to feel safe. Safe in your body. Safe in the therapy room. Safe enough in your daily life that therapy does not become one more destabilizing experience. This phase focuses on building the therapeutic relationship, developing skills for managing overwhelming emotions and nervous system activation, reducing crisis and chaos, and establishing the internal and external resources you will need for the deeper work ahead. For some clients, this phase takes weeks. For others, it takes months. There is no shortcut, and we do not rush it. Phase Two: Processing and Mourning Once sufficient safety is established, the work shifts to engaging with the traumatic material itself. This does not mean simply retelling what happened, though narrative can be part of it. It means allowing the emotions, body sensations, and relational meanings of the trauma to surface and be processed in the context of a safe therapeutic relationship. Trauma processing in our practice is not a technique applied to you. It is something that happens between you and your therapist, in a relationship where the patterns that trauma created can be seen, understood, and gradually reworked. How you relate to your therapist, what feels safe to share and what does not, the moments you shut down or pull away, all of it is material that tells us something about how trauma shaped your capacity for connection. This phase also involves mourning. Mourning the childhood you did not have. Mourning the safety you deserved. Mourning the years lost to survival mode. This grief is not a side effect of treatment. It is a central part of it. Our Grief and Loss Therapy page goes deeper into how we approach this work. Phase Three: Reconnection and Integration The final phase focuses on rebuilding. Rebuilding your relationship with yourself, with other people, and with the life you want to live. This means developing a sense of identity that is not organized around the trauma. It means learning to tolerate closeness, to trust, to take risks, to let yourself be known. It means moving from surviving to living. This phase is not an endpoint. It is an ongoing process that continues well beyond therapy. But when the foundation has been laid in Phases One and Two, the capacity for genuine connection and meaning-making becomes available in ways it may never have been before. The Tools Within Our Framework Our clinical approach is grounded in relational psychodynamic and psychoanalytic theory. This is our primary modality and the foundation that holds everything else. Within that framework, our therapists draw from several additional approaches when they serve the work: EMDR for processing specific traumatic memories, particularly when intrusive images, flashbacks, or body-based trauma responses are prominent. EMDR is powerful, but it works best within a relational container. For complex trauma, it requires careful preparation and pacing that a standalone EMDR protocol does not always provide. Our guide, Is EMDR right for you? , explains how we decide when it fits. IFS (Internal Family Systems) for working with the protective parts of the self that developed in response to trauma, the parts that numb, the parts that rage, the parts that people-please, and the vulnerable parts they are trying to protect. Somatic approaches for trauma that is stored in the body and does not respond to talk alone. Chronic tension, dissociation, startle responses, and the inability to feel safe in your own skin often require body-based work to shift. These are tools we use within the relational framework. They are not the framework itself. The foundation is always the therapeutic relationship, because trauma happened in relationship, and lasting healing requires relationship too. This is not a twelve-session fix. It is repair that honors what you carried. Why Short-Term Protocols Often Fall Short for Complex Trauma If you have tried therapy before and it did not stick, or if you started a trauma treatment program and dropped out, you are not alone. Research shows that dropout rates for manualized PTSD treatments are strikingly high. A large VA study found that 56 percent of patients dropped out of Prolonged Exposure and 47 percent dropped out of Cognitive Processing Therapy. Among those who did drop out of CPT, 76 percent left by session five, before trauma processing had even begun. Higher dropout is consistently observed among people with childhood trauma rather than single-incident trauma, the population most likely to have C-PTSD. This is not because those treatments are bad. For single-incident PTSD, they can be highly effective. But Complex PTSD requires something different. The disturbances in self-organization, the affect dysregulation, the shattered sense of self, the difficulty in relationships, these do not resolve through exposure and cognitive restructuring alone. They require developmental repair: the slow, sustained experience of being seen, understood, and responded to in a relationship that does not replicate the conditions that caused the injury in the first place. That kind of repair cannot happen in 12 sessions. It takes time. We are honest about this because we respect your investment, and because the research supports it. Patients with C-PTSD from childhood trauma consistently show weaker improvements in standard short-term protocols compared to those with single-incident trauma. The ISTSS Expert Consensus Guidelines specifically recommend phase-based treatment for complex trauma rather than direct exposure protocols. You should expect some noticeable relief early in treatment as you begin to feel less alone and develop skills for managing activation. But we specialize in the longer arc of healing, the work that addresses not just what happened to you but how it shaped your relationship with yourself and your capacity for connection. From surviving to living, in the city you call home. What to Expect in PTSD and C-PTSD Therapy at Turning Leaf Your first sessions are about safety. Your therapist will ask about your history, your symptoms, and your goals. You will not be asked to dive into traumatic material before you are ready. The early work is about building a relationship strong enough to hold what comes next. fees & insurance frequency & support Typically weekly. For intensive work, twice-weekly sessions are available. format In-person at our Old City Philadelphia office or telehealth for anyone located in Pennsylvania. insurance Aetna, BCBS plans, United Healthcare, Optum, and VCAP (Victims Compensation) . Out-of-network support offered. self-pay $130 to $200 per session depending on the therapist. related Trauma Therapy EMDR Therapy IFS Therapy Grief Therapy Getting Started 01 Complete our short intake A short adaptive form. It asks only what applies to you. 02 We match you, personally Our intake coordinator reviews your response and matches you with the clinician who fits your concern, insurance, and schedule. 03 Meet your therapist Your first session is a clinical consultation, scheduled directly with the right fit. Start your intake → Or call (215) 399-4128 Using Your Insurance for PTSD Therapy Therapy for PTSD and complex PTSD is covered as a standard outpatient behavioral health benefit under every plan we participate in. Turning Leaf is in-network with Aetna , Highmark Blue Cross , Capital Blue Cross , Anthem , Empire , the Federal Employee Program , Horizon BCBS of New Jersey , United Healthcare , Optum , and Pennsylvania VCAP . Pennsylvania VCAP is worth flagging on this page: if you are the victim of a crime, VCAP can cover counseling costs, and where approved you may owe nothing per session. Otherwise in-network copays run $15 to $50 after deductible, verified for you in advance of your first appointment. Independence Blue Cross, Cigna, Medicare, and Medicaid are out of network with our practice. Sessions in that case are $130 to $200, and we provide a superbill after every session so you can seek out-of-network reimbursement. The insurance page explains the path in plain terms. Frequently Asked Questions About PTSD and C-PTSD Therapy What is the difference between PTSD and Complex PTSD? + PTSD develops in response to a specific traumatic event or events. Complex PTSD develops from prolonged, repeated trauma, usually beginning in childhood or occurring in relationships where escape is difficult. C-PTSD includes all the symptoms of PTSD plus three additional areas of disruption: difficulty regulating emotions, a deeply negative sense of self, and persistent difficulty in relationships. C-PTSD is recognized by the World Health Organization (ICD-11) and affects an estimated 3.8 percent of the U.S. population. Is Complex PTSD a real diagnosis? + Yes. C-PTSD is recognized by the World Health Organization in the ICD-11 diagnostic system, which has been adopted internationally since 2022. It is not yet included in the DSM-5-TR, the diagnostic manual used by most U.S. clinicians, but the research supporting it as a distinct condition is substantial and growing. Many trauma specialists, including our team, use ICD-11 criteria to conceptualize and guide treatment regardless of DSM status. What is the best type of therapy for Complex PTSD? + The International Society for Traumatic Stress Studies recommends phase-based treatment for Complex PTSD. This approach begins with stabilization and safety, moves to processing traumatic material, and progresses to reconnection and integration. Our practice follows this model using a relational psychodynamic foundation, drawing from EMDR, IFS, and somatic approaches as needed within that framework. How long does C-PTSD therapy take? + There is no standard timeline. You can expect some relief within the first weeks of treatment as you begin to feel safer and develop skills for managing symptoms. Deeper work, the kind that addresses the relational and developmental roots of C-PTSD, takes longer. Many of our clients engage in therapy for a year or more, and the depth of that commitment is what produces lasting change rather than temporary symptom reduction. Therapy can also feel harder before it feels better, which is often a sign of the work deepening rather than failing. What does C-PTSD look like in adults? + In adults, C-PTSD often shows up as chronic anxiety or depression, difficulty regulating emotions, a persistent sense of shame or worthlessness, trouble maintaining close relationships, people-pleasing or fawning, dissociation or emotional numbness, hypervigilance, and difficulty trusting others. Many adults with C-PTSD have been misdiagnosed with depression, anxiety, bipolar disorder, or personality disorders without anyone connecting the symptoms to their trauma history. What causes Complex PTSD? + C-PTSD develops from prolonged, repeated exposure to traumatic situations, particularly those involving interpersonal harm where escape is difficult. The most common causes include childhood abuse (physical, sexual, emotional), childhood neglect, domestic violence, narcissistic abuse, and any prolonged situation of captivity or control. Roughly 64 percent of U.S. adults report at least one adverse childhood experience, and 17 percent report four or more (CDC). Can Complex PTSD be cured? + C-PTSD is highly treatable. Most people who engage in sustained, quality treatment experience significant and lasting improvement in their symptoms, their relationships, and their sense of self. The goal is not to erase the past but to change your relationship to it so that trauma no longer organizes your life. What is phase-based trauma treatment? + Phase-based treatment is the clinical standard for complex trauma, originally developed by Judith Herman. It consists of three overlapping phases: safety and stabilization (building resources and therapeutic trust), processing and mourning (engaging with traumatic material in a safe relational context), and reconnection and integration (rebuilding identity, relationships, and engagement with life). What is the fawn response? + Fawning is a survival strategy where a person responds to threat by complying, people-pleasing, or suppressing their own needs to keep the threatening person calm. It often develops in childhood when fighting back was dangerous and escape was impossible. In adulthood, it can look like chronic people-pleasing, difficulty saying no, losing yourself in relationships, or automatically prioritizing others’ emotions over your own. Does insurance cover PTSD and C-PTSD therapy in Philadelphia? + Yes. Turning Leaf is in-network with Aetna, United Healthcare, Optum, and these Blue Cross plans: Highmark, Capital Blue Cross, Anthem, Empire, the Federal Employee Program, and Horizon BCBS of New Jersey. We also accept Pennsylvania VCAP (Victims Compensation Assistance Program) for survivors of violent crime, which where approved can cover the full cost of counseling. Most in-network clients pay a copay of $15 to $50 after any deductible. We are out-of-network with Independence Blue Cross, Cigna, Medicare, and Medicaid; those sessions are $130 to $200, and for plans with out-of-network benefits we provide a superbill after every session on request. I tried trauma therapy before and it did not work. Can you still help? + Yes. Many of our clients have tried shorter-term or exposure-based treatments that provided temporary relief but did not address the deeper relational and developmental wounds of complex trauma. Our phase-based, relational approach is specifically designed for the kind of trauma that does not resolve with protocols alone. If previous therapy felt too intense too fast, or if it focused on symptoms without reaching the underlying patterns, our approach may be what you need. Take the First Step You have survived things that should not have happened to you. That survival required immense strength, even if it does not feel that way from the inside. Therapy is not about proving that strength. It is about no longer needing to use it just to get through an ordinary day. request an appointment Take the first step. You have survived things that should not have happened to you. Therapy is about no longer needing that strength just to get through an ordinary day. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/trauma-informed-therapy-philadelphia/ ===================================================================== Home / Specialties / Trauma Therapy old city, philadelphia Trauma Therapy in Philadelphia That Treats the Root, Not the Label Trauma therapy at Turning Leaf in Old City, Philadelphia, is relational, phase-based care for single-incident, complex, developmental, and relational trauma, delivered by 26 trauma-informed therapists, several of them additionally trained in EMDR, IFS, and somatic work. Trauma-informed care is not a specialty we offer alongside others; it is the foundation of the practice. We ask "what happened to you?" rather than "what’s wrong with you?" In person at 123 Chestnut Street or by secure video across Pennsylvania, and in New Jersey through our NJ-licensed clinicians. In-network with Aetna, BCBS, United, Optum, and PA VCAP; self-pay $130 to $200. Trauma-informed therapy is not a technique. It is a way of understanding why you struggle the way you do, and it starts with a shift in the question. Instead of asking "What is wrong with you?" a trauma-informed therapist asks "What happened to you?" That single reframing changes everything: how we listen, how we interpret your symptoms, how we build treatment, and what kind of healing becomes possible. trauma and PTSD WHAT WE TREAT HERE Trauma responses from single events and from prolonged experiences INSURANCE In-network with Aetna, Blue Cross plans, United Healthcare, Optum, PA VCAP Typical copay $15 to $50. See all plans SELF-PAY $130 to $200 per session Superbills provided for out-of-network reimbursement. Rates SESSIONS 53 minutes, usually weekly FORMAT In person in Old City Philadelphia, or telehealth Across Pennsylvania, and New Jersey with select clinicians. Telehealth AGES Teens and adults APPROACH Trauma-informed across every specialty EMDR, IFS, and somatic approaches NEW CLIENTS We are accepting new clients After your intake form, a coordinator reviews it and verifies your benefits; most people have a first session within about a week. Start your intake → ON THIS PAGE What Makes Therapy "Trauma-Informed" Our Approach: Relational Psychodynamic Therapy as the Foundation What Trauma Actually Is How Trauma Lives in the Body and Brain Signs That Unresolved Trauma May Be Affecting Your Life How Trauma Therapy Works at Turning Leaf in Philadelphia Trauma in Philadelphia Getting started Using your insurance Frequently Asked Questions Take the First Step The first question is not what is wrong with you. It is what happened to you. At Turning Leaf Therapy in Old City Philadelphia, trauma-informed care is the lens through which all of our clinical work is conducted. It is not a specialty we offer alongside other services. It is the foundation beneath every session, every therapeutic relationship, and every treatment plan across our practice of 26 therapists. Roughly 70 percent of U.S. adults experience at least one traumatic event in their lifetime (VA NCPTSD). In Philadelphia, that number is even higher: the Philadelphia Urban ACE Study found that nearly 70 percent of adults experienced at least one adverse childhood experience, and 40 percent experienced four or more. Trauma is not an edge case. It is the norm. And a practice that does not center it is missing the context for most of what walks through the door. What Makes Therapy "Trauma-Informed" SAMHSA (the Substance Abuse and Mental Health Services Administration) defines a trauma-informed approach through four commitments: an organization realizes the widespread impact of trauma, recognizes signs and symptoms in clients and staff, responds by integrating knowledge into policies and practices, and actively resists re-traumatization. In practice, this means six principles guide every interaction. Safety: physical, psychological, and emotional safety is the first priority. Trustworthiness and transparency: you know what to expect and why. Peer support: healing does not happen in isolation. Collaboration and mutuality: the therapist works alongside you, not above you. Empowerment, voice, and choice: you lead the pace and direction of your own treatment. Cultural, historical, and gender issues: your identity, your history, and your community context are never separated from your clinical care. These principles sound simple. Applying them consistently requires a practice built around them from the ground up. Most therapists have some training in trauma. Fewer have built their entire clinical identity around it. The difference shows up in how quickly trust is built, how carefully pacing is managed, and how deeply the work can go without retraumatizing the person it is meant to help. Our Approach: Relational Psychodynamic Therapy as the Foundation Turning Leaf Therapy is a relational psychodynamic and trauma-informed practice. This means we believe the therapeutic relationship itself is the most powerful clinical tool available for healing trauma, particularly trauma that occurred in relationships. Relational psychodynamic therapy holds that human beings are formed, wounded, and healed in relationship. When the source of your pain was a person, whether a caregiver who was absent or unpredictable, a partner who was controlling or violent, a family system that dismissed your experience, or a community that devalued your identity, the healing has to happen in relationship too. No protocol or worksheet can do what a consistent, attuned, trustworthy human relationship can do. This is not a passive process. In relational therapy, the therapist pays close attention to what happens between the two of you: the moments of trust and rupture, the patterns you bring into the room, the ways old relational dynamics replay themselves in new relationships, including this one. When a client who was chronically dismissed as a child tests whether the therapist will really listen, that test is not resistance. It is the material. Working through it is how relational patterns actually change. Research supports this approach. A landmark review by Jonathan Shedler in the American Psychologist (2010) found that psychodynamic therapy produces effect sizes that increase after treatment ends, rising from 0.97 at termination to 1.51 at long-term follow-up. This "sleeper effect" suggests that psychodynamic therapy sets in motion psychological processes that continue producing change long after sessions stop. Additionally, psychodynamic therapy demonstrates lower dropout rates than trauma-focused CBT protocols, with one meta-analysis finding a relative risk reduction of 37 percent (p=0.049). When therapy honors the complexity of trauma rather than pushing through it, people stay. Within this relational framework, we also draw on evidence-based modalities to address specific dimensions of trauma. EMDR therapy helps reprocess traumatic memories that remain stuck in the nervous system. Internal Family Systems (IFS) works with the protective parts that formed in response to overwhelming experience. Somatic approaches address how trauma lives in the body. DBT and ACT provide emotion regulation and distress tolerance skills. Cognitive behavioral therapy offers structured tools for managing symptoms. No single modality is sufficient for all trauma presentations. The relational psychodynamic framework is what holds them together and determines when each one is called for. Trauma is defined by the imprint it leaves, not by how big it looked from outside. What Trauma Actually Is Most people think of trauma as a catastrophic event: a car accident, a combat deployment, a violent assault. These are traumatic. But they represent only one category. Trauma is better understood as any experience that overwhelms your capacity to cope and leaves a lasting imprint on how you see yourself, other people, and the world. "Big T" and "little t" Trauma Clinicians often distinguish between "Big T" trauma and "little t" trauma. Big T traumas are the events most people recognize as traumatic: abuse, assault, combat, natural disasters, life-threatening accidents, witnessing violence. These events are objectively overwhelming and often meet the diagnostic criteria for PTSD. Little t traumas are the experiences that may not seem dramatic from the outside but leave a lasting mark on how you function. A parent who was emotionally unavailable. Being humiliated by a teacher in front of the class. Growing up in a home where conflict was constant but never physical. Being chronically overlooked, dismissed, or made to feel that your needs did not matter. Individually, these experiences might seem manageable. Cumulatively, they shape how you relate to yourself and others as profoundly as any single catastrophic event. Many people who carry little t trauma do not identify as having experienced trauma at all. They minimize their experiences because "other people had it worse." But trauma is not defined by what happened to you measured against someone else’s suffering. It is defined by how your nervous system responded and whether that response still runs your life. Research consistently shows that cumulative little t traumas can produce the same psychological and physiological effects as Big T events, including anxiety, depression, relational difficulties, and somatic symptoms. If you have ever thought "What happened to me was not that bad" while simultaneously struggling with patterns you cannot explain, the distinction between Big T and little t may be the most important concept on this page. Single-Incident Trauma Accidents, assaults, natural disasters, sudden loss, witnessing violence. These events are identifiable, often time-limited, and typically recognized by others as traumatic. They respond well to targeted interventions like EMDR, which has demonstrated that 90 percent of single-trauma victims no longer met PTSD criteria after three sessions (Shapiro, 2001). Our PTSD and Complex PTSD Therapy page addresses this in depth. Complex and Developmental Trauma Prolonged, repeated trauma, especially during childhood. Abuse, neglect, chronic family instability, growing up with an addicted or mentally ill caregiver, exposure to ongoing domestic violence. The ICD-11 defines Complex PTSD as arising from "prolonged exposure to significantly threatening events from which escape is difficult or impossible." Complex trauma does not just create symptoms. It shapes personality, attachment patterns, and the very architecture of the self. Relational Trauma Harm that occurred within significant attachment relationships. This is the category that a relational psychodynamic practice is uniquely equipped to address. When the person who was supposed to protect you was also the source of your pain, the wound is relational and the healing must be too. Relational trauma disrupts the capacity to trust, to be vulnerable, to receive care without suspicion. These patterns do not resolve through insight alone. They shift through experiencing a relationship that works differently. Our Attachment Therapy page explores this territory. Medical Trauma Not all trauma involves violence or abuse. A serious diagnosis, a traumatic birth, an emergency surgery, a prolonged ICU stay, or an invasive medical procedure can leave lasting psychological imprints. Research shows that 20 to 30 percent of ICU survivors develop PTSD symptoms, and approximately 9 percent of women experience clinically significant post-traumatic stress following childbirth. Medical trauma is uniquely disorienting because it occurs in settings that are supposed to help you, creating a painful confusion between safety and threat. Philadelphia is home to some of the country’s largest hospital systems, and many of our clients carry unprocessed experiences from medical contexts they were told they should feel grateful to have survived. Intergenerational Trauma Trauma transmitted across generations through family systems, attachment patterns, and emerging epigenetic mechanisms. Research has found that grandchildren of Holocaust survivors are overrepresented by 300 percent among psychiatric referrals. Intergenerational trauma is not abstract. It is the anxiety your mother carried that you absorbed before you had words. It is the emotional numbness your father modeled because his father modeled it before him. Our Identity Exploration Therapy page addresses the process of understanding how inherited patterns shape present identity. Community Violence and Environmental Trauma Between 2015 and 2024, Philadelphia recorded 3,839 gun deaths and 16,475 shootings. The Philadelphia Urban ACE Study found that 40.5 percent of adults witnessed violence in their community and 27.3 percent lived in a neighborhood they did not feel safe in. These are not peripheral statistics. They are the lived reality of a significant portion of the clients we serve. Trauma-informed care in Philadelphia requires acknowledging that many of our clients carry not just individual wounds but the cumulative weight of living in a city where violence, poverty, and systemic disinvestment are structural realities. Trauma is not only a memory. It is a state the body has been holding. How Trauma Lives in the Body and Brain If you have read Bessel van der Kolk’s The Body Keeps the Score , which has sold over 3 million copies and spent more than seven years on the New York Times bestseller list, you already have a sense of this. Trauma is not just a memory. It is a physiological state that persists in the body long after the event is over. When you experience a threat, your autonomic nervous system activates survival responses: fight, flight, freeze, or fawn. These are involuntary. You do not choose them. Your nervous system chooses them for you, based on what it calculates will keep you alive. The problem is that after trauma, this system stays activated. The threat is gone, but your body does not know that. You remain in a state of chronic hyperarousal (anxiety, hypervigilance, insomnia, irritability) or hypoarousal (numbness, disconnection, dissociation, fatigue), or you swing between both. Dan Siegel’s concept of the window of tolerance describes the optimal zone of arousal where you can think clearly, feel your emotions without being overwhelmed, and engage with the world. Trauma narrows this window. Therapy, particularly relational therapy that provides the consistent experience of safety, gradually expands it. Stephen Porges’ polyvagal theory explains this through the vagus nerve, which mediates three nervous system states: the ventral vagal state (safe and social), the sympathetic state (fight or flight), and the dorsal vagal state (freeze and shutdown). Trauma survivors often oscillate between sympathetic activation and dorsal shutdown, rarely accessing the ventral vagal state of safety and connection. The therapeutic relationship, when experienced as reliably safe, provides the co-regulatory experience that helps the nervous system learn that safety is possible again. Signs That Unresolved Trauma May Be Affecting Your Life Many people who benefit from trauma therapy do not initially identify as having experienced "trauma." They come to therapy for anxiety that will not respond to logic, depression that does not lift despite changes in circumstance, relationship patterns that repeat no matter who the partner is, or a persistent feeling of being disconnected from themselves. Unresolved trauma often shows up in ways that do not look like trauma at first: Emotionally: reactions that feel disproportionate to the situation, chronic anxiety or dread without a clear cause, emotional numbness or difficulty feeling anything at all, shame that permeates your sense of self, hypervigilance and difficulty relaxing. Relationally: difficulty trusting, people-pleasing as a survival strategy, patterns of choosing unavailable or harmful partners, fear of conflict, pushing people away when they get close, expecting abandonment. Physically: chronic pain without medical explanation, persistent fatigue, tension you carry in your body, sleep disturbances, weakened immune system, digestive issues. Behaviorally: substance use, emotional eating, workaholism, avoidance of situations that trigger memories or feelings, dissociating during stress, difficulty being present. These responses are not signs of weakness or dysfunction. They are adaptations. They are the strategies your nervous system developed to survive an environment that was not safe. Trauma-informed therapy does not pathologize these adaptations. It honors them as evidence of your resilience while helping you develop responses that serve you better now. Trauma happened in relationship. In relationship, it can also heal. How Trauma Therapy Works at Turning Leaf in Philadelphia Judith Herman’s foundational three-stage model of trauma recovery, from Trauma and Recovery (1992), provides the roadmap for our work. It is not a rigid protocol. It is a framework that respects the pace and complexity of genuine healing. Stage 1: Safety and Stabilization Herman wrote that the first task of recovery is to establish safety, and that "this task takes precedence over all others." Before any trauma can be processed, you need a stable foundation: a therapeutic relationship you can trust, skills for managing overwhelming emotions, and an understanding of what is happening in your body. This stage is not preliminary to the "real work." It is the real work. For many clients, especially those with complex or relational trauma, this stage takes months, and rushing it undermines everything that follows. Stage 2: Remembrance and Mourning When sufficient safety is established, the trauma story can be told in depth, at a pace you set. This is not about reliving the experience. It is about transforming traumatic memory so it can be integrated into your broader life narrative rather than existing as an intrusive, fragmented presence. This is where modalities like EMDR, IFS, and somatic approaches are most directly engaged. Stage 3: Reconnection The final stage involves reconnecting with the world, with relationships, with a sense of purpose, and with a version of yourself that is no longer organized around survival. Herman’s core thesis: "The essential features of psychological trauma are disempowerment and disconnection from others. Recovery therefore is based upon empowerment of the survivor and restoration of relationships." Not everyone needs all three stages. Some clients come to therapy already feeling safe and needing help with Stage 2 processing. Others are primarily working on Stage 3 reconnection after years of isolation. The model provides a compass, not a script. We practice in this city. Our clients carry its history, and its resilience. Trauma in Philadelphia Philadelphia has a unique and important relationship with trauma. It was here, in 2012-2013, that researchers conducted the Philadelphia Urban ACE Study, which expanded the original CDC-Kaiser ACE framework to include five community-level adverse experiences: witnessing violence, experiencing racism, living in an unsafe neighborhood, being bullied, and living in foster care. This expansion fundamentally changed how public health professionals understand trauma, recognizing that individual experiences of adversity cannot be separated from the communities in which they occur. The data was stark. Forty percent of Philadelphia adults had experienced four or more ACEs, nearly double the national rate from the original Kaiser study. Nearly 14 percent experienced adversity limited only to the expanded community-level categories and would have been entirely missed by the conventional ACE framework. Philadelphia also carries the weight of structural violence: a poverty rate of 19.7 percent (nearly double the national average), the lowest economic mobility ranking of any major metro region in the United States (Raj Chetty, Harvard/Opportunity Insights), a gun violence epidemic that killed 3,839 people in the past decade, and racial disparities so stark that Black Philadelphians are 13 times more likely to be shot than white Philadelphians. We practice in this city. Our clients carry this city’s history. A trauma-informed practice in Philadelphia must reckon with these realities, not as background context but as the daily environment in which our clients live, work, raise children, and try to heal. Our approach to life transitions , grief , identity , and LGBTQIA+ affirming care is shaped by this understanding. fees & insurance format In-person at our Old City Philadelphia office (123 Chestnut St) or telehealth for anyone located in Pennsylvania. insurance Aetna, BCBS plans, United Healthcare, and Optum. (Note: We do not accept Independence Blue Cross) . fees $130 to $200 per session for self-pay clients, depending on the therapist. Superbills provided after every session on request. See our Fees and Insurance page for full details. related PTSD & Complex PTSD EMDR Therapy IFS Therapy Attachment Therapy Getting Started 01 Complete our short intake A short adaptive form. It asks only what applies to you. 02 We match you, personally Our intake coordinator reviews your response and matches you with the clinician who fits your concern, insurance, and schedule. 03 Meet your therapist Your first session is a clinical consultation, scheduled directly with the right fit. Start your intake → Or call (215) 399-4128 Using Your Insurance for Trauma Therapy Trauma therapy is not billed as anything exotic. It is outpatient behavioral health, covered under the plans we participate in the same way a visit for anxiety or depression would be. We are in-network with Aetna , United Healthcare , Optum , Highmark Blue Cross , Capital Blue Cross , Anthem , Empire , the Federal Employee Program , Horizon BCBS of New Jersey , and Pennsylvania VCAP . For most in-network clients the per-session cost is a copay of $15 to $50 after deductible. Our coordinators confirm your benefits before your first appointment rather than leaving you to interpret your plan documents. We are out of network with Independence Blue Cross, Cigna, Medicare, and Medicaid. Those sessions are $130 to $200 self-pay, with a superbill provided every time for out-of-network reimbursement. The insurance page explains the process without overpromising what any given plan will pay back. Frequently Asked Questions What is trauma-informed therapy? + Trauma-informed therapy is a therapeutic approach that recognizes the widespread impact of trauma and integrates that understanding into every aspect of treatment. Rather than treating symptoms in isolation, it asks "What happened to you?" and understands current difficulties as adaptations to overwhelming past experiences. SAMHSA defines it through six principles: safety, trustworthiness, peer support, collaboration, empowerment, and attention to cultural and historical context. What is the difference between trauma-informed therapy and EMDR? + Trauma-informed therapy is a philosophy and framework that shapes how a therapist approaches all clinical work. EMDR is a specific modality used to reprocess traumatic memories. At Turning Leaf, EMDR is one of several evidence-based tools we use within our trauma-informed, relational psychodynamic framework. Our EMDR Therapy page explains this modality in detail. How do I know if I need trauma therapy or counseling? + If you experience disproportionate emotional reactions, chronic anxiety or depression that does not respond to standard approaches, relationship patterns that repeat despite your best efforts, physical symptoms without medical explanation, or a persistent sense of disconnection from yourself or others, unresolved trauma may be a factor. You do not need to have experienced a dramatic event to benefit from trauma-informed care. What happens in a trauma therapy session? + Early sessions focus on building safety and trust, understanding your history and goals, and developing skills for managing overwhelming emotions. As therapy progresses, you may work more directly with traumatic material at a pace you set. Sessions may include talking, experiential exercises, body awareness work, or specific modalities like EMDR or IFS depending on what serves you best. How long does trauma therapy take? + This depends on the nature and complexity of your trauma. Single-incident trauma may respond to targeted treatment in 8 to 16 sessions. Complex or developmental trauma, which involves patterns built over years, typically benefits from longer-term work. Your therapist will discuss a recommended approach after the initial sessions. Therapy can also feel harder before it feels better, which is often a sign of the work deepening rather than failing. Does trauma therapy actually work? + Yes. Research consistently demonstrates that trauma therapy is effective. EMDR has been shown to resolve PTSD symptoms in 90 percent of single-trauma cases within three sessions. Psychodynamic therapy produces effect sizes that increase after treatment ends (Shedler, 2010). Approximately 75 percent of people who enter psychotherapy experience meaningful benefit (APA). What is the difference between trauma-informed care and trauma-specific treatment? + Trauma-informed care is a philosophical approach that shapes how a practice operates: prioritizing safety, avoiding retraumatization, understanding symptoms as adaptations. Trauma-specific treatment refers to particular clinical interventions designed to process traumatic experiences, such as EMDR, IFS, Prolonged Exposure, or Cognitive Processing Therapy. At Turning Leaf, trauma-informed care is our foundation, and trauma-specific modalities are the tools we use within it. Can trauma therapy help even if I do not remember what happened? + Yes. Trauma is stored in the body and nervous system, not just in conscious memory. Somatic responses, relational patterns, and emotional reactions can all be addressed in therapy without requiring explicit recall of the traumatic event. Many clients enter therapy with implicit trauma, experiences that shaped them but that they cannot narrate. What types of trauma do you treat? + We treat single-incident trauma, complex and developmental trauma, relational trauma, medical trauma, intergenerational trauma, community violence exposure, identity-based trauma, and grief-related trauma. Our practice serves children, teens, and adults across this full range, in person in Old City, Philadelphia, and by secure video across Pennsylvania. Do you accept insurance for trauma therapy? + Yes. Turning Leaf is in-network with Aetna, United Healthcare, Optum, Pennsylvania VCAP, and these Blue Cross plans: Highmark, Capital Blue Cross, Anthem, Empire, the Federal Employee Program, and Horizon BCBS of New Jersey. Most in-network clients pay a copay of $15 to $50 after any deductible. We are out-of-network with Independence Blue Cross, Cigna, Medicare, and Medicaid; those sessions are $130 to $200, and for plans with out-of-network benefits we provide a superbill after every session on request. Take the First Step Trauma changes how you see the world. It changes what feels safe, who you trust, and how much of yourself you are willing to show. Therapy does not undo what happened. But it can change what the experience means to you, how it lives in your body, and how much power it holds over your present. That work takes a relationship: someone who can hold what you are carrying without looking away, who can stay steady when things get difficult, and who believes, based on evidence and experience, that healing is possible. request an appointment Take the first step. Trauma changes what feels safe. Therapy can change what the experience means to you, how it lives in your body, and how much power it holds over your present. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/grief-therapy-philadelphia/ ===================================================================== Home / Specialties / Grief Therapy old city, philadelphia Grief Therapy in Philadelphia That Honors the Full Weight of Your Loss Grief counseling and therapy at Turning Leaf in Old City, Philadelphia, is relational, psychodynamic, and trauma-informed care for every kind of loss: death, traumatic loss, perinatal loss, relational endings, and the losses the world does not recognize as grief. Sessions are 53 minutes, in person at 123 Chestnut Street or by secure video across Pennsylvania, and in New Jersey through our NJ-licensed clinicians. In-network with Aetna, BCBS, United, and Optum; self-pay $130 to $200. For most people grief softens over time. For an estimated 4 to 15 percent of bereaved adults (American Psychiatric Association) , it does not, and a year on it still shapes the day. Approximately 2.8 million people die in the United States each year, and each death leaves behind an estimated four to five grieving loved ones, generating roughly 12.5 million newly bereaved Americans annually (Evermore Foundation). But death is only one kind of loss. At Turning Leaf Therapy in Old City Philadelphia, our clinical team includes 10 therapists who specialize in grief and loss in all its forms, including losses that the culture around you may never have named. The death of someone you love. The traumatic circumstances that sometimes surround that death. The end of a relationship you built your life around. A pregnancy that ended before it was supposed to. And something that can be even harder to articulate: the grief of realizing that the childhood you deserved, the safety, the care, the attunement, was something you never actually received. life transitions WHAT WE TREAT HERE Death, traumatic loss, perinatal loss, and losses the world does not name INSURANCE In-network with Aetna, Blue Cross plans, United Healthcare, Optum, PA VCAP Typical copay $15 to $50. See all plans SELF-PAY $130 to $200 per session Superbills provided for out-of-network reimbursement. Rates SESSIONS 53 minutes, usually weekly FORMAT In person in Old City Philadelphia, or telehealth Across Pennsylvania, and New Jersey with select clinicians. Telehealth AGES Teens (13 to 17) and adults APPROACH Relational, trauma-informed EMDR for traumatic grief when it fits NEW CLIENTS We are accepting new clients After your intake form, a coordinator reviews it and verifies your benefits; most people have a first session within about a week. Start your intake → ON THIS PAGE Grief Is an Attachment Response Why Some Losses Hit Harder Than Others The Losses We Work With How Grief Counseling Works at Turning Leaf When Grief Needs More Than Time What to Expect in Grief Therapy at Turning Leaf Getting started Using your insurance Frequently Asked Questions About Grief Therapy Take the First Step Grief is love with nowhere to go, and love like that does not simply end. We are a relational, psychodynamic, and trauma-informed practice. That means we do not approach grief as a problem to fix or a timeline to follow. We approach it as a deeply personal process shaped by who or what you lost, what that loss means in the context of your whole life, and what it connects to underneath. If you are looking for a grief therapist in Philadelphia, you have probably already discovered that the world does not make much room for grief. You may have been given a few days off work and the general expectation that you should be "back to normal" soon. You may be weeks, months, or years out from a loss and still feel its weight in ways that confuse or worry you. You may be grieving something that never happened, the parent who was never really there, the childhood that should have been safe but was not, and wondering whether that even counts as grief. It does. And it deserves a space where it can be fully held. Grief Is an Attachment Response Most people think of grief as sadness about someone who died. That is part of it. But grief is much broader and much deeper than sadness alone. From a relational and psychodynamic perspective, grief is fundamentally an attachment response. The psychologist John Bowlby, who spent decades studying how humans form bonds, understood grief as what happens when the attachment system is activated by separation from someone who provided safety, comfort, or a sense of home. The yearning, the searching, the waves of pain that come without warning, these are not signs of weakness or disorder. They are the natural expressions of a bond that still exists even though the person or the relationship is gone. This framework also explains something that often goes unrecognized: you can grieve what you never had. If you grew up without the attuned, safe, consistent caregiving that every child needs, you carry a loss even if no one died. The absence of a parent who could see you clearly, respond to your emotions without punishing or ignoring them, and make the world feel safe enough to explore, that absence is a loss. It shapes everything that comes after. And at some point, often in adulthood, the weight of that absence becomes something that needs to be mourned. This is not self-pity. It is one of the most important and courageous forms of grief work there is. Mourning the childhood you deserved but did not receive is what allows you to stop unconsciously recreating the conditions of that childhood in your adult relationships. It is what makes space for something different. A present loss reopens every earlier one it is connected to. Why Some Losses Hit Harder Than Others One of the most disorienting aspects of grief is when a loss triggers a response that seems disproportionate. A breakup that levels you for months. A job loss that sends you into a depression you cannot climb out of. The death of a distant relative that somehow breaks you open in ways the death of someone closer did not. From a psychodynamic perspective, this happens because present losses reopen earlier attachment wounds. The current loss activates unconscious memories from earlier separations, abandonments, or relational injuries that were never fully processed. The grief you are feeling now is real, but it may also be carrying the weight of something older, something that started before you had language to describe it. A child who lost a parent, either through death, divorce, or emotional absence, carries that original loss forward. A child who never had an attuned caregiver carries forward a different kind of loss: the loss of something that should have been there but never was. When a later loss echoes the same emotional signature, the earlier wound reopens. The result is compounded grief, a grief response that feels bigger than the event because it is connected to more than just the event. This is one of the reasons our approach is relational and psychodynamic rather than purely skills-based. We work with both layers simultaneously: the grief of what is happening now and the earlier relational injuries it is connected to. For many of our clients, this is the first time anyone has helped them see that link. For the losses the world recognizes, and the ones it does not. The Losses We Work With Grief is not limited to death. Any significant loss can activate the same attachment responses and deserve the same quality of therapeutic attention. Death of a Loved One The loss of a parent, partner, child, sibling, or close friend is the most recognized form of grief. Even when a death is expected, the reality of permanent absence often lands differently than anticipated. The first year is especially disorienting as you encounter every holiday, season, and milestone for the first time without them. But grief does not end at the one-year mark. It reshapes over time, and the reshaping is its own process. Traumatic Grief Sometimes the circumstances of a death are themselves traumatic. Sudden or violent death, suicide, overdose, homicide, accidents, or witnessing the death of someone you love can produce a grief response that is entangled with trauma symptoms. You may be grieving the person while simultaneously being haunted by the way they died. Intrusive images of the death, hypervigilance, nightmares, or emotional numbness may sit alongside the sadness, yearning, and disbelief of grief. The trauma can block the mourning process, making it difficult to access the more tender feelings of loss because your nervous system is stuck in a protective state. Traumatic grief requires a therapist who understands both grief and trauma, not as separate conditions to be treated sequentially, but as intertwined experiences that need to be held together. Our practice was built on trauma-informed care. Our therapists are trained to work with the trauma response and the grief response simultaneously, helping you process the way the death happened so that you can eventually mourn the person you lost. Perinatal and Pregnancy Loss Miscarriage, stillbirth, and infant loss are among the most profoundly isolating forms of grief. Research estimates that 10 to 26 percent of known pregnancies end in miscarriage, and approximately 21,000 babies are stillborn in the United States each year (ACOG, CDC). Despite how common these losses are, they remain deeply disenfranchised. The world often does not know what to say, so it says nothing, or it says something that minimizes the loss rather than honoring it. From a relational perspective, perinatal loss involves mourning not just the baby but the imagined future, the identity you were forming as a parent, and the developmental transition that pregnancy set in motion. Studies show that women who experience perinatal loss have nearly four times higher odds of developing depression and seven times higher odds of PTSD compared to women with live births. Yet 90 percent of women who experience pregnancy loss report wanting follow-up care, and only 30 percent receive it. Our team includes therapists with specialized training in reproductive mental health. If you are grieving a pregnancy loss, you do not have to process it alone. Relationship Loss The end of a marriage, a partnership, a close friendship, or a family relationship can produce grief that rivals bereavement in its intensity. The person is still alive, but the relationship, and the future you imagined with them, is gone. This creates a form of ambiguous loss that is often socially minimized. From an attachment perspective, romantic breakups and family estrangements activate the same separation distress system as death. Therapy provides a space to grieve the relationship fully: the parts that were painful, the parts you miss, and the parts you are still trying to make sense of. Mourning the Childhood You Did Not Have This is the form of grief that often does not get called grief. But it is. If you grew up with a parent who was emotionally absent, inconsistent, critical, abusive, or simply unable to give you the safety and attunement you needed, you experienced a loss. Not a single event, but an ongoing absence that shaped who you became. You may have spent decades adapting to that absence, becoming self-reliant, becoming a caretaker, becoming whatever the environment required you to be. Those adaptations got you through childhood. They also cost you something. At some point, often when life slows down enough for the feelings to surface or when a new loss cracks open something old, the grief of what you never received can no longer be outrun. You may not even recognize it as grief at first. It might show up as depression, anxiety, anger, emptiness, or a persistent sense that something is missing that you cannot name. Therapy for this kind of grief involves allowing yourself to feel the full weight of what was absent, not to blame or to dwell, but to finally acknowledge the truth of your experience so you can stop carrying it unconsciously. It is some of the deepest and most transformative work we do. Anticipatory Grief If someone you love is terminally ill, living with a progressive condition, or aging in ways that change who they are, you may be grieving before the death occurs. Anticipatory grief is real grief. It is the pain of watching someone you love become someone you can no longer fully reach, and it is complicated by the fact that they are still here. Disenfranchised Grief Some losses are not recognized by the culture around you. The death of an ex-partner. The loss of a pet who was your closest companion. A miscarriage no one knew about. Grief after the death of someone who hurt you. These losses are real, and the pain is real, but the absence of social permission to grieve can make the mourning process more complicated and more isolating. Disenfranchised grief often needs therapy more than any other kind, precisely because the griever has nowhere else to bring it. The therapeutic relationship may be the first space where the loss is fully witnessed and validated. Ambiguous Loss Some losses lack the clarity that allows mourning to begin. A parent with dementia who is physically present but psychologically absent. A family member lost to addiction who is alive but unreachable. Immigration or displacement that separates you from people and places you may never return to. Psychologist Pauline Boss described these as ambiguous losses, and their defining feature is that they resist closure. Therapy provides a space to acknowledge the loss even when the world does not recognize it as one. We do not rush you toward closure. We hold the space while you move through. How Grief Counseling Works at Turning Leaf Our clinical approach is grounded in relational psychodynamic and psychoanalytic theory, with trauma-informed care woven into everything we do. This is our primary modality. What that means for grief therapy is that we do not hand you a set of stages and tell you where you should be. We do not rush you toward acceptance or closure. We provide what the psychoanalyst Donald Winnicott called a holding environment: a consistent, safe, relational space where overwhelming feelings can be experienced, expressed, and gradually integrated without judgment or timeline. The therapeutic relationship itself is central to this work. When you lose someone who was a primary source of safety or connection, there is a relational void. When you are grieving the absence of a childhood you never had, there is a relational wound that predates conscious memory. In both cases, the therapy room becomes a space where what was missing can finally be acknowledged, where the full complexity of what you are mourning can be explored, and where you can begin to develop what the research calls a continuing bond with the people you have lost, or a new internal relationship with the childhood self who deserved more than they received. We are not rigid about modality. Our therapists draw from EMDR (particularly useful for traumatic grief where intrusive images of the death interfere with mourning), IFS, somatic approaches, and other techniques when they serve the work. But the foundation is always relational. Grief happened in the context of a relationship, and it heals in the context of one too. The grief of what you never received is also, at its root, about relationship, and it can only be fully mourned inside one. When Grief Needs More Than Time Most people who experience a significant loss will grieve intensely and then gradually find their way forward. The pain does not disappear, but it becomes something you can carry rather than something that carries you. For some, that natural process gets stuck. Prolonged grief disorder, formally recognized in 2022, affects approximately 7 to 10 percent of bereaved adults (APA). It involves persistent, intense yearning or preoccupation with the person who died, lasting beyond 12 months, accompanied by emotional numbness, disbelief, difficulty engaging in ongoing life, or a sense that life has lost its meaning. Among bereaved parents, rates of complicated grief reach as high as 30 percent. Traumatic grief can also keep the mourning process frozen. When the nervous system is still responding to the trauma of how someone died, the grief itself cannot move. The trauma response and the grief response become tangled, and untangling them requires a therapist who can work with both. If your grief has not shifted despite the passage of time, if it feels as raw today as it did in the first weeks, or if you have organized your life around avoiding reminders of the loss, therapy can help. Grief and depression can overlap but are not the same. In grief, the pain comes in waves and is connected to the loss. In depression, the pain becomes pervasive and turns inward. If what started as grief has begun to feel more like depression, our Depression Therapy page explains how we approach that work. Healing is not moving on. It is learning to carry what you love. What to Expect in Grief Therapy at Turning Leaf Your first sessions are about creating safety. Your therapist will ask about your loss, your history, and what your life looks like right now. You set the pace. There is no requirement to tell the full story before you are ready. You should expect some relief relatively quickly. Many clients describe the simple experience of being heard, of having someone sit with them in their pain without trying to fix it or rush them through it, as the first real relief they have felt since the loss. We specialize in going further. For grief rooted in complex attachment dynamics, compounded by earlier losses, entangled with trauma, or connected to the absence of childhood safety and attunement, we provide intensive, longer-term treatment. The deeper work involves understanding not just who or what you lost but what the loss activates in you, and how your relational history shapes the way you mourn. fees & insurance frequency Typically weekly. For clients in acute grief or doing intensive processing, twice-weekly sessions are sometimes recommended. format In-person at our Old City Philadelphia office or telehealth for anyone located in Pennsylvania. insurance Aetna, BCBS plans, United Healthcare, and Optum Behavioral Health. Out-of-network support offered. self-pay $130 to $200 per session depending on the therapist related Depression Therapy PTSD & Complex PTSD Life Transitions Childhood Emotional Neglect Getting Started 01 Complete our short intake A short adaptive form. It asks only what applies to you. 02 We match you, personally Our intake coordinator reviews your response and matches you with the clinician who fits your concern, insurance, and schedule. 03 Meet your therapist Your first session is a clinical consultation, scheduled directly with the right fit. Start your intake → Or call (215) 399-4128 Using Your Insurance for Grief Therapy Therapy for grief and loss is covered as a standard outpatient behavioral health benefit under every plan we participate in. Turning Leaf is in-network with Aetna , Highmark Blue Cross , Capital Blue Cross , Anthem , Empire , the Federal Employee Program , Horizon BCBS of New Jersey , United Healthcare , Optum , and Pennsylvania VCAP . In-network clients typically pay $15 to $50 per session after any deductible. Grief does not require a dramatic diagnosis to be covered, and your benefits are verified before your first session so cost is one less thing to carry. If your card reads Independence Blue Cross, Cigna, Medicare, or Medicaid, we sit outside your network. Sessions are $130 to $200 and each one produces a superbill you can submit for reimbursement, which is one less thing to negotiate while you are grieving. The insurance page explains the path in plain terms. Frequently Asked Questions About Grief Therapy When should I see a therapist or grief counselor? + There is no minimum waiting period. Some people benefit from starting therapy within days or weeks of a loss. Others come months or years later when they realize the grief has not shifted on its own. If your grief is interfering with your ability to function, or if you feel alone in it, therapy is worth exploring. How long does grief therapy take? + There is no standard timeline. Some clients find meaningful relief within several weeks as they begin to feel less isolated in their grief. Deeper work, particularly for complicated, traumatic, or compounded grief, takes longer. Your therapist will work with you to determine what makes sense for your situation. Therapy can also feel harder before it feels better, which is often a sign of the work deepening rather than failing. What is complicated grief or prolonged grief disorder? + Prolonged grief disorder affects approximately 7 to 10 percent of bereaved adults. It involves intense yearning or preoccupation with the deceased persisting beyond 12 months, along with emotional numbness, disbelief, difficulty with ongoing life, or a sense of meaninglessness. It was formally recognized as a diagnosis in 2022 and responds well to therapy. What is traumatic grief? + Traumatic grief occurs when the circumstances of a death are themselves traumatic, such as sudden death, suicide, overdose, violence, or witnessing the death. The trauma response and the grief response become entangled, and the trauma can block the natural mourning process. Our practice specializes in treating both trauma and grief simultaneously. Can therapy help with grief about a childhood that was not safe or nurturing? + Yes. Mourning the safety, attunement, and care you deserved but did not receive as a child is one of the most important forms of grief work. It is often the key to understanding patterns in your adult relationships, your emotional life, and your sense of self. This work is central to what we do as a relational, psychodynamic practice. What types of loss can grief therapy help with? + We work with clients grieving the death of a loved one, traumatic or sudden loss, pregnancy and perinatal loss, the end of relationships, estrangement from family members, anticipatory grief related to terminal illness or dementia, the loss of childhood safety, and any experience of significant loss that is affecting your life. Can grief therapy help with grief after miscarriage or pregnancy loss? + Yes. Perinatal loss is one of the most isolating forms of grief because it is often minimized or unacknowledged by the surrounding community. Our team includes therapists with training in reproductive mental health who understand the particular weight of these losses. What is the difference between grief and depression? + In grief, pain comes in waves and is connected to the loss. In depression, the pain becomes pervasive and turns inward, often affecting your sense of self-worth. The two can overlap, and we are trained to work with both. Can grief therapy help if my loss happened years ago? + Yes. There is no expiration date on grief. Many clients come to us years after a loss, often because something in their current life has reactivated grief they thought they had moved past. Present losses and life transitions can reopen earlier wounds, and therapy provides a space to finally process what was never fully addressed. Does insurance cover grief therapy in Philadelphia? + Yes. Turning Leaf is in-network with Aetna, United Healthcare, Optum, Pennsylvania VCAP, and these Blue Cross plans: Highmark, Capital Blue Cross, Anthem, Empire, the Federal Employee Program, and Horizon BCBS of New Jersey. Most in-network clients pay a copay of $15 to $50 after any deductible. We are out-of-network with Independence Blue Cross, Cigna, Medicare, and Medicaid; those sessions are $130 to $200, and for plans with out-of-network benefits we provide a superbill after every session on request. Take the First Step Grief asks something enormous of you: to keep living in a world that has fundamentally changed, or to finally feel the weight of what was missing all along. You do not have to figure that out alone. Our team at Turning Leaf Therapy provides a space where your loss can be fully held, where the complexity of what you are feeling does not have to be simplified, and where healing happens not by moving on but by moving through. request an appointment Take the first step. You do not have to figure this out alone. Healing happens not by moving on but by moving through. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/relationship-therapy-philadelphia/ ===================================================================== Home / Specialties / Relationship Therapy old city, philadelphia Relationship Therapy in Philadelphia That Rewrites the Blueprint, Not Just the Ending Relationship therapy at Turning Leaf in Old City Philadelphia is individual, relational psychodynamic work on the patterns you carry into every connection: partner choice, people-pleasing, avoidance, abandonment fear. 15 of our therapists specialize in it, in person in Old City or by secure video across Pennsylvania, and in New Jersey through our NJ-licensed clinicians. In-network with Aetna, BCBS, United, and Optum; self-pay $130 to $200. This is not couples counseling. This is individual therapy for the person who has started to notice that no matter who they are with, something familiar keeps happening. The same arguments. The same distance. The same feeling of being too much or not enough. The same ending. relational and attachment WHAT WE TREAT HERE Relational patterns carried into every connection you form INSURANCE In-network with Aetna, Blue Cross plans, United Healthcare, Optum, PA VCAP Typical copay $15 to $50. See all plans SELF-PAY $130 to $200 per session Superbills provided for out-of-network reimbursement. Rates SESSIONS 53 minutes, usually weekly FORMAT In person in Old City Philadelphia, or telehealth Across Pennsylvania, and New Jersey with select clinicians. Telehealth AGES Adults APPROACH Individual relational psychodynamic therapy Attachment-focused, not couples counseling NEW CLIENTS We are accepting new clients After your intake form, a coordinator reviews it and verifies your benefits; most people have a first session within about a week. Start your intake → ON THIS PAGE Why Individual Therapy for Relationship Issues The Patterns That Bring People to This Work How Relational Psychodynamic Therapy Works With Relationship Patterns Your Attachment Style Can Change Getting started Using your insurance Frequently Asked Questions Take the First Step The pattern is not bad luck. It is a blueprint, and a blueprint can be redrawn. Relationship problems are the most common reason people seek therapy, and most of the time, the real work does not require both people in the room. It requires one person willing to look at the patterns they carry into every connection they form. At Turning Leaf Therapy in Old City Philadelphia, 15 of our therapists specialize in relationship-focused individual therapy. We are a relational, psychodynamic, and trauma-informed practice, which means the way you relate to other people is not a side topic in our work. It is the center of it. Why Individual Therapy for Relationship Issues You might be wondering whether you should be looking for couples counseling instead. Here is the distinction that matters. Couples counseling works on the dynamic between two specific people. It addresses communication, conflict resolution, and the particular patterns of a particular relationship. It requires both people to show up, participate, and be willing to change. Individual therapy for relationship issues works on you. It addresses the relational templates you carry into every relationship, the ones that were set long before you met your current partner or your last one or the one before that. It does not require anyone else to participate, because the work is about understanding what you bring to connection, why you bring it, and how it can change. If you keep finding yourself in the same kinds of relationships, if your friendships follow similar patterns, if you struggle with the same dynamics at work, the common denominator is not bad luck. It is the relational blueprint you are operating from. And that blueprint can be rewritten. But only from the inside. The faces change. The pattern repeats, until it is finally made conscious. The Patterns That Bring People to This Work You may recognize yourself in one or more of these descriptions. Most of our clients recognize themselves in several. You Keep Choosing the Same Person in Different Bodies The faces change but the dynamic does not. You are drawn to people who are emotionally unavailable, or controlling, or intermittently attentive in a way that keeps you off-balance. Friends point it out. You can see it in retrospect. But in the moment, the pull feels automatic, almost magnetic. Psychoanalytic theory has a name for this: repetition compulsion. It describes the unconscious tendency to recreate the emotional conditions of early relationships, not because you want to suffer but because your nervous system gravitates toward what it recognizes. Familiarity registers as safety, even when what is familiar is painful. The person who grew up with an emotionally distant parent may find themselves drawn to partners who are just out of reach. The person who grew up managing a volatile caregiver may find themselves attracted to intensity and unpredictability, mistaking adrenaline for love. This is not a character flaw. It is how the human attachment system works. And it is one of the most important things therapy can help you understand and interrupt. You Lose Yourself in Relationships When you are in a relationship, you mold yourself to fit. You adopt the other person’s interests, preferences, even opinions. You say yes when you mean no. You suppress your own needs to keep the peace. You do not know what you want for dinner, let alone what you want from your life, when there is another person’s feelings to manage first. An estimated 40 million Americans carry codependent traits (Hughes-Hammer et al., 1998). Among women being treated for depression, 36 percent were found to be moderately to severely codependent. This is not a personality defect. It is an adaptation, often rooted in childhood environments where a child’s own needs had to be subordinated to a parent’s emotional state. Pete Walker, who identified the fawn response as a fourth trauma response alongside fight, flight, and freeze, describes it as seeking safety by merging with the wishes and demands of others. The fawning person acts as though the price of admission to any relationship is the forfeiture of their own needs, preferences, and boundaries. It is the hardest trauma response to identify because it is socially rewarded. Kindness, agreeableness, and selflessness are valued. The cost is invisible, mostly to the person paying it. You Pull Away When Things Get Close Intimacy feels dangerous. Not logically, but in your body. When a relationship starts to deepen, you find reasons to withdraw: picking fights, going quiet, suddenly noticing flaws you had not noticed before. You may tell yourself you value independence. From the outside, you may appear self-sufficient and emotionally contained. From the inside, the avoidance may feel less like choice and more like necessity. Roughly 23 to 25 percent of adults carry a dismissive-avoidant attachment pattern. It develops when early caregivers were consistently emotionally unavailable or dismissive of the child’s needs. The adaptation: stop needing. If expressing vulnerability leads to disconnection, then suppressing it becomes the strategy for maintaining whatever connection is available. In adulthood, this shows up as discomfort with closeness, difficulty identifying emotions, and a tendency to withdraw precisely when a partner is reaching for connection. You Cannot Stop Scanning for Signs of Abandonment A delayed text spirals into a narrative about being left. A partner’s quiet mood triggers panic. You need reassurance, and when you get it, the relief lasts minutes before the anxiety returns. You know it is disproportionate to the situation. You cannot make it stop. Approximately 11 to 20 percent of adults carry an anxious-preoccupied attachment pattern. It develops when caregiving was inconsistent: sometimes responsive, sometimes absent. The child learns that amplifying distress increases the odds of getting a response. In adulthood, this becomes hypervigilance to relational cues, protest behaviors designed to pull a partner closer, and a chronic sense that you are one misstep away from being abandoned. Our Anxiety Therapy page addresses the broader anxiety picture. But when the anxiety lives primarily in your relationships, when it is specifically about connection, closeness, and the fear of losing it, the work belongs here. You Stay in Relationships You Know Are Not Good for You Friends have told you to leave. Part of you agrees. But something keeps you attached in a way that does not respond to logic. It is not weakness. It is often a combination of attachment system activation (under threat, humans seek increased closeness, even with the source of the threat), nervous system conditioning (the cycle of tension and relief creates a neurochemical pattern that feels like love), and familiar dynamics (if your childhood included similar relational patterns, abuse can feel "normal" in a way that genuine safety does not). We do not judge anyone for staying. We understand why leaving is not as simple as it sounds. And we are here when you are ready to explore what has been keeping you in place. You Are Processing Infidelity, Divorce, or a Breakup The end of a relationship involves genuine grief, and our Grief and Loss Therapy page goes deeper into that work. But relationship endings also surface patterns that existed long before this particular relationship. Why you chose this person. What you tolerated and why. What you gave away and what you held back. Individual therapy after infidelity, divorce, or a breakup is not just about healing from this loss. It is about understanding what this relationship revealed about the relational templates you carry, so the next chapter is built on something different. Research estimates that 20 percent of men and 13 percent of women report extramarital sex (General Social Survey/Institute for Family Studies). The divorce rate for first marriages is approximately 41 percent (APA). In Philadelphia County, 1,837 divorces were recorded in 2024 (Pennsylvania Department of Health). Behind every one of those numbers is a person trying to figure out what happened and what comes next. That work is best done in individual therapy, where the focus is entirely on you. Your Relationship Patterns Show Up Everywhere, Not Just in Romance The people-pleasing you do with your partner also shows up at work. The conflict avoidance you practice in your marriage also shapes your friendships. The difficulty trusting a romantic partner mirrors the difficulty trusting a supervisor. Relational patterns are not situation-specific. They are templates that travel with you into every connection you form. If you are noticing the same dynamics across multiple areas of your life, that is important information. It means the pattern is yours to understand and yours to change. Relational patterns live below thought. They change in relationship, not by insight alone. How Relational Psychodynamic Therapy Works With Relationship Patterns Our clinical approach is grounded in relational psychodynamic and psychoanalytic theory. This is not incidental. Relational psychodynamic therapy was built to do exactly this work. The core insight is that your sense of self, your capacity for connection, and your relational patterns were all shaped within your earliest relationships. The way your caregivers responded to your needs, your emotions, and your bids for closeness created internal working models, unconscious blueprints for how relationships are supposed to work. Those blueprints now operate automatically in every significant relationship you form. Relational patterns do not live at the level of conscious thought. They live in implicit, procedural memory. They are activated before you have time to think. This is why knowing your pattern does not, by itself, change it. Cognitive approaches to relationship difficulties focus on changing thoughts and behaviors. They can be useful for developing communication skills or managing conflict. But relational psychodynamic therapy changes patterns at the level where they operate: in relationship. The therapeutic relationship itself becomes the space where your patterns become visible, not as abstract concepts but as lived experiences happening in real time between you and your therapist. You may notice that you perform for your therapist the way you perform for everyone else. You may notice that you withhold your real feelings because expressing them has never felt safe. You may notice that you are scanning your therapist’s face for signs of judgment or disengagement. These are not distractions from the work. They are the work. Research consistently supports this approach. Jonathan Shedler’s landmark 2010 review found that psychodynamic therapy achieves effect sizes of 0.97 for symptom improvement, growing to 1.51 at long-term follow-up, a "sleeper effect" where benefits continue deepening after therapy ends. For interpersonal problems specifically, effect sizes reach 1.56 (Leichsenring and Leibing, 2003). This growing-after-therapy pattern makes sense from an attachment perspective: once new internal working models are established, they continue to shape relational experience long after the last session. Our therapists also draw from EMDR, IFS, DBT, ACT, and somatic approaches when they serve the work. But the relational psychodynamic framework is the foundation, because relationship patterns were formed in relationship and can only transform in relationship. Insecure attachment is not a life sentence. Security can be earned. Your Attachment Style Can Change If you have read our Attachment Therapy page , you know that roughly 40 percent of adults carry an insecure attachment pattern. You may also know that attachment researchers have identified a category called "earned secure attachment": adults who experienced insecure childhoods but have developed the capacity for secure, satisfying relationships through later corrective relational experiences. Earned secure individuals represent approximately 20 to 25 percent of securely attached adults. The research finding that matters most: earned secure individuals are statistically indistinguishable from continuously secure individuals on measures of relationship quality, emotional regulation, and parenting. The security is real. Long-term relational psychodynamic therapy is the most studied pathway to earned security. The mechanism is straightforward: the therapeutic relationship provides consistent attunement, reliable responsiveness, and non-retaliatory engagement. Over time, this repeated experience contradicts the old blueprint and builds a new one. It does not happen in 12 sessions. But it does happen. fees & insurance focus Individual Relationship Therapy. Focuses on your patterns and the blueprints you carry, rather than couples counseling. format In-person at our Old City Philadelphia office (123 Chestnut St) or telehealth for anyone located in Pennsylvania. insurance Aetna, BCBS plans, United Healthcare, and Optum Behavioral Health. Out-of-network support offered. fees $130 to $200 per session for self-pay clients, depending on the therapist. Superbills provided after every session on request. related Attachment Therapy Anxiety Therapy Grief Therapy Relational Therapy Getting Started 01 Complete our short intake A short adaptive form. It asks only what applies to you. 02 We match you, personally Our intake coordinator reviews your response and matches you with the clinician who fits your concern, insurance, and schedule. 03 Meet your therapist Your first session is a clinical consultation, scheduled directly with the right fit. Start your intake → Or call (215) 399-4128 Using Your Insurance for Relationship Therapy Therapy for relational patterns is covered as a standard outpatient behavioral health benefit under every plan we participate in. Turning Leaf is in-network with Aetna , Highmark Blue Cross , Capital Blue Cross , Anthem , Empire , the Federal Employee Program , Horizon BCBS of New Jersey , United Healthcare , Optum , and Pennsylvania VCAP . One clarification that matters for billing: this is individual therapy, which is a covered outpatient benefit under all of the plans above. Most in-network clients pay $15 to $50 per session after deductible, and your benefits are verified before you begin. Independence Blue Cross, Cigna, Medicare, and Medicaid fall outside our network. Sessions are $130 to $200 with a superbill provided every time so you can pursue reimbursement yourself. The insurance page explains the path in plain terms. Frequently Asked Questions How is individual relationship therapy different from couples counseling? + Couples counseling focuses on the dynamic between two specific people. Individual relationship therapy focuses on you: the relational patterns you carry into every connection, where those patterns came from, and how they can change. You do not need a partner present to do this work. In many cases, individual therapy is more effective for lasting relational change because it addresses the underlying templates rather than the surface-level dynamics of one particular relationship. Can therapy help if my partner will not go to counseling? + Yes. You do not need your partner’s participation to do meaningful work on your relational patterns. In fact, individual therapy often produces changes that positively influence the relationship as a whole, because when one person changes how they show up, the dynamic between both people shifts. Why do I keep choosing the same type of partner? + Repetitive partner selection is driven by internal working models, the unconscious relational blueprints formed in your earliest caregiving relationships. Your nervous system gravitates toward what it recognizes, even when what is familiar is painful. Therapy helps you become conscious of these patterns so you can begin making different choices from a place of awareness rather than automatic pilot. What is relational psychodynamic therapy? + Relational psychodynamic therapy is an evidence-based approach that understands your relational patterns as shaped by early attachment experiences and maintained through unconscious processes. It uses the therapeutic relationship itself as the primary vehicle for change. Research shows it produces effect sizes of 0.97 for symptom improvement, growing to 1.51 at long-term follow-up (Shedler, 2010). Can individual therapy improve my current relationship? + Yes. When you understand the patterns you bring to your relationships, and when those patterns begin to shift through therapy, the way you relate to your partner changes. You become better able to communicate needs, tolerate conflict, set boundaries, and receive closeness. These shifts often improve the relationship even when your partner is not in therapy. How does childhood affect adult relationships? + Early attachment experiences create internal working models that function as unconscious blueprints for all future relationships. A child who experienced inconsistent caregiving may develop anxious attachment patterns in adulthood. A child who learned that expressing needs leads to rejection may become avoidantly attached. These patterns operate automatically until they are made conscious and worked through in therapy. What are the signs I need individual therapy for relationship patterns? + Common signs include repeating the same relationship dynamics with different partners, difficulty setting or holding boundaries, chronic people-pleasing or conflict avoidance, fear of abandonment or fear of intimacy, staying in relationships you know are not good for you, losing yourself in relationships, or recognizing that the same relational struggles show up across multiple areas of your life. Is it normal to go to therapy for dating and relationship struggles? + Yes. Relationship difficulties are among the most common reasons people seek therapy. You do not need to be in crisis or in a failing relationship to benefit. Many of our clients come to therapy because they want to understand their patterns before entering their next relationship, or because they are tired of the same cycle repeating. How long does this kind of therapy take? + Relational patterns took years to form and are deeply encoded. While you may experience relief and insight early in therapy, lasting change in how you relate to others requires sustained work. Many of our clients engage in this therapy for a year or more. The depth of that commitment is what produces the kind of change that does not fade when life gets stressful. Therapy can also feel harder before it feels better, which is often a sign of the work deepening rather than failing. Can therapy help me trust again after infidelity or betrayal? + Yes. Betrayal shatters the internal working model of safety in relationships. Individual therapy provides a space to grieve, to process the specific meaning of the betrayal in the context of your history, and to gradually rebuild the capacity for trust. This is not about forcing yourself to trust prematurely. It is about understanding what trust requires and rebuilding it at the foundation level. Take the First Step Every relationship you have ever been in has taught you something about the relational patterns you carry. Some of those lessons have been painful. All of them have been informative. Therapy is where you take what you have learned, make sense of it, and begin building something different. Not with the next person. With yourself, first. request an appointment Take the first step. Every relationship has taught you something about the patterns you carry. Therapy is where you make sense of them and build something different. With yourself, first. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/attachment-therapy-philadelphia/ ===================================================================== Home / Specialties / Attachment Therapy old city, philadelphia Attachment Therapy in Philadelphia That Gets to the Root of Your Relational Patterns Attachment therapy at Turning Leaf in Old City Philadelphia is relational psychodynamic work on the anxious, avoidant, and disorganized patterns formed in your earliest relationships, and the path to earned secure attachment. Sessions are 53 minutes, in person in Old City or by secure video across Pennsylvania, and in New Jersey through our NJ-licensed clinicians. In-network with Aetna, BCBS, United, and Optum; self-pay $130 to $200. Research estimates that roughly 40 percent of adults carry an insecure attachment pattern, a way of relating to other people that developed in childhood and continues to shape romantic relationships, friendships, work dynamics, and even the relationship you have with yourself (Mickelson et al., 1997). At Turning Leaf Therapy in Old City Philadelphia, attachment is not just one of the things we work with. It is the lens through which we understand nearly everything our clients bring into the room. We are a relational, psychodynamic, and trauma-informed practice, and relational psychodynamic therapy is, at its core, attachment-based therapy. The therapeutic relationship itself is the instrument of change, not a backdrop for delivering techniques. relational and attachment WHAT WE TREAT HERE Anxious, avoidant, and disorganized attachment patterns INSURANCE In-network with Aetna, Blue Cross plans, United Healthcare, Optum, PA VCAP Typical copay $15 to $50. See all plans SELF-PAY $130 to $200 per session Superbills provided for out-of-network reimbursement. Rates SESSIONS 53 minutes, usually weekly FORMAT In person in Old City Philadelphia, or telehealth Across Pennsylvania, and New Jersey with select clinicians. Telehealth AGES Teens (13 to 17) and adults APPROACH Attachment-focused, relational Long-term, depth-oriented work NEW CLIENTS We are accepting new clients After your intake form, a coordinator reviews it and verifies your benefits; most people have a first session within about a week. Start your intake → ON THIS PAGE What Attachment-Based Therapy Actually Is Understanding Your Attachment Style The Chronic Shame Underneath Insecure Attachment How Attachment Wounds Follow You Into Adulthood Can Your Attachment Style Actually Change? Why Relational Psychodynamic Therapy Is Built for Attachment Work What Attachment Therapy Looks Like at Turning Leaf Getting started Using your insurance Frequently Asked Questions About Attachment Therapy Take the First Step Our earliest bonds become the blueprint for how safe closeness is allowed to feel. If you have been learning about attachment styles through social media, books, or your own research and have started to recognize patterns in yourself that you want to understand and change, you are in the right place. If you have never heard the term "attachment style" but know that something about the way you connect with people, or struggle to, has been following you your entire life, you are also in the right place. What Attachment-Based Therapy Actually Is Attachment-based therapy is an approach grounded in the work of John Bowlby, the British psychiatrist who demonstrated that our earliest relationships with caregivers create internal blueprints for how we expect all relationships to function. These blueprints, which researchers call internal working models, form outside of conscious awareness and include a model of self (am I worthy of love and care?) and a model of others (can other people be relied on?). Once established, they operate automatically, filtering how you perceive, interpret, and respond to every relational interaction for the rest of your life. Attachment-based therapy works by making these unconscious patterns visible, understanding where they came from, and gradually building new relational experiences that allow the old blueprints to update. It is not about learning coping skills or changing your thoughts. It is about transforming your capacity for connection at the level where it was originally shaped: in relationship. A brief but important note: attachment-based therapy is a well-established, evidence-based clinical approach. It is not the same as the discredited practice sometimes called "attachment therapy" (holding therapy). What we practice is grounded in decades of peer-reviewed research and aligns with the work of Bowlby, Ainsworth, Main, and contemporary relational psychodynamic theory. Most of us carry more than one pattern. Therapy helps you read your own map. Understanding Your Attachment Style You may already have a sense of your attachment style from books, online quizzes, or social media. That awareness is a real starting point, and we take it seriously. At the same time, attachment is more nuanced than the categories suggest. Most people carry elements of more than one style, and the style that shows up depends on the context, the relationship, and how activated your system is. Therapy helps you understand your patterns with a depth that self-assessment alone cannot provide. Here is a brief overview of the four attachment patterns, what creates them, and how they tend to show up in adult life. Secure Attachment Approximately 56 to 62 percent of adults have a predominantly secure attachment style. Secure attachment develops when caregivers are consistently responsive, attuned, and available. This does not mean perfect. Research by Edward Tronick shows that caregivers and infants are actually out of sync about 60 to 70 percent of the time. What makes the difference is repair. When a caregiver notices the disconnection and reconnects, the child learns that relationships can withstand difficulty and that rupture does not mean abandonment. Adults with secure attachment can generally communicate their needs, tolerate closeness and independence, manage conflict without catastrophizing, and maintain a coherent sense of self across relationships. Anxious Attachment Roughly 11 to 20 percent of adults carry an anxious attachment pattern (also called anxious-preoccupied in clinical literature). It develops when caregiving is inconsistent. Sometimes the parent responds, sometimes they are preoccupied, overwhelmed, or emotionally unavailable. The child learns to amplify their distress signals to increase the odds of getting a response. In an unpredictable environment, being louder and more persistent is an intelligent adaptation. In adulthood, this can look like a persistent fear of abandonment, difficulty self-soothing, reading neutral situations as rejection (a delayed text that triggers a spiral), protest behaviors designed to pull the other person closer (calling repeatedly, creating conflict to provoke engagement), and a chronic sense that you need more from relationships than other people seem to need. Underneath all of it is often a deep, wordless conviction that you are too much. Avoidant Attachment Approximately 23 to 25 percent of adults have a dismissive-avoidant attachment pattern. It develops when caregivers are consistently emotionally unavailable, dismissive of emotions, or subtly rejecting of the child’s dependency needs. The child learns that expressing vulnerability leads to disconnection, so they suppress it. If needing people leads to pain, not needing them is the safer strategy. In adulthood, avoidant attachment can look like discomfort with closeness, compulsive self-reliance, difficulty identifying or expressing emotions, a preference for independence that can feel more like isolation, and withdrawal when a partner tries to connect emotionally. Others may experience you as distant or detached. From the inside, it may feel like you simply do not need what other people seem to need, or like closeness carries an unnameable sense of danger. Fearful-Avoidant (Disorganized) Attachment Roughly 5 percent of the general population (and a much higher percentage in clinical populations) carries a fearful-avoidant or disorganized attachment pattern. It is the most painful of the insecure styles and the most strongly associated with childhood trauma. Disorganized attachment develops when the caregiver is simultaneously the source of comfort and the source of fear. This creates a biological paradox that the child cannot resolve: the person they need to go to for safety is also the person who frightens them. With no coherent strategy available, the child oscillates between approaching and withdrawing, and this push-pull dynamic carries forward into adulthood. In adult relationships, disorganized attachment can look like intense desire for closeness followed by sudden withdrawal, chaotic relational patterns, difficulty with trust, emotional flooding, splitting (idealizing someone one moment and devaluing them the next), and dissociation during relational stress. It is the attachment style most strongly correlated with depression, anxiety, C-PTSD, and dissociative experiences. The shame formed before you had words for it. It is not the truth about you. The Chronic Shame Underneath Insecure Attachment One of the most important things we help our clients understand is that insecure attachment does not just affect your relationships. It shapes your relationship with yourself. And the way it does this is through shame. Every insecure attachment pattern carries its own version of shame, and that shame is often the driving force behind the relational difficulties that bring people to therapy. When a child’s emotional needs are consistently unmet, the child does not conclude that the parent has limitations. Children are not capable of that kind of reasoning. Instead, the child internalizes the failure as evidence of their own defectiveness. If I were easier to love, my parent would love me the way I need. If I were less needy, less emotional, less difficult, less me, things would be different. That conclusion becomes shame. And because it forms before conscious memory, it does not register as a belief you can examine and challenge. It registers as a felt sense, a deep, pre-verbal knowing that something about you is fundamentally wrong. Each attachment style processes this shame differently. If you carry anxious attachment , shame often presents as the conviction that you are too much. Too needy, too emotional, too intense, too clingy. You may have heard these words from partners, friends, or family members, and each time they landed as confirmation of something you already suspected about yourself. The hyperactivation of the anxious system, the reaching, the protesting, the inability to let go, is in part an attempt to get someone to finally prove that you are not too much. That you are worth staying for. If you carry avoidant attachment , shame is buried deeper. It may not feel like shame at all. It may feel like nothing, which is itself a signal. The dismissive strategy works by cutting off access to vulnerability, and since shame IS vulnerability, the system suppresses it. But the underlying message is the same: my needs drove people away, so my needs must be the problem. Avoidant individuals often describe themselves as "not needing much" from relationships, but what they are really describing is a long-standing agreement with themselves to never ask for what they were once denied. If you carry disorganized attachment , shame is often the most pervasive and the most disorienting. Because the attachment figure was both the source of safety and the source of fear, the child absorbs the impossibility of the situation as proof of their own badness. The logic, formed before words, goes something like: if I am being hurt by the person who is supposed to love me, I must deserve it. This kind of shame can be so foundational that the person builds their entire identity around it without recognizing that it does not belong to them. This is why attachment work is not just about improving your relationships with other people. It is about changing the relationship you have with yourself. And that change happens not by thinking differently but by being in a relationship, the therapeutic relationship, where the old shame can finally be seen, named, and gently challenged through the experience of being met with something other than what you originally received. How Attachment Wounds Follow You Into Adulthood Attachment patterns do not stay in childhood. They travel with you into every significant relationship you form. In romantic relationships , they shape who you are attracted to, how you behave when you feel close, and what you do when you feel threatened. Anxious and avoidant partners frequently find each other in a dynamic researchers call the pursuer-distancer pattern: one reaches, the other withdraws, the reaching intensifies, the withdrawal deepens. Both partners are stuck in their attachment strategies, and neither can see that the pattern itself is the problem. In friendships , attachment shows up as difficulty trusting, over-investing and then feeling hurt, or keeping people at a comfortable distance that never quite becomes true intimacy. In the workplace , attachment patterns influence how you respond to authority, how you handle criticism, whether you can collaborate or default to compulsive self-reliance, and how much of your identity you have outsourced to professional achievement. In parenting , attachment patterns are the primary channel of intergenerational transmission. Research shows an 85 percent concordance rate between parent and child attachment classifications. The patterns you carry from your own childhood shape how you respond to your child’s emotional needs, often in ways that operate below conscious awareness. The connection between insecure attachment and mental health is well-documented. A comprehensive meta-analysis of 224 studies with nearly 80,000 participants found that attachment anxiety correlated with poor mental health outcomes at r = .42, and attachment avoidance at r = .28 (Zhang et al., 2022). Insecure attachment is a significant risk factor for anxiety, depression, C-PTSD, relationship difficulties, eating disorders, and substance use. In clinical populations, the rate of insecure attachment rises to approximately 86 percent. This is not a coincidence. Anxiety, depression, and trauma responses are frequently the downstream consequences of attachment disruption. They are what happens when a nervous system shaped by early relational injury tries to navigate a world that requires the very thing it learned was not safe: connection. This is also why our other specialty pages keep circling back to attachment. It is not a separate issue. It is the thread that runs through all of them. Insecure attachment can be re-earned. Careful repair holds. Can Your Attachment Style Actually Change? Yes. This is one of the most important findings in attachment research, and it is the foundation of the work we do. Researchers use the term "earned secure attachment" to describe adults who experienced insecure childhoods but have developed the capacity for secure, coherent, reflective relationships in adulthood. Earned secure individuals represent approximately 8 to 20 percent of study samples (Filosa et al., 2024). The critical finding is that earned secure individuals are statistically indistinguishable from continuously secure individuals on measures of relationship satisfaction, emotional regulation, and parenting behavior. The security is real. It is not a performance. In one landmark study, 40 percent of inpatients with insecure attachment classifications shifted to secure after one year of intensive psychodynamic psychotherapy (Fonagy et al., 1996). Jonathan Shedler’s review in the American Psychologist found that the benefits of psychodynamic therapy not only persist after treatment ends but continue to grow, with effect sizes increasing from 0.97 at termination to 1.51 at long-term follow-up. This "growing after therapy ends" pattern is consistent with what attachment researchers would predict: once new internal working models are established, they continue to shape relational experience in increasingly positive ways. Change is real. But it is not quick, and it is not achieved through insight alone. Attachment patterns are stored in implicit, procedural memory. They operate below the level of conscious thought. Changing them requires not just understanding your patterns but having new relational experiences, over time, that are different enough from the original ones to update the internal blueprint. That is what long-term relational psychodynamic therapy provides. The therapy relationship becomes a secure base: somewhere to return to, and set out from. Why Relational Psychodynamic Therapy Is Built for Attachment Work Not all therapy is equally suited to this work. Approaches that focus primarily on changing thoughts (cognitive behavioral therapy) or developing coping strategies operate at a level that insecure attachment patterns do not live at. These approaches have their place, and our therapists incorporate cognitive behavioral, DBT, ACT, EMDR, IFS, and somatic techniques when they serve the work. But attachment patterns are relational, implicit, and pre-verbal. They were formed in relationship, and they can only be transformed in relationship. This is why relational psychodynamic therapy exists. It is not a technique applied to you. It is a relationship you enter, and it is within that relationship that the patterns maintaining your suffering become visible, understandable, and available for change. Here is how that works in practice. Your attachment patterns will show up with your therapist. This is not a problem. It is the point. If you carry anxious attachment, you may become preoccupied with what your therapist thinks of you, seek excessive reassurance, or feel abandoned between sessions. If you carry avoidant attachment, you may intellectualize, stay on the surface, or resist the growing closeness. If you carry disorganized attachment, you may oscillate between trusting your therapist and pulling away. These responses are not obstacles to therapy. They are the material of therapy. Rupture and repair become the engine of change. Moments of disconnection, misunderstanding, or disappointment in the therapeutic relationship are inevitable. What matters is how they are handled. When your therapist notices the rupture, names it, and works through it with you, something shifts. Research shows that successfully repaired ruptures in therapy predict better outcomes than therapies with no ruptures at all. This is because the experience of rupture followed by repair is precisely what was missing in the original attachment relationship. Each repair rewrites a small piece of the old blueprint. Mentalization develops. Mentalization is the capacity to understand your own behavior and other people’s behavior as driven by underlying feelings, needs, and intentions rather than taking everything at face value. Insecure attachment disrupts this capacity. Relational psychodynamic therapy rebuilds it by providing a relationship in which your internal experience is consistently met with curiosity rather than judgment, dismissal, or retaliation. What Attachment Therapy Looks Like at Turning Leaf Our clinical approach is grounded in relational psychodynamic and psychoanalytic theory, with trauma-informed care woven into everything we do. This is our primary modality. The therapeutic relationship is not a backdrop for delivering interventions. It is the intervention. Your first sessions are about building safety and trust. Your therapist will ask about your history, your relationships, and what brought you in. You will not be asked to perform or produce insights. The early work is about laying the relational foundation for everything that follows. You should expect some relief relatively quickly. Many clients describe the experience of being truly seen and responded to by a therapist who understands attachment as the first time they have felt that kind of attunement. That in itself begins to shift something. The deeper work takes time. Attachment patterns took years to form and have been reinforced by every significant relationship since. Reorganizing them is not a 12-session project. Many of our clients engage in therapy for a year or more, and the depth of that commitment is what makes the change durable rather than temporary. Research supports this: long-term psychodynamic therapy is the approach most consistently associated with lasting attachment reorganization. fees & insurance frequency Typically weekly. For clients doing intensive attachment work, twice-weekly sessions are sometimes recommended. format In-person at our Old City Philadelphia office or telehealth for anyone located in Pennsylvania. insurance Aetna, BCBS plans, United Healthcare, and Optum Behavioral Health. Out-of-network support offered. self-pay $130 to $200 per session depending on the therapist. related Relationship Therapy Childhood Emotional Neglect PTSD & Complex PTSD Relational Therapy Getting Started 01 Complete our short intake A short adaptive form. It asks only what applies to you. 02 We match you, personally Our intake coordinator reviews your response and matches you with the clinician who fits your concern, insurance, and schedule. 03 Meet your therapist Your first session is a clinical consultation, scheduled directly with the right fit. Start your intake → Or call (215) 399-4128 Using Your Insurance for Attachment Therapy Therapy for attachment patterns is covered as a standard outpatient behavioral health benefit under every plan we participate in. Turning Leaf is in-network with Aetna , Highmark Blue Cross , Capital Blue Cross , Anthem , Empire , the Federal Employee Program , Horizon BCBS of New Jersey , United Healthcare , Optum , and Pennsylvania VCAP . Copays for in-network clients generally land between $15 and $50 per session after deductible. Because attachment work tends to run longer than a handful of sessions, we confirm your benefits before you start so the arithmetic is settled at the outset rather than discovered later. Independence Blue Cross, Cigna, Medicare, and Medicaid are out of network with our practice. Sessions in that case are $130 to $200, and we provide a superbill after every session so you can seek out-of-network reimbursement. The insurance page explains the path in plain terms. Frequently Asked Questions About Attachment Therapy What is attachment-based therapy? + Attachment-based therapy is an evidence-based approach grounded in the research of John Bowlby and Mary Ainsworth. It works by understanding how your earliest relationships created internal blueprints for connection and then uses the therapeutic relationship itself to help those blueprints update. It is distinct from the discredited practice once called "attachment therapy" (holding therapy), which used coercive methods and is not part of modern evidence-based practice. What are the four attachment styles? + The four attachment styles are secure (approximately 56 to 62 percent of adults), anxious-preoccupied (11 to 20 percent), dismissive-avoidant (23 to 25 percent), and fearful-avoidant/disorganized (approximately 5 percent in the general population, much higher in clinical settings). Each insecure style represents an adaptive response to the caregiving environment a person grew up in. Can your attachment style change? + Yes. Research on "earned secure attachment" shows that adults who experienced insecure childhoods can develop secure attachment through therapy and corrective relational experiences. In one study, 40 percent of insecure inpatients shifted to secure after one year of psychodynamic psychotherapy (Fonagy et al., 1996). Earned secure individuals function equivalently to people who were securely attached from the start. How long does attachment therapy take? + Attachment patterns are deeply embedded in implicit, procedural memory. While you can expect some relief early in treatment, lasting reorganization of attachment patterns requires sustained relational work over time. Many of our clients engage in therapy for a year or more. The depth of the commitment is what produces the kind of change that does not fade when life gets stressful. Therapy can also feel harder before it feels better, which is often a sign of the work deepening rather than failing. How do attachment patterns affect adult relationships? + Attachment patterns shape who you are attracted to, how you behave when you feel close or threatened, and what happens during conflict. They influence romantic relationships, friendships, workplace dynamics, and parenting. A meta-analysis of 224 studies found significant correlations between insecure attachment and poor mental health outcomes across multiple domains (Zhang et al., 2022). What is the difference between attachment trauma and PTSD? + PTSD develops from discrete traumatic events (accidents, assaults, combat). Attachment trauma is relational, developmental, and cumulative, occurring within the very relationships meant to provide safety. Attachment trauma often results from what did not happen (emotional neglect, unavailability, lack of attunement) rather than what did. Both can co-occur, and our PTSD and Complex PTSD Therapy page explains how we treat complex trauma. How do I know if I have insecure attachment? + Common signs include persistent fear of abandonment, difficulty trusting others, discomfort with emotional closeness, chronic people-pleasing, patterns of intense relationships that end abruptly, feeling like you are "too much" or "not enough" in relationships, and a deep sense of shame that you cannot trace to a specific event. If any of this resonates, therapy can help you understand the pattern and begin to change it. Is relational psychodynamic therapy effective for attachment issues? + Yes. Psychodynamic therapy produces effect sizes comparable to other evidence-based treatments, with the distinctive feature that gains continue to grow after therapy ends (Shedler, 2010). Research has shown that psychodynamic psychotherapy can change attachment classifications, improve reflective functioning, and produce outcomes that are statistically equivalent to continuously secure individuals (Levy et al., 2006; Fonagy et al., 1996). What is earned secure attachment? + Earned security describes adults who experienced insecure childhoods but have developed the capacity for coherent, reflective, secure relationships in adulthood, typically through therapy or other significant corrective relational experiences. Research consistently shows earned secure individuals are indistinguishable from continuously secure individuals on measures of relationship quality, emotional regulation, and parenting. Does insurance cover attachment therapy in Philadelphia? + Yes. Turning Leaf is in-network with Aetna, United Healthcare, Optum, Pennsylvania VCAP, and these Blue Cross plans: Highmark, Capital Blue Cross, Anthem, Empire, the Federal Employee Program, and Horizon BCBS of New Jersey. Most in-network clients pay a copay of $15 to $50 after any deductible. We are out-of-network with Independence Blue Cross, Cigna, Medicare, and Medicaid; those sessions are $130 to $200, and for plans with out-of-network benefits we provide a superbill after every session on request. Take the First Step The patterns that keep showing up in your relationships are not random. They are not evidence of something broken in you. They are the strategies you developed to survive the relational environment you grew up in. Those strategies got you here. Therapy is about building something different, not by erasing the past, but by finally having the kind of relationship that teaches your nervous system what the original one could not. request an appointment Take the first step. The patterns in your relationships are not evidence of something broken in you. They are strategies you developed to survive, and they can change. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/cen-therapy-philadelphia/ ===================================================================== Home / Specialties / Childhood Emotional Neglect old city, philadelphia Childhood Emotional Neglect Therapy in Philadelphia, for the Childhood That Looked Fine From the Outside Childhood emotional neglect (CEN) therapy at Turning Leaf in Old City Philadelphia is relational psychodynamic care for the adult consequences of an emotional childhood unseen: chronic emptiness, people-pleasing, perfectionism, a harsh inner critic. Sessions are 53 minutes, in person in Old City or by secure video across Pennsylvania, and in New Jersey through our NJ-licensed clinicians. In-network with Aetna, BCBS, United, and Optum; self-pay $130 to $200. Nearly two thirds of American adults (CDC) report at least one adverse childhood experience. Emotional neglect is one of them, and one of the easiest to miss, because nothing obviously bad happened. You had a roof over your head. You were fed, clothed, sent to school. Nobody hit you. From the outside, it looked like a perfectly fine childhood. And yet something is wrong now, and you cannot quite name what it is. You feel empty for no clear reason. You struggle in relationships but cannot explain why. You are a people-pleaser who puts everyone else first and feels guilty the moment you stop. You have a harsh inner critic that is relentless, far harder on you than you would ever be on anyone else. You may have been told you are "too sensitive" or "too much," or praised for being "so independent" and "so easy." And somewhere underneath all of it, there is a quiet, persistent feeling that you are fundamentally different from other people, that everyone else received some instruction manual for emotional life that you never got. relational and attachment WHAT WE TREAT HERE The adult effects of childhood emotional neglect INSURANCE In-network with Aetna, Blue Cross plans, United Healthcare, Optum, PA VCAP Typical copay $15 to $50. See all plans SELF-PAY $130 to $200 per session Superbills provided for out-of-network reimbursement. Rates SESSIONS 53 minutes, usually weekly FORMAT In person in Old City Philadelphia, or telehealth Across Pennsylvania, and New Jersey with select clinicians. Telehealth AGES Adults APPROACH Relational, attachment-focused Parts work and somatic attention NEW CLIENTS We are accepting new clients After your intake form, a coordinator reviews it and verifies your benefits; most people have a first session within about a week. Start your intake → ON THIS PAGE It Was Not What They Did. It Was What They Could Not Do. What Childhood Emotional Neglect Looks Like in Adulthood The Parentified Child Does This Sound Like You? Why Relational Therapy Is the Right Treatment for Relational Wounds If You Have Read the Books Getting started Using your insurance Frequently Asked Questions Take the First Step From the outside, it looked like a perfectly fine childhood. If any of this resonates, what you are experiencing may have a name: childhood emotional neglect. Childhood emotional neglect (CEN) is not about what happened to you. It is about what did not happen for you. It is the absence of emotional attunement, validation, and responsiveness from the people who raised you. Research estimates that approximately 18 percent of the general population experienced emotional neglect in childhood (Stoltenborgh et al., 2013), and neglect in all its forms accounts for 60 to 78 percent of all confirmed child maltreatment cases, making it the most common and least recognized form of childhood adversity. At Turning Leaf Therapy in Old City Philadelphia, we specialize in working with adults who are realizing, often for the first time, that what was missing in their childhood is what explains so much of what they struggle with now. It Was Not What They Did. It Was What They Could Not Do. Most people understand trauma as something that happened: abuse, violence, catastrophe. But there is another kind of trauma, quieter and often harder to see, that is defined by absence. Psychologist Jonice Webb, who pioneered the CEN framework, describes it as "the white space in the family picture." It is not the dramatic foreground. It is everything that should have been in the background but was not there. In a healthy childhood, a caregiver notices when you are upset and asks what is wrong. They help you name your feelings. They respond to your distress with comfort rather than dismissal. They let you know that your inner experience matters, that you are a person with feelings worth attending to. This process is called mirroring: the caregiver reflects back to the child what the child is experiencing, and through that reflection, the child learns that their feelings are real, valid, and manageable. When mirroring is absent, something crucial fails to develop. The psychoanalyst Heinz Kohut described the child’s need to see a "gleam in the mother’s eye," a reflected confirmation that they are seen and valued. Without it, the child does not learn to trust their own emotional experience. They grow into an adult who struggles to identify what they feel, who dismisses their own needs, who measures their worth through usefulness to others, and who carries a vague but persistent sense that something essential is missing. The parents who create these conditions are not always bad parents. Many of them loved their children. They were simply limited in their capacity to respond emotionally. They may have been overwhelmed, depressed, anxious, preoccupied with their own unprocessed pain, or raised by emotionally absent parents themselves. Lindsay Gibson, whose book Adult Children of Emotionally Immature Parents has sold over one million copies, identifies four types of emotionally immature parents: the emotional parent (run by their own feelings, turning the child into a caretaker of the parent’s emotional state), the driven parent (focused on achievement at the cost of emotional connection), the passive parent (checked out, conflict-avoidant, unable to protect), and the rejecting parent (actively dismissive or derogatory). What these parenting patterns share is a failure to see the child as a separate person with an inner life that matters. The child adapts. They learn to suppress their needs, manage the parent’s emotions, become hyper-independent, or develop a "role-self," the version of themselves that keeps whatever connection is available. The authentic self goes underground. And it stays underground, sometimes for decades, until something in adulthood cracks the surface open. A persistent emptiness, even when everything in your life looks full. What Childhood Emotional Neglect Looks Like in Adulthood CEN does not announce itself. It shows up in patterns that feel like personality traits rather than wounds. Many of the adults we work with have spent years in therapy for anxiety or depression without ever examining what was missing in childhood, because there was nothing dramatic to point to. Chronic emptiness A persistent sense of something missing that you cannot name. Not depression exactly, though it can coexist with depression. More like a void where emotional life should be. You function well on the outside. Inside, it feels hollow. Difficulty identifying your feelings Clinicians call this alexithymia: the inability to recognize and name your own emotional states. You might know something is "off" without being able to say whether you are angry, sad, scared, or hurt. Research shows that emotional neglect has the strongest correlation with alexithymia of all childhood maltreatment types (Ditzer et al., 2023, meta-analysis of 78 studies). Your feelings were never mirrored back to you, so you never learned the vocabulary. People-pleasing Your worth was tied to what you provided, not who you were. Saying no feels dangerous because, in your earliest experience, having needs meant risking the only connection available. You became the person who says yes to everything, anticipates what everyone needs before they ask, and feels guilty the moment you stop performing. Perfectionism Achievement became a substitute for love. If you could not earn emotional attunement by being yourself, you could earn praise by being exceptional. The inner logic: "If I am good enough, quiet enough, need-free enough, maybe I can feel safe." The problem is that "good enough" keeps moving, because perfection was never the real goal. Connection was. A harsh inner critic The voice in your head that tells you nothing you do is ever sufficient. In IFS terms, this is a manager part that learned early that self-criticism was safer than vulnerability. In psychodynamic terms, it is an internalized version of the emotional environment you grew up in: you treat yourself the way you were treated. Our IFS Therapy page explores working with inner critic parts in depth. Counter-dependence A deep resistance to relying on anyone. Self-sufficiency is your identity. Asking for help feels like failure. Webb identifies this as one of the hallmark signs of CEN: the person who would rather suffer alone than risk the vulnerability of needing someone. This is not independence. It is a survival strategy built on the experience that no one was reliably there. Feeling fundamentally different from other people A persistent sense that everyone else knows something you do not, that other people have access to some essential quality of human connection that you missed. Webb calls this "the feeling of being fundamentally flawed." It is not a cognitive distortion. It is the internalized experience of having your emotional self be invisible to the people who mattered most. Relationship difficulties Choosing emotionally unavailable partners who replicate the childhood dynamic. Difficulty with intimacy and vulnerability. Becoming the caretaker in relationships. Feeling more comfortable giving than receiving. Struggling to know what you want because you spent your childhood learning what everyone else wanted. Our Relationship Therapy and Attachment Therapy pages address these patterns. The "good kid" paradox If you were described as "so mature for your age," "the easy one," "so responsible," or "never asked for anything," these were not compliments. They were descriptions of a child who learned that having needs was not safe. Your hyper-independence was not a personality trait. It was an adaptation. Society rewarded it. Your inner world paid for it. The child who became the caretaker, long before it was fair to ask. The Parentified Child Some children do not just suppress their needs. They take on the role of the parent. This is called parentification: the reversal of roles where the child becomes the emotional caretaker of the adult. You may have been the one your parent turned to when they were overwhelmed. The one who mediated conflicts. The one who managed a parent’s anxiety, depression, or rage so the household could function. The one who learned to read the room before you learned to read a book. There are two forms. Instrumental parentification involves practical caretaking: cooking, cleaning, managing younger siblings, handling logistics that should have been an adult’s responsibility. Emotional parentification involves becoming the parent’s confidant, therapist, or emotional regulator. Emotional parentification is considered more damaging because it requires the child to abandon their own emotional development in service of the parent’s. The long-term effects include chronic difficulty setting boundaries, people-pleasing as a relational default, low self-worth that is tied entirely to being useful, and a deep fear that if you stop being helpful, you will be abandoned. Because in your earliest experience, love was conditional on function. Does This Sound Like You? Read through the following and notice how many resonate. I often feel empty for no clear reason. I have difficulty identifying what I am feeling. I feel guilty when I ask for help or take up space. People describe me as independent or low-maintenance and I take pride in that. I feel like something is fundamentally wrong with me but I cannot name what it is. I had a "good" childhood but still struggle as an adult. I put others’ needs before my own automatically. I feel like I am making up my problems or that other people have it worse. I struggle with intimacy or keep choosing emotionally unavailable partners. I have a harsh inner critic that is much harder on me than I am on anyone else. I was the easy child, the responsible one, or the one who never caused problems. I feel fundamentally different from other people, like they have access to something I do not. If several of these resonate, you are not making it up. The very fact that you doubt whether your experience "counts" is itself a hallmark of CEN: the wound teaches you to dismiss your own pain. Therapy can help. In therapy you are finally noticed, named, and responded to. Structure can still be built. Why Relational Therapy Is the Right Treatment for Relational Wounds CEN happened in the context of a relationship. It was in the space between you and a caregiver that your emotional needs went unseen. And it is in the space between you and a therapist that those needs can finally be met. Relational psychodynamic therapy, the foundation of Turning Leaf’s clinical work, is built on the understanding that human beings are shaped by their earliest relationships and that healing happens through new relational experiences. The therapy itself becomes the corrective experience: a relationship in which your feelings are noticed, named, and responded to. Possibly for the first time. This is not an abstract process. It is specific and felt. When you tell your therapist something painful and they do not dismiss it, that is a new experience. When you express a need and it is met with curiosity rather than criticism, that is a new experience. When you test the relationship, consciously or unconsciously, by pulling away or performing or apologizing for taking up space, and the therapist stays present and names what is happening, that is a new experience. Over time, these experiences build an internal structure that was not built in childhood: a felt sense that your inner world matters, that you deserve attention, and that connection does not require you to disappear. Heinz Kohut, whose self psychology work provides much of the theoretical foundation for this treatment, argued that the experience of being fully understood by another person is inherently curative. He described the therapeutic process as one where "the internal psychological structures that should have developed in childhood may belatedly and effectively develop." This is not about talking about the past endlessly. It is about having a different kind of experience in the present that rewires what you believe about yourself and relationships. Research supports this model. Psychodynamic therapy produces effect sizes that increase after treatment ends, with one landmark review showing improvements rising from 0.97 at termination to 1.51 at long-term follow-up (Shedler, American Psychologist, 2010). The changes set in motion are not just symptom relief. They are structural shifts in how you relate to yourself and others. A 2025 study in Frontiers in Psychiatry found that while childhood maltreatment was associated with greater symptom severity at intake, it did not predict worse therapy outcomes, confirming that therapy is effective for this population. Within this relational framework, we also use EMDR to process specific memories of emotional neglect that remain activating, IFS to work with the protective parts that formed in response to unmet needs, and somatic approaches to address the ways neglect lives in the body. Our trauma-informed therapy page describes our overall clinical approach. The books opened the door. Therapy is what is on the other side. If You Have Read the Books If you have read Lindsay Gibson’s Adult Children of Emotionally Immature Parents or Jonice Webb’s Running on Empty and felt seen for the first time, you are not alone. Many of our clients arrive having already identified what happened in their childhood. They have the language. What they need now is the experience: a therapeutic relationship that provides what the books describe but cannot deliver on their own. Reading about mirroring is not the same as being mirrored. Understanding your attachment style intellectually is not the same as experiencing earned secure attachment in a live relationship with someone who can hold what you are carrying. The books opened the door. Therapy is what is on the other side. fees & insurance format In-person at our Old City Philadelphia office (123 Chestnut St) or telehealth for anyone located in Pennsylvania. insurance Aetna, BCBS plans, United Healthcare, and Optum. (Note: We do not accept Independence Blue Cross) . fees $130 to $200 per session for self-pay clients, depending on the therapist. Superbills provided after every session on request. related Attachment Therapy Relationship Therapy IFS Therapy Grief Therapy Getting Started 01 Complete our short intake A short adaptive form. It asks only what applies to you. 02 We match you, personally Our intake coordinator reviews your response and matches you with the clinician who fits your concern, insurance, and schedule. 03 Meet your therapist Your first session is a clinical consultation, scheduled directly with the right fit. Start your intake → Or call (215) 399-4128 Using Your Insurance for Childhood Emotional Neglect Therapy Childhood emotional neglect is not its own diagnostic code, and it does not need to be. The anxiety, depression, and relational difficulties it produces are covered outpatient behavioral health concerns under every plan we take, which is what your sessions are billed as. We are in-network with Aetna , Highmark , Capital Blue Cross , Anthem , Empire , FEP , Horizon BCBS NJ , United Healthcare , Optum , and Pennsylvania VCAP . Most in-network clients pay $15 to $50 per session after deductible. Because this work tends to be longer-term, knowing that number matters, and we verify your benefits before the first session rather than after. Independence Blue Cross, Cigna, Medicare, and Medicaid are out of network here. Sessions are $130 to $200, with a superbill after each one for reimbursement; the insurance page has the specifics. Frequently Asked Questions Can you have trauma from a "good" childhood? + Yes. Childhood emotional neglect is defined not by what happened to you but by what did not happen for you: the absence of emotional attunement, validation, and responsiveness from caregivers. Many people with CEN grew up in homes that looked functional and even loving from the outside. The wound is in what was missing, and it is real. What is childhood emotional neglect? + Childhood emotional neglect (CEN) is a parent’s failure to respond sufficiently to a child’s emotional needs. It includes the absence of mirroring (reflecting back the child’s emotional experience), emotional responsiveness (responding to the child’s distress with comfort), and validation (communicating that the child’s feelings matter). Research estimates approximately 18 percent of the general population experienced CEN (Stoltenborgh et al., 2013). Is emotional neglect the same as emotional abuse? + No. Emotional abuse involves active harm: belittling, threatening, shaming, manipulating. Emotional neglect is the absence of emotional responsiveness. A parent can be emotionally neglectful without ever saying a cruel word. They simply did not notice, respond to, or validate the child’s emotional experience. Both cause harm, but neglect is harder to recognize because there is nothing specific to point to. Why do I feel empty inside even though my life seems fine? + Chronic emptiness is one of the hallmark signs of childhood emotional neglect. When your emotional experience was consistently unacknowledged in childhood, the internal world can feel hollow or inaccessible in adulthood. This is not depression in the traditional sense, though the two often coexist. It is the absence of a felt connection to your own inner life. Can you be emotionally neglected by loving parents? + Yes. This is one of the most important things to understand about CEN. Many emotionally neglectful parents love their children. They are simply limited in their capacity to attune to and respond to their child’s emotional needs, often because they were raised the same way. Jonice Webb’s framework specifically includes a large category of "well-meaning but neglectful" parents. Why can I not identify or name my feelings? + This is called alexithymia, and research shows it has the strongest correlation with childhood emotional neglect of all maltreatment types. When your feelings were never noticed, reflected back, or responded to, you never developed the internal vocabulary for your emotional experience. Therapy helps build this capacity. Why do I feel like I am making up my problems or do not deserve therapy? + Because the wound itself taught you to dismiss your own experience. CEN communicates to the child that their emotions do not matter. That message gets internalized. The fact that you doubt whether your pain "counts" is not evidence that it does not. It is evidence that it does. What does therapy for childhood emotional neglect look like? + At Turning Leaf, we use relational psychodynamic therapy as the primary approach. The therapeutic relationship itself provides the experiences that were missing in childhood: being noticed, being heard, having your feelings reflected back and responded to. Over time, this builds internal structures for emotional awareness, self-compassion, and relational security that were not built in childhood. Is childhood emotional neglect a form of trauma? + Yes. CEN is a form of relational and developmental trauma, sometimes called "trauma of omission." Research shows that cumulative emotional neglect can produce the same psychological and physiological effects as more visible forms of trauma, including anxiety, depression, relationship difficulties, and changes in brain structure. Why am I a people-pleaser and how does it connect to my childhood? + People-pleasing develops when a child learns that their worth is tied to what they provide rather than who they are. If emotional attunement was not available freely, the child learns to earn connection through performance, helpfulness, and the suppression of their own needs. This becomes automatic in adulthood and feels like personality rather than adaptation. It can change. How long does therapy for CEN take? + CEN patterns developed over years and are deeply embedded. Most clients benefit from longer-term therapy, typically six months to a year or more, because the work involves not just understanding the patterns but experiencing a new kind of relationship that gradually rewires them. Some clients see meaningful shifts within the first months as they begin naming feelings and setting boundaries. Therapy can also feel harder before it feels better, which is often a sign of the work deepening rather than failing. Do you accept insurance for this type of therapy? + Yes. Turning Leaf is in-network with Aetna, United Healthcare, Optum, Pennsylvania VCAP, and these Blue Cross plans: Highmark, Capital Blue Cross, Anthem, Empire, the Federal Employee Program, and Horizon BCBS of New Jersey. Most in-network clients pay a copay of $15 to $50 after any deductible. We are out-of-network with Independence Blue Cross, Cigna, Medicare, and Medicaid; those sessions are $130 to $200, and for plans with out-of-network benefits we provide a superbill after every session on request. Take the First Step You have probably spent a long time believing that your struggles do not count because nothing "bad enough" happened. You have compared your experience to others and concluded that you do not deserve to take up space with it. That conclusion is not truth. It is the wound talking. What you needed as a child was someone who noticed how you felt, who responded with care, who let you know that your inner world mattered. You did not get that. But you can get it now. Not retroactively, not perfectly, but in a real relationship with a real person who is trained to provide exactly the kind of emotional attunement that was missing. That is what therapy at Turning Leaf offers. Not advice. Not worksheets. A relationship. request an appointment Take the first step. What you needed as a child was someone who noticed how you felt. You can get that now, in a real relationship trained to provide it. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/lgbtqia-affirming-therapy-philadelphia/ ===================================================================== Home / Specialties / LGBTQIA+ Affirming Therapy old city, philadelphia LGBTQIA+ and Trans-Affirming Therapy in Philadelphia, Where You Don't Have to Explain Yourself LGBTQIA+ and trans-affirming therapy at Turning Leaf in Old City, Philadelphia, is relational, trauma-informed counseling and psychotherapy from 11 clinicians who specialize in it, several of them part of the community: transgender and nonbinary clients, gender identity exploration, coming out, and gender-affirming care letters. Sessions are 53 minutes, in person at 123 Chestnut Street or by secure video across Pennsylvania, and in New Jersey through our NJ-licensed clinicians. In-network with Aetna, BCBS, United, and Optum; self-pay $130 to $200. The Trevor Project’s 2024 national survey found that LGBTQ+ young people in very accepting communities attempted suicide at less than half the rate of those in unaccepting ones. Affirming care is not a nicety. It is the intervention. LGBTQ+ individuals are two and a half times more likely to experience depression, anxiety, and substance misuse than their cisgender, heterosexual peers (American Psychiatric Association). Not because of who they are, but because of what the world has asked them to carry. At Turning Leaf Therapy in Old City Philadelphia, we have 11 therapists who specialize in LGBTQIA+ affirming care. Several members of our team are part of the community themselves. We also have clinicians who provide gender-affirming care letters for surgery and hormone therapy. identity and LGBTQIA+ WHAT WE TREAT HERE Affirming care for trans, nonbinary, queer, and relationship-diverse clients INSURANCE In-network with Aetna, Blue Cross plans, United Healthcare, Optum, PA VCAP Typical copay $15 to $50. See all plans SELF-PAY $130 to $200 per session Superbills provided for out-of-network reimbursement. Rates SESSIONS 53 minutes, usually weekly FORMAT In person in Old City Philadelphia, or telehealth Across Pennsylvania, and New Jersey with select clinicians. Telehealth AGES Teens (13 to 17) and adults APPROACH Affirming, relational, trauma-informed Gender-affirming care letters available NEW CLIENTS We are accepting new clients After your intake form, a coordinator reviews it and verifies your benefits; most people have a first session within about a week. Start your intake → ON THIS PAGE What Affirming Therapy Actually Means Why This Matters What We Help With Rooted in Philadelphia’s LGBTQIA+ Community Getting started Using your insurance Frequently Asked Questions Take the First Step A place where you do not have to explain yourself. You should not have to spend your therapy session educating your therapist about your identity, your relationships, or your pronouns. Here, you will not need to. You can walk in and get to the thing that actually brought you through the door. What Affirming Therapy Actually Means There is a difference between a therapist who is "LGBTQ friendly" and one who is affirming. A friendly therapist will not judge you. An affirming therapist actively understands that your identity is a healthy, natural part of who you are and brings that understanding into every aspect of your care. Affirming therapy is guided by the American Psychological Association’s practice guidelines for sexual minority and gender diverse clients. It means your therapist will not treat your identity as something to explain, overcome, or work around. It means they understand minority stress, the unique psychological weight of living in a world that was not built for you. It means they are familiar with the specific challenges facing LGBTQIA+ individuals and can help you navigate them without starting from scratch. It also means your therapist will follow your lead. If you are exploring your identity, they will hold space for that exploration without pushing you toward a label. If you know exactly who you are and want to work on something else entirely, they will honor that too. The disparities are caused by a hostile world, not by who you are. Why This Matters The mental health disparities facing LGBTQIA+ communities are real and well-documented. They are not caused by identity. They are caused by what happens to people when society treats their identity as a problem. Psychologist Ilan Meyer’s minority stress model, the most widely cited framework in LGBTQIA+ mental health research, describes how chronic exposure to prejudice, discrimination, and stigma creates a layer of stress that sits on top of everyday life. Some of that stress is external: being misgendered, facing workplace discrimination, navigating family rejection. Some of it is internal: the messages you absorbed growing up about who you were supposed to be, the hypervigilance of monitoring how "out" you can safely be in any given room, the exhaustion of code-switching between contexts. The Trevor Project’s 2024 national survey of over 18,000 LGBTQ+ young people found that 39 percent had seriously considered suicide in the past year. Among transgender and nonbinary youth, that number rose to 46 percent. Half of those who wanted mental health care were unable to access it. And 90 percent said their well-being had been negatively impacted by recent political rhetoric targeting LGBTQIA+ communities. These are not individual failures. They are the predictable consequences of a social environment that generates chronic stress for an entire population. Affirming therapy does not treat your identity as the source of your pain. It helps you heal the wounds that living in that environment has created. For coming out, for gender, for chosen family: you bring it, we hold it. What We Help With Coming Out and Identity Exploration Coming out is not a single event. It is an ongoing process that unfolds across every new relationship, workplace, doctor’s office, and family gathering for the rest of your life. There is no right timeline for it, and there is no "too late." Some of our clients are exploring their sexual orientation or gender identity for the first time. Some came out decades ago and are still processing what it cost them. Some are coming out in their 40s, 50s, or 60s and navigating what that means for existing relationships, marriages, and family structures. All of it is welcome here. If you are still figuring things out, therapy can be a place to explore without pressure. If you have known who you are for a long time and are dealing with the aftermath of not being able to live it openly, therapy can help with that too. Transgender, Nonbinary, and Gender Identity Support, Including Transition We work with transgender, nonbinary, genderqueer, gender-fluid, and gender-questioning individuals at every stage of their journey. Whether you are beginning to explore your gender identity, navigating social transition, considering medical transition, or processing the emotional complexity of any of these experiences, our team is here. Therapy for gender-diverse individuals is not about proving anything or meeting a set of criteria. It is about having a place where your experience is understood and supported, where you can process the grief, joy, confusion, and clarity that often come in waves during gender exploration and transition. Gender-Affirming Care Letters Our team includes clinicians who provide gender-affirming care letters for surgery and hormone therapy, following the WPATH Standards of Care. These letters are not about gatekeeping. They are about making sure you have the support and documentation you need for the next step in your care. If you are already in therapy with us, your therapist can write your letter as part of your ongoing work together. If you need a letter and are not currently a client, we can discuss the process during your initial consultation. Internalized Stigma and Shame Growing up in a world that sends constant messages about who you should be leaves marks. Even when you consciously reject those messages, the earlier versions of them can live in your body and your nervous system long after you have come out or come into yourself. Internalized homophobia, biphobia, and transphobia can show up as persistent shame that does not seem to attach to anything specific. It can look like difficulty accepting love, choosing partners who do not treat you well, distancing yourself from the LGBTQIA+ community, or a quiet voice that still insists something about you is not quite right. These are not character flaws. They are the residue of growing up in a system that told you who you are was wrong. Therapy can help you separate your own voice from the one that was given to you. LGBTQIA+ Relationships and Couples Therapy We work with couples and partners across the full spectrum of LGBTQIA+ relationships, including same-sex couples, mixed-orientation couples, polyamorous and consensually non-monogamous relationships, and partners navigating one person’s transition. LGBTQIA+ relationships share many of the same challenges as any relationship, but they also carry layers that a therapist needs to understand: the impact of societal stigma on intimacy, navigating different levels of outness between partners, family of origin tensions, the absence of culturally visible relationship models, and the ways minority stress can show up between people who love each other. Family of Origin and Chosen Family Family rejection is one of the strongest predictors of mental health difficulties for LGBTQIA+ individuals. Research from the Family Acceptance Project found that youth from highly rejecting families are eight times more likely to attempt suicide than those with accepting families. If your family of origin has been a source of pain around your identity, therapy can help you grieve what you deserved and did not receive, set boundaries that protect your well-being, and build the relationships that actually sustain you. Many of our clients have built chosen families, networks of friends, partners, mentors, and community members who provide the belonging and support that biological family could not. These relationships matter deeply, and they carry their own joys and complexities. We honor them fully. Grief and Loss in the LGBTQIA+ Community LGBTQIA+ grief often goes unrecognized. The partner who was called your "friend" at the funeral. The years spent hiding parts of yourself. The community members lost to violence, to the AIDS crisis, to suicide. The family relationships that ended when you came out. These losses are real, and they deserve to be mourned. Our Grief and Loss Therapy page goes deeper into how we approach grief work, including disenfranchised grief, the kind of loss that the world does not give you permission to mourn openly. Intersectional Identities We understand that your LGBTQIA+ identity does not exist in isolation. It intersects with your race, ethnicity, disability, faith background, immigration status, socioeconomic reality, and every other part of who you are. For BIPOC LGBTQIA+ individuals, the experience of navigating racism in predominantly white queer spaces and homophobia or transphobia in communities of origin creates a specific kind of isolation that requires specific understanding. For clients who carry religious trauma alongside their identity, therapy can help you integrate your faith and your selfhood, or grieve the spiritual community that could not hold both. We do not treat identities in silos. We treat whole people. Rooted in Philadelphia's Gayborhood, and the community it holds. Rooted in Philadelphia’s LGBTQIA+ Community Philadelphia has one of the largest and most historically significant LGBTQIA+ communities in the country. The Gayborhood in Washington Square West, with its rainbow street signs and crosswalks, is one of the most recognized LGBTQ neighborhoods in the United States. Philadelphia was the first major city to add black and brown stripes to its Pride flag, a statement about inclusion that reflects the city’s values. Our office in Old City sits from Mazzoni Center (which has served the LGBTQ+ community since 1979 and hosts the world’s largest Trans Wellness Conference), and from the William Way LGBT Community Center. We are part of this city’s fabric. And we believe that affirming, high-quality mental health care should be accessible, not just to those who can pay out of pocket. fees & insurance format In-person at our Old City Philadelphia office (123 Chestnut St) or telehealth for anyone located in Pennsylvania. insurance Aetna, BCBS plans, United Healthcare, and Optum Behavioral Health. Out-of-network support offered. fees $130 to $200 per session for self-pay clients, depending on the therapist. Superbills provided after every session on request. related Identity Exploration Teen Therapy Grief Therapy Our Team Getting Started 01 Complete our short intake A short adaptive form. It asks only what applies to you. 02 We match you, personally Our intake coordinator reviews your response and matches you with the clinician who fits your concern, insurance, and schedule. 03 Meet your therapist Your first session is a clinical consultation, scheduled directly with the right fit. Start your intake → Or call (215) 399-4128 Using Your Insurance for LGBTQIA+ Affirming Therapy Therapy for affirming care is covered as a standard outpatient behavioral health benefit under every plan we participate in. Turning Leaf is in-network with Aetna , Highmark Blue Cross , Capital Blue Cross , Anthem , Empire , the Federal Employee Program , Horizon BCBS of New Jersey , United Healthcare , Optum , and Pennsylvania VCAP . Affirming therapy carries no separate billing category and no surcharge; it is covered outpatient behavioral health under each plan above. In-network clients typically pay $15 to $50 per session after deductible, and we verify your benefits before your first session so you are not left decoding plan documents. Independence Blue Cross, Cigna, Medicare, and Medicaid are out of network with us. Sessions are then $130 to $200 with a superbill after each one. If keeping your care off an insurance record matters to you, paying privately is a legitimate choice and we will not argue you out of it. The insurance page explains the path in plain terms. Frequently Asked Questions What is LGBTQIA+ affirming therapy? + Affirming therapy is a clinical approach that recognizes LGBTQIA+ identities as healthy, natural variations of human experience, not something to be fixed, managed, or worked around. It is grounded in the American Psychological Association’s practice guidelines and informed by the minority stress model. Your therapist will understand the unique challenges facing LGBTQIA+ individuals and will not require you to educate them about your identity. What is the difference between LGBTQ-friendly and LGBTQ-affirming? + A friendly therapist will not judge you for your identity. An affirming therapist goes further: they actively understand LGBTQIA+ experiences, are trained in the specific mental health challenges facing queer and trans communities, and incorporate that understanding into your care. Affirming is the clinical standard recommended by the APA. Do I need to be out to start therapy? + No. You do not need to have anything figured out before you begin. Therapy can be a safe place to explore questions about your identity, your sexuality, or your gender at whatever pace feels right. Your therapist will follow your lead. Can a straight or cisgender therapist be LGBTQ affirming? + Yes. Affirming care is about training, understanding, and clinical practice, not solely about the therapist’s own identity. That said, several of our therapists are members of the LGBTQIA+ community, and we are happy to match you with a therapist who feels like the right fit. Do you provide gender-affirming care letters? + Yes. Our team includes clinicians who provide letters for gender-affirming surgery and hormone therapy in accordance with the WPATH Standards of Care. If you are already a client, your therapist can write your letter. If you are new to the practice, we can discuss the process during your consultation. Do you offer couples therapy for LGBTQ+ relationships? + Yes. We work with couples and partners across the spectrum of LGBTQIA+ relationships, including same-sex couples, polyamorous and consensually non-monogamous relationships, and partners navigating gender transition. Does insurance cover LGBTQIA+ affirming therapy? + Yes. Turning Leaf is in-network with Aetna, United Healthcare, Optum, Pennsylvania VCAP, and these Blue Cross plans: Highmark, Capital Blue Cross, Anthem, Empire, the Federal Employee Program, and Horizon BCBS of New Jersey. Most in-network clients pay a copay of $15 to $50 after any deductible. We are out-of-network with Independence Blue Cross, Cigna, Medicare, and Medicaid; those sessions are $130 to $200, and for plans with out-of-network benefits we provide a superbill after every session on request. There is no separate billing code for affirming therapy. It is covered as standard mental health treatment. What issues does LGBTQIA+ affirming therapy help with? + Anything you bring to therapy. Common concerns include anxiety, depression, relationship difficulties, coming out, gender identity exploration, internalized stigma, family rejection, grief, trauma, and the cumulative toll of minority stress. Your identity may or may not be the focus of your work. That is entirely up to you. How much does LGBTQIA+ therapy cost in Philadelphia? + At Turning Leaf, session fees for self-pay clients range from $130 to $200, and we accept multiple major insurance plans. Many LGBTQIA+-focused practices in Philadelphia are private-pay only, which can create a significant barrier to care. How do I know if a therapist is truly affirming? + Look for therapists who list LGBTQIA+ care as a specialty (not just a checkbox), who use inclusive language on their website and intake forms, who display pronouns, and who have specific training in affirming care. During your first session, notice whether you feel like you can be yourself without performing or explaining. That feeling is the signal. How long does therapy take? + It depends on what brings you in and what you want from therapy. Some people come for a focused stretch around a specific concern, while many stay longer for deeper, open-ended work. Therapy can also feel harder before it feels better, and that is often the work deepening, not failing. You and your therapist will revisit your goals together over time. Take the First Step You have spent enough time in spaces where you had to shrink, translate, or explain yourself to be understood. Therapy does not have to be another one of those spaces. Here, you can bring your whole self. request an appointment Take the first step. You have spent enough time in spaces where you had to shrink, translate, or explain yourself. Here, you can bring your whole self. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/identity-exploration-therapy-philadelphia/ ===================================================================== Home / Specialties / Identity Exploration old city, philadelphia Identity Exploration Therapy in Philadelphia for When the Question Is "Who Am I?" Identity exploration therapy at Turning Leaf in Old City Philadelphia is relational psychodynamic support across gender, sexuality, faith, cultural identity, career, and life direction, from 12 clinicians who specialize in it. Sessions are 53 minutes, in person in Old City or by secure video across Pennsylvania, and in New Jersey through our NJ-licensed clinicians. In-network with Aetna, BCBS, United, and Optum; self-pay $130 to $200. Not everyone walks into therapy with a diagnosis. Sometimes what brings you through the door is a quieter kind of distress: a growing sense that you do not recognize yourself, that the life you have built does not feel like yours, or that somewhere along the way you lost track of who you actually are. Research suggests that up to 75 percent of adults between 25 and 33 experience a period of significant identity questioning (LinkedIn/Censuswide), and identity development continues well into the 50s and 60s (Kroger & Marcia, 2011). At Turning Leaf Therapy in Old City Philadelphia, we have 12 therapists who specialize in identity exploration, and our relational psychodynamic approach is built on the understanding that the self is not something you find. It is something that emerges, shifts, and deepens in the context of your relationships, including the one you build with your therapist. identity and LGBTQIA+ WHAT WE TREAT HERE Questions of identity across gender, sexuality, faith, culture, and direction INSURANCE In-network with Aetna, Blue Cross plans, United Healthcare, Optum, PA VCAP Typical copay $15 to $50. See all plans SELF-PAY $130 to $200 per session Superbills provided for out-of-network reimbursement. Rates SESSIONS 53 minutes, usually weekly FORMAT In person in Old City Philadelphia, or telehealth Across Pennsylvania, and New Jersey with select clinicians. Telehealth AGES Teens (13 to 17) and adults APPROACH Relational, culturally attuned Parts work and narrative approaches NEW CLIENTS We are accepting new clients After your intake form, a coordinator reviews it and verifies your benefits; most people have a first session within about a week. Start your intake → ON THIS PAGE What Identity Exploration Therapy Is When Identity Becomes the Question The Psychodynamic Lens: Identity as Relational What Identity Therapy Looks Like Here Getting started Using your insurance Frequently Asked Questions Take the First Step Identity is not a fixed thing you find. It keeps unfolding across a life. If you are here because something feels off but you cannot quite name it, that is enough. You do not need a label to deserve support. What Identity Exploration Therapy Is Identity exploration therapy is not a single technique. It is a way of approaching the fundamental question of who you are across every dimension of your life: your values, your relationships, your cultural background, your gender and sexuality, your career, your family role, your spirituality, and the ways all of these intersect. Most therapy focuses on specific symptoms or conditions. Identity work focuses on the person underneath those symptoms. It asks not just "What is wrong?" but "Who are you becoming?" and "Who were you before you learned to hide?" Psychologist James Marcia’s research identifies four ways people relate to identity. Some people are in what he calls identity diffusion, where nothing feels anchored and there is no clear sense of direction. Some are in foreclosure, living out an identity that was handed to them (by parents, culture, or circumstance) without ever questioning whether it fits. Some are in moratorium, actively searching and questioning, which often feels like crisis but is actually the most productive space for growth. And some have reached identity achievement, where commitments are made after genuine exploration. Most of our clients arrive somewhere between foreclosure and moratorium. They have been living a life that looks right from the outside but feels hollow from the inside. Or the structure that held their identity together (a relationship, a job, a belief system, a role) has collapsed, and they do not know who they are without it. The question can surface at any age, triggered by almost anything. When Identity Becomes the Question Identity questions do not arrive on a predictable schedule. They can surface at any age, triggered by almost anything. Here are some of the most common moments that bring people to us. Quarter-Life Crisis You finished school, entered the workforce, and checked the boxes you were supposed to check. But now, in your mid-20s to early 30s, something is not adding up. The career you chose does not feel like yours. The relationships you built feel performative. You look at the life you have assembled and wonder whether any of it reflects who you actually are. This is more common than most people realize. A 2025 cross-cultural study across eight countries found that 40 to 77 percent of emerging adults experience quarter-life crisis episodes, with career uncertainty as the primary trigger (Robinson et al., Emerging Adulthood). These episodes typically last one to two years and come in two forms: feeling locked into a path that does not fit, or feeling locked out of the life you want but cannot access. Midlife Identity Shifts At some point in your 40s or 50s, you may find yourself asking questions you thought you had already answered. Who am I beyond my career? What do I want from the second half of my life? Why does everything I have built feel like it belongs to someone else? Research confirms this is not just a cliché. A large-scale study across 500,000 people found that indicators of psychological distress, including concentration difficulties, sleep disruption, and feelings of being overwhelmed, all peak in the late 40s to early 50s (Blanchflower, 2020). A 2025 study in Nature/Scientific Reports found that nearly a third of adults exhibit high midlife crisis symptoms. This is not a breakdown. It is often the beginning of a more authentic relationship with yourself. After Divorce, Job Loss, or the End of a Role When a relationship ends, a career dissolves, children leave home, or a parent dies, the identity that was organized around that role can collapse with it. "Who am I without my marriage?" "Who am I if I am not the caregiver?" "Who am I when the thing I was building toward is gone?" These are not signs of weakness. They are signs that you built your identity around something external, and when it shifted, the internal structure was not strong enough to hold on its own. Therapy can help you build that structure. Racial and Cultural Identity Philadelphia is one of the most racially and ethnically diverse cities in the United States, with a diversity index above 71 percent and residents who speak over 40 languages. For many Philadelphians, identity is not a single thing. It is the work of navigating between cultures, switching codes, and managing the exhaustion of being one version of yourself in one context and another version somewhere else. Racial identity development is not a one-time event. Researchers like William Cross (who developed the foundational model of Black racial identity development) and Janet Helms (who mapped White racial identity development) have shown that racial awareness moves through stages, often prompted by encounters that challenge previously unexamined assumptions. Bicultural individuals face a specific tension: research consistently shows that integrating both cultural identities produces better psychological outcomes than choosing one over the other (Nguyen and Benet-Martinez, 2013), but the daily work of holding two worlds together is real and rarely acknowledged. If you are a first-generation American, an immigrant, or someone navigating the space between the culture you were raised in and the one you live in now, therapy can be a place where you do not have to translate yourself. Gender and Sexual Identity Exploration Questions about gender identity and sexual orientation can surface at any age. Some people have carried these questions since childhood. Others encounter them for the first time in adulthood, sometimes after decades of living within an identity that felt assumed rather than chosen. Our LGBTQIA+ Affirming Therapy page goes deeper into how we support gender and sexual identity exploration specifically. Here, the important thing to know is that identity questioning is welcome. You do not need to have it figured out to start therapy. Leaving a Religion or Faith Tradition For many people, religious identity is not just one facet of who they are. It is the foundation: the community, the moral framework, the daily practices, the answers to the biggest questions. When that foundation shifts, whether through gradual disillusionment, a crisis of faith, or a deliberate departure, the result can feel less like changing your mind and more like losing yourself. Approximately 28 to 29 percent of U.S. adults are now religiously unaffiliated, and 35 percent have changed religions between childhood and adulthood (Pew Research). Among adults under 30, nearly 4 in 10 identify as "nones." Religious deconstruction often follows a pattern that Marcia’s research would call the disruption of foreclosure: an identity accepted without exploration is suddenly called into question, and the person must do the developmental work of exploration for the first time, often with significant grief, anxiety, and social consequences. Therapy can hold the space for that process without pushing you in any direction. Beneath the self built to please is the self that went underground. Therapy helps it surface. The Psychodynamic Lens: Identity as Relational Our approach to identity work is grounded in relational psychodynamic therapy, which understands the self as something that develops in relationship. You did not form your identity in isolation. It was shaped by the people who raised you, the environments you grew up in, and the relational patterns you learned to survive them. The British psychoanalyst Donald Winnicott described what happens when early caregiving does not leave enough room for a child’s authentic experience. The child develops what he called a False Self: a compliant, adaptive facade that keeps the peace but buries the spontaneous, alive, real person underneath. People with an active False Self can build successful lives that feel, underneath it all, hollow or "not mine." The feeling of not knowing who you are is often the feeling of having lived from the False Self for so long that access to the True Self has been lost. This is not a character flaw. It is an adaptation. The False Self protected you. But it was never meant to be permanent. The work of identity exploration in relational psychodynamic therapy is not about taking a personality test or listing your values on a worksheet. It is about what happens in the room between you and your therapist. How you show up. What you censor. What feels dangerous to say out loud. The moments where you perform versus the moments where something real slips through. Over time, in a relationship that is safe enough to hold your complexity, the parts of you that were buried begin to surface. This connects directly to our work with Attachment . If your earliest relationships taught you that your real self was too much, too little, or simply not what was wanted, you built an identity around managing other people’s needs rather than expressing your own. Attachment patterns are identity patterns. The two cannot be separated. You do not need to know who you are to begin. You only need the question. What Identity Therapy Looks Like Here Your early sessions are about understanding what brought you in and what "lost" feels like for you specifically. Your therapist will not hand you a framework or a label. They will listen for the places where your story does not feel like yours. This work takes time. Identity did not form overnight and it does not reorganize in a few sessions. But our clients often describe early relief simply from having their experience named and taken seriously in a room where they do not have to perform. fees & insurance pace & focus There is no formula. For some clients, identity work is the central focus. For others, it emerges alongside work on anxiety, depression, or trauma. format In-person at our Old City Philadelphia office (123 Chestnut St) or telehealth for anyone located in Pennsylvania. insurance Aetna, BCBS plans, United Healthcare, and Optum Behavioral Health. Out-of-network support offered. fees $130 to $200 per session for self-pay clients, depending on the therapist. Superbills provided after every session on request. related LGBTQIA+ Affirming Therapy Life Transitions Attachment Therapy Getting Started 01 Complete our short intake A short adaptive form. It asks only what applies to you. 02 We match you, personally Our intake coordinator reviews your response and matches you with the clinician who fits your concern, insurance, and schedule. 03 Meet your therapist Your first session is a clinical consultation, scheduled directly with the right fit. Start your intake → Or call (215) 399-4128 Using Your Insurance for Identity Exploration Therapy Therapy for identity exploration is covered as a standard outpatient behavioral health benefit under every plan we participate in. Turning Leaf is in-network with Aetna , Highmark Blue Cross , Capital Blue Cross , Anthem , Empire , the Federal Employee Program , Horizon BCBS of New Jersey , United Healthcare , Optum , and Pennsylvania VCAP . Identity work is billed as standard outpatient psychotherapy, and you do not need a diagnosis of anything dramatic to be covered. Most in-network clients pay $15 to $50 per session after deductible. Your benefits are verified before your first appointment. We do not participate in Independence Blue Cross, Cigna, Medicare, or Medicaid. In those cases sessions are $130 to $200 and you receive a superbill each time for out-of-network reimbursement. Some people prefer paying privately here anyway, since insurance billing requires a diagnosis. The insurance page explains the path in plain terms. Frequently Asked Questions What is identity exploration therapy? + Identity exploration therapy helps you examine and understand your sense of self across multiple dimensions: values, relationships, cultural background, gender, sexuality, career, spirituality, and family roles. It is grounded in the understanding that identity is not fixed but develops and shifts throughout life, particularly during major transitions. Our approach uses relational psychodynamic therapy, which views the self as formed within relationships and best explored within the safety of the therapeutic relationship. Is feeling lost a good enough reason to start therapy? + Yes. You do not need a diagnosis to benefit from therapy. Many of our clients come in saying some version of "I do not know what is wrong, but something is off." That feeling of disconnection, of not recognizing yourself, of going through the motions, is itself a meaningful signal worth exploring. How do I know if I am having an identity crisis? + Common signs include persistent feelings of emptiness or disconnection, difficulty making decisions, a sense that your life looks fine from the outside but feels hollow from the inside, loss of interest in things that used to matter, feeling like you are performing a role rather than living authentically, and the recurring question "Who am I?" or "What do I actually want?" Research shows that identity crises are normal developmental experiences that can occur at any age, not just adolescence. Can adults have identity crises? + Absolutely. While Erik Erikson placed identity formation in adolescence, longitudinal research confirms that identity development is a lifelong process. Adults commonly revisit identity questions during major transitions such as career changes, divorce, becoming a parent, empty nest, retirement, religious shifts, and midlife. Studies show that identity trajectories continue to evolve well into the 50s and 60s. What is the difference between an identity crisis and depression? + They often co-occur and can look similar from the outside. Depression involves persistent low mood, loss of interest, fatigue, and changes in sleep or appetite. An identity crisis involves a fundamental questioning of who you are and what your life means. Depression can be a consequence of unresolved identity distress, and identity confusion often masquerades as depression. A thorough assessment helps clarify what is driving what. Do you work with cultural and racial identity concerns? + Yes. Our team reflects Philadelphia’s diversity, and we have therapists with specific experience in racial identity development, bicultural identity, immigrant and first-generation identity, code-switching, and the intersection of cultural identity with other aspects of self. What type of therapy helps with identity issues? + Relational psychodynamic therapy is particularly well-suited to identity work because it understands the self as formed within relationships. Rather than applying external frameworks or worksheets, it works within the therapeutic relationship itself to help buried aspects of identity surface and develop. We also draw from existential, narrative, IFS, and multicultural approaches when they serve the work. How long does identity exploration therapy take? + There is no fixed timeline. Some clients experience meaningful shifts within a few months. Deeper identity reorganization, particularly when connected to attachment patterns or early relational experiences, often unfolds over a year or more. The pace is yours. Therapy can also feel harder before it feels better, which is often a sign of the work deepening rather than failing. Take the First Step You do not need to know who you are to begin. You only need to know that the question matters enough to explore. That is what this work is for. request an appointment Take the first step. You do not need to know who you are to begin. You only need to know that the question matters enough to explore. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/teen-therapy-philadelphia/ ===================================================================== Home / Specialties / Teen Therapy old city, philadelphia Therapy for Teens in Philadelphia Who Are Going Through Something They Cannot Put Into Words Teen therapy at Turning Leaf in Old City, Philadelphia, is individual therapy for adolescents ages 13 to 17, grounded in relational psychodynamic and trauma-informed care, in person at 123 Chestnut Street or by secure video anywhere in Pennsylvania. We see teens as the primary client, with periodic family involvement and caregiver sessions as part of a collaborative treatment approach. In-network with Aetna, BCBS, United, and Optum; self-pay $130 to $200. Half of all lifetime mental illness begins by age 14 (NIMH). The adolescent years are not just a time of risk. They are the most powerful window for therapeutic intervention, because the brain is still building itself and new relational experiences can reshape its architecture. One in five American adolescents (NIMH) had at least one major depressive episode in a single year. teens WHAT WE TREAT HERE Anxiety, depression, identity, self-harm, and family strain in adolescence INSURANCE In-network with Aetna, Blue Cross plans, United Healthcare, Optum, PA VCAP Typical copay $15 to $50. See all plans SELF-PAY $130 to $200 per session Superbills provided for out-of-network reimbursement. Rates SESSIONS 53 minutes, usually weekly FORMAT In person in Old City Philadelphia, or telehealth Across Pennsylvania, and New Jersey with select clinicians. Telehealth AGES Teens (13 to 17) APPROACH Relational, trauma-informed Caregivers involved as partners NEW CLIENTS We are accepting new clients After your intake form, a coordinator reviews it and verifies your benefits; most people have a first session within about a week. Start your intake → ON THIS PAGE If You Are a Parent Reading This Signs Your Teenager Might Need Therapy What Therapy Can Do Your Role as a Parent or Caregiver If You Are a Teen Reading This Why the Teenage Brain Makes Therapy So Powerful Right Now What We Help Teens With What the First Session Looks Like, in Old City or Online Getting started Using your insurance Frequently Asked Questions Take the First Step If You Are a Parent Reading This You are here because something changed. Maybe it happened gradually: your teenager stopped talking at dinner, started spending more time alone, lost interest in things that used to matter. Maybe it happened fast: a call from the school, a conversation that scared you, something you found on their phone. Either way, you are looking for help, and the fact that you are here means you are paying attention. Signs Your Teenager Might Need Therapy Normal adolescence involves mood shifts, boundary-testing, and increasing privacy. These are healthy developmental behaviors. The question is not whether your teen is having a hard time. The question is whether the hard time has become a pattern that is interfering with their ability to function. Consider three factors: duration, intensity, and impact. A bad week is normal. Persistent sadness or withdrawal lasting more than two weeks is not. Frustration with a friend is normal. Anger that is consistently disproportionate to the situation is not. A dip in grades during a stressful month is normal. Academic decline over an entire semester alongside social withdrawal is not. The CDC’s 2023 Youth Risk Behavior Survey found that 40 percent of all high school students reported persistent feelings of sadness or hopelessness. Among female students, that number rose to 53 percent. Among LGBTQ+ students, 65 percent. These are not isolated struggles. They are a generational pattern, and your teenager is living inside it. Specific signs that therapy may help include persistent sadness or irritability lasting more than two weeks, withdrawal from friends, family, or activities they used to enjoy, significant changes in sleep or appetite, academic decline, increased anger or emotional reactions that feel disproportionate, self-harm behaviors, statements reflecting hopelessness or worthlessness, school avoidance, increased secrecy or risky behavior, and drastic changes in peer groups. What Therapy Can Do Therapy gives your teenager something they may not have right now: a relationship with an adult who is not their parent, not their teacher, and not their coach. Someone whose only role is to understand them. In relational psychodynamic therapy, the therapeutic relationship itself is the vehicle for change. Your teen’s therapist does not just teach skills or assign worksheets. They build a relationship where your teenager can safely explore what they think, feel, and fear. Over time, this relationship becomes a template for how they relate to everyone else: peers, family, romantic partners, and eventually themselves. A 2021 meta-analysis of psychodynamic therapy with children and adolescents (Midgley et al., Frontiers in Psychology) found robust effect sizes (g = 1.07) with a notable "sleeper effect": patients continued to improve after therapy ended. The IMPACT study, the largest randomized trial comparing psychodynamic therapy and CBT for adolescent depression, found comparable outcomes between the two approaches. Your teen does not need to fit into a manualized program. They need a relationship where they can be known. Your Role as a Parent or Caregiver We see teens individually as the primary modality. We also encourage caregiver sessions alongside your teen’s individual work, because what happens at home matters. Periodic family sessions may be recommended when family dynamics are part of what your teen is working through. For older teens (ages 16 and 17), we ask the teen to consent to and be actively involved in their treatment. We strongly encourage concurrent caregiver consent. Under Pennsylvania law (Act 65 of 2020), minors aged 14 and older can consent to outpatient mental health treatment independently. This legal framework supports what we believe clinically: teens do their best therapeutic work when they feel ownership over the process, and families do their best work when parents are included as partners rather than gatekeepers. You will not be shut out. You will be informed of general progress, safety concerns, and recommendations for how to support your teen at home. What remains confidential is the specific content of what your teen shares in session. This boundary is not about keeping secrets from you. It is about giving your teenager the safety to be honest, which is the foundation everything else is built on. If You Are a Teen Reading This You do not have to know what to say. You do not have to have the right words for what is going on. You do not even have to want to be here. A lot of people who end up in therapy started by thinking it was not for them. Here is what therapy actually is: a room where you can say the thing you have not been able to say anywhere else. Where you do not have to perform or manage anyone’s feelings. Where someone is paying attention to you, not to fix you, but to understand you. Maybe you are anxious all the time and you do not know why. Maybe you feel disconnected from your friends, your family, or yourself. Maybe you are angry and you do not know where to put it. Maybe everything looks fine from the outside but nothing feels right on the inside. Maybe someone told you to come here and you are not sure it is going to help. That is all fine. You do not need to arrive ready. You just need to show up. Your therapist is not going to tell your parents everything you say. There are limits to confidentiality (if you are in danger or someone else is), but what you share in your sessions is yours. You get to decide how much your parents are involved. You get to set the pace. And if it takes a few sessions before you trust your therapist enough to talk about the real stuff, that is completely normal. Building that trust is part of the work, not a sign that something is wrong. Why the Teenage Brain Makes Therapy So Powerful Right Now Adolescence is not just an emotional experience. It is a neurobiological event. The teenage brain is undergoing a level of structural change rivaled only by the first three years of life. The prefrontal cortex, the part of the brain responsible for impulse control, decision-making, and emotional regulation, is the last region to fully develop, continuing to mature into the mid-to-late twenties. Meanwhile, the limbic system, which drives emotional intensity, reward-seeking, and social sensitivity, is already fully active. This creates a developmental gap of roughly ten years between the brain’s emotional accelerator and its regulatory brakes. At the same time, the brain is undergoing synaptic pruning: eliminating neural connections that are not being used while strengthening the ones that are. This is a "use it or lose it" process. The experiences your teenager has during this window literally shape the architecture of their adult brain. This is why adolescence is not just a time of vulnerability. It is the most therapeutically responsive period of the lifespan. New relational experiences during this window do not just feel different. They build differently. They wire differently. Therapy during adolescence is not a remedial intervention. It is an investment in the neural foundation of adulthood. What We Help Teens With The issues that bring teens to therapy are rarely single-issue. They layer, overlap, and feed into each other. Here is what we see most often. Anxiety Not just nervousness. The kind that makes your chest tight before school, that keeps you rehearsing conversations for hours, that convinces you everyone is watching and judging. Approximately 32 percent of adolescents have an anxiety disorder, with most anxiety disorders emerging between ages 11 and 13. Our Anxiety Therapy page goes deeper into how we work with anxiety. Depression The sadness that does not lift, the loss of interest in things that used to matter, the exhaustion that sleep does not fix. Nearly 1 in 5 adolescents experienced depression in the past two weeks according to recent CDC data, with rates among girls more than double those among boys. Our Depression Therapy page addresses depression in more detail. Self-Harm and Suicidal Thoughts Emergency department visits for intentional self-harm are highest among adolescents aged 15 to 19 at 472 per 100,000, nearly four times the rate of older adults. Self-harm typically begins between ages 11 and 15. If your teen is hurting themselves, this is not attention-seeking. It is a signal that their pain has exceeded their capacity to cope. Therapy provides both immediate safety and the deeper relational work that addresses what is underneath. Identity Exploration Gender, sexuality, race, culture, values, the question of "Who am I?" is the central developmental task of adolescence. For LGBTQ+ teens, identity exploration happens under the additional weight of minority stress: discrimination, internalized stigma, and the fear of rejection. Our LGBTQIA+ Affirming Therapy and Identity Exploration Therapy pages address this work in depth. Family Conflict Tension between teens and parents is developmentally normal. Chronic conflict that feels unsafe, unresolvable, or emotionally damaging is not. Therapy helps teens understand their role in family dynamics without carrying the weight of the entire system. Social Media and Technology Up to 95 percent of teens use social media, and one-third use it "almost constantly" (Surgeon General’s Social Media Advisory, 2023). Adolescents who spend more than three hours daily on social media face double the risk of depression and anxiety symptoms. The issue is not screen time in the abstract. It is what social media does to a developing sense of self: comparison, performance, validation-seeking, and the collapse of boundaries between public and private. Academic Pressure and School Avoidance The Philadelphia School District’s 2021 Youth Risk Behavior Survey found that 44.6 percent of students felt persistently sad or hopeless, up from 28.9 percent just two years earlier. Academic struggles are rarely about intelligence. They are about anxiety, depression, attention, trauma, or a system that is not designed for how your teen learns. Grief, Loss, and Trauma Philadelphia’s landmark ACE Study found that nearly 70 percent of adults experienced at least one adverse childhood experience, and 40 percent experienced four or more. Our practice is built around trauma-informed care. Our PTSD and Complex PTSD Therapy and Grief and Loss Therapy pages address these areas specifically. What the First Session Looks Like, in Old City or Online The first session usually includes the teen, the parent or caregiver, and the therapist. Your therapist will explain how therapy works, what confidentiality means and where its limits are, and what to expect going forward. There will be time for the parent to share concerns and context, and time for the teen to be heard separately. Nobody is expected to share everything in the first session. The first session is about beginning to build safety. It is about your teen getting a sense of whether this is someone they could trust. For many teens, the therapist becomes the first non-parental adult in their life with whom they can be fully honest. That relationship does not happen in one hour. It builds over weeks and months. And it is often the most important relationship of their adolescence. fees & insurance format In-person at our Old City Philadelphia office (123 Chestnut St) or telehealth for anyone located in Pennsylvania. insurance Aetna, BCBS plans, United Healthcare, and Optum Behavioral Health. Out-of-network support offered. fees $130 to $200 per session for self-pay clients, depending on the therapist. Superbills provided after every session on request. related Anxiety Therapy LGBTQIA+ Affirming Therapy Identity Exploration Getting Started For children under 13, availability is limited. Contact us to discuss fit. 01 Complete our short intake A short adaptive form. It asks only what applies to you. 02 We match you, personally Our intake coordinator reviews your response and matches you with the clinician who fits your concern, insurance, and schedule. 03 Meet your therapist Your first session is a clinical consultation, scheduled directly with the right fit. Start your intake → Or call (215) 399-4128 Using Your Insurance for Teen Therapy Therapy for adolescents is covered as a standard outpatient behavioral health benefit under every plan we participate in. Turning Leaf is in-network with Aetna , Highmark Blue Cross , Capital Blue Cross , Anthem , Empire , the Federal Employee Program , Horizon BCBS of New Jersey , United Healthcare , Optum , and Pennsylvania VCAP . Coverage for a minor runs through the policyholder, so bring the parent or guardian plan details when you reach out. In-network copays generally fall between $15 and $50 per session after deductible, and we verify the family benefits before the first appointment. If the family plan is Independence Blue Cross, Cigna, Medicare, or Medicaid, we are out of network. Sessions are $130 to $200 and a superbill goes home with you each time for reimbursement claims. The insurance page explains the path in plain terms. Frequently Asked Questions How do I know if my teenager needs therapy or counseling? + Look for patterns, not single incidents. If your teen has experienced persistent sadness, withdrawal, irritability, or behavioral changes lasting more than two weeks, if these changes are interfering with school, friendships, or family life, or if you have concerns about self-harm or safety, therapy is an appropriate and helpful next step. Approximately 40 percent of high school students report persistent sadness or hopelessness (CDC YRBS, 2023), so your teen is not alone in what they are experiencing. Is what my teen says in therapy confidential from parents? + Yes, with important exceptions. Specific content shared in sessions remains between the teen and therapist. General progress, engagement level, and safety concerns are shared with parents. The therapist is legally required to break confidentiality if there is a risk of harm to the teen or others, or in cases of suspected abuse. Under Pennsylvania law, minors aged 14 and older can consent to outpatient mental health treatment independently. Do parents participate in teen therapy sessions? + Teens are seen individually as the primary modality. We encourage periodic caregiver sessions alongside the teen’s individual work, and family sessions may be recommended when family dynamics are part of what the teen is working through. You are a partner in this process, not an outsider. How does teen therapy differ from adult therapy? + Teen therapy requires developmental attunement: understanding that emotional intensity is neurologically driven, that trust takes longer to build, and that the therapeutic relationship may be the teen’s first experience of a trustworthy non-parental adult. Our relational approach prioritizes this relationship as the vehicle for change, rather than relying primarily on techniques or exercises. How long does teen therapy typically take? + This varies based on what your teen is working through. Some teens benefit from 10 to 15 sessions focused on a specific concern. Others engage in longer-term therapy as deeper patterns around identity, attachment, and family dynamics emerge. Your therapist will discuss a recommended approach after the initial sessions. Therapy can also feel harder before it feels better, which is often a sign of the work deepening rather than failing. Can teens do therapy via telehealth? + Yes. Telehealth is effective for adolescent mental health and many teens prefer it. Sessions are available via secure video for anyone located in Pennsylvania. Do you accept insurance for teen therapy? + Yes. Turning Leaf is in-network with Aetna, United Healthcare, Optum, Pennsylvania VCAP, and these Blue Cross plans: Highmark, Capital Blue Cross, Anthem, Empire, the Federal Employee Program, and Horizon BCBS of New Jersey. Most in-network clients pay a copay of $15 to $50 after any deductible. We are out-of-network with Independence Blue Cross, Cigna, Medicare, and Medicaid; those sessions are $130 to $200, and for plans with out-of-network benefits we provide a superbill after every session on request. Take the First Step Something brought you to this page. Whether you are a parent who has been watching your teenager struggle, or a teen who found this on your own, the next step is the same. You do not have to have it figured out before you reach out. You just have to be willing to start. request an appointment Take the first step. Whether you are a parent who has been watching your teenager struggle, or a teen who found this on your own, the next step is the same. You just have to be willing to start. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/life-transitions-therapy-philadelphia/ ===================================================================== Home / Specialties / Life Transitions old city, philadelphia Life Transitions Therapy in Philadelphia for When Everything Is Changing and Nothing Feels Settled Life transitions therapy at Turning Leaf in Old City Philadelphia is relational psychodynamic support for the seasons when the ground moves: career change, divorce, new parenthood, empty nest, retirement, relocation, and the identity questions they expose. Eight of our therapists specialize in it, in person in Old City or by secure video across Pennsylvania, and in New Jersey through our NJ-licensed clinicians. In-network with Aetna, BCBS, United, and Optum; self-pay $130 to $200. Life transitions are one of the most common reasons people seek therapy, and one of the most underrecognized. The Holmes-Rahe Stress Scale, one of the most widely cited measures in stress research, demonstrates that even positive life events like marriage (50 stress units), pregnancy (40), and gaining a new family member (39) register as significant stressors. Scores above 300 units correlate with an 80 percent chance of health breakdown within two years. You do not have to be struggling with a clinical diagnosis to be struggling. life transitions WHAT WE TREAT HERE Career change, divorce, parenthood, relocation, empty nest, retirement INSURANCE In-network with Aetna, Blue Cross plans, United Healthcare, Optum, PA VCAP Typical copay $15 to $50. See all plans SELF-PAY $130 to $200 per session Superbills provided for out-of-network reimbursement. Rates SESSIONS 53 minutes, usually weekly FORMAT In person in Old City Philadelphia, or telehealth Across Pennsylvania, and New Jersey with select clinicians. Telehealth AGES Teens (13 to 17) and adults APPROACH Relational, psychodynamic Attachment-focused where transitions expose patterns NEW CLIENTS We are accepting new clients After your intake form, a coordinator reviews it and verifies your benefits; most people have a first session within about a week. Start your intake → ON THIS PAGE Why Transitions Hit Harder Than They Should When Good Changes Still Feel Like Loss How Attachment Patterns Show Up During Transitions The Transitions That Bring People to Our Philadelphia Practice When a Transition Becomes Something More How Relational Psychodynamic Therapy Helps With Transitions Getting started Using your insurance Frequently Asked Questions Take the First Step Change is the event. Transition is the quiet, internal work that follows. At Turning Leaf Therapy in Old City Philadelphia, eight of our therapists specialize in life transitions. We are a relational, psychodynamic, and trauma-informed practice, which means we understand transitions not as problems to manage but as moments that reveal who you are, how you were shaped, and what you need to grow into next. If you are here because something feels off but you cannot quite name it, that is enough. You do not need a label to deserve support. Why Transitions Hit Harder Than They Should William Bridges, the foundational thinker on transitions, drew a distinction that most people miss: change is external; transition is internal. Change is the event. Transition is the psychological process of letting go of an old identity, moving through disorientation, and gradually building something new. Bridges described three phases. The first is ending: every transition, even a wanted one, begins with a loss. Leaving a job means losing daily structure, colleagues, and a role that answered the question "What do you do?" Becoming a parent means losing autonomy, sleep, and the version of yourself that existed before. The second phase is the neutral zone: the disorienting in-between where the old identity has dissolved but the new one has not yet formed. Bridges called this the core of the transition process. It feels like limbo. It is actually where the deepest psychological work happens. The third phase is new beginnings, which cannot be forced. They arrive when the internal work catches up with the external change. Most people get stuck in the neutral zone. They expect the new beginning to arrive on the same timeline as the external change, and when it does not, they assume something is wrong with them. Nothing is wrong. They are in transition. And transitions take longer than anyone tells you they will. Even the changes we choose ask us to leave something behind. When Good Changes Still Feel Like Loss One of the least understood aspects of transitions is that positive changes produce genuine grief. Becoming a parent involves mourning your independence. Getting promoted means losing the comfort of a familiar role. Moving to a city you chose still means leaving a place that held your history. Pauline Boss calls this ambiguous loss: loss that lacks clarity, finality, or social acknowledgment. Kenneth Doka calls it disenfranchised grief: grief that is not openly acknowledged or socially validated. When you get the job you wanted and feel inexplicably sad, or when your youngest leaves for college and the house feels like it belongs to someone else, you are experiencing real loss. The fact that no one sends sympathy cards for these transitions does not make them less real. It makes them lonelier. Under pressure, we reach for the oldest ways we learned to feel safe. How Attachment Patterns Show Up During Transitions From a relational psychodynamic perspective, transitions are stress tests for the attachment system. Under pressure, people default to their earliest relational strategies. Anxiously attached individuals may become hypervigilant and clingy, seeking constant reassurance from partners, friends, or family. Avoidantly attached individuals may withdraw, refusing to acknowledge that the transition is affecting them. Disorganized attachment may surface as contradictory behavior: desperately wanting support while pushing it away. Understanding these patterns is not just intellectually interesting. It is clinically essential. When someone in the middle of a major transition finds themselves reacting in ways that feel disproportionate, the reaction often has less to do with the current change and more to do with how earlier experiences of upheaval were handled. Our Attachment Therapy page goes deeper into this work. Career, divorce, parenthood, retirement. Different roads, the same crossing. The Transitions That Bring People to Our Philadelphia Practice Every transition is different, but they share a common psychological structure: something ends, the ground opens up, and you have to find your footing in unfamiliar territory. Here are the transitions we work with most often. Career Change, Job Loss, and Burnout The average American holds nearly 13 jobs between ages 18 and 58 (Bureau of Labor Statistics, 2024). Median employee tenure has dropped to 3.9 years, the lowest since 2002. During the Great Resignation of 2021 and 2022, nearly 48 million Americans quit their jobs in a single year. Behind these statistics are individual people trying to answer a question that carries more psychological weight than it appears: if I am not this job, who am I? Career identity runs deep. Involuntary job loss activates the same neurological threat systems as physical danger. Burnout, now recognized by the WHO as an occupational phenomenon, erodes the capacity for engagement, meaning, and effectiveness. Even positive career changes involve grieving a former role, former colleagues, and a former version of yourself. Our Anxiety Therapy and Depression Therapy pages address the symptoms that often surface during career transitions. Divorce and Relationship Endings Divorce scores 73 on the Holmes-Rahe Stress Scale, second only to the death of a spouse. In Pennsylvania, approximately 2.2 to 2.4 divorces occur per 1,000 people annually. Philadelphia County recorded 1,837 divorces in 2024. But the statistics do not capture the internal experience: the dismantling of a shared future, the restructuring of daily life, the grief for what the relationship was and what it was supposed to become. Divorce activates core relational wounds around abandonment, trust, and worthiness of love. Our Grief and Loss Therapy page addresses the grief dimension, and our Relationship Therapy page explores the relational patterns that transitions like these bring to the surface. Becoming a Parent Becoming a parent is often described as the most significant transition in adult life. The concept of matrescence, first coined by anthropologist Dana Raphael and later developed by psychiatrist Alexandra Sacks, frames the transition to motherhood as a developmental period comparable to adolescence: involving brain changes, hormonal shifts, identity disruption, and the simultaneous emergence of a new self. Patrescence describes the parallel process in fathers, including hormonal changes (testosterone decreases, oxytocin increases) and an identity shift that cultural scripts often leave little room to acknowledge. Approximately 1 in 8 women experience postpartum depression. Global estimates put the prevalence closer to 17 percent. Roughly 10 percent of new fathers experience paternal postpartum depression. Postpartum anxiety affects approximately 1 in 4 to 5 women. And roughly 67 percent of couples report a decline in relationship satisfaction in the first three years after a baby arrives. Loving your baby and grieving your old life are not contradictory. They happen at the same time. Therapy provides a space to hold both. Empty Nest The United States saw a 10.6 percent increase in empty-nester households from 2010 to 2020. Roughly 37 percent of householders aged 45 to 64 live without children at home. Adjustment typically takes 18 months to two years. Empty nest is a textbook example of ambiguous loss. Your child is not gone from your life, but your daily role has fundamentally changed. The structure that organized your mornings, your evenings, your weekends, your sense of purpose, is gone. For parents whose identity was primarily organized around caregiving, the empty nest does not just change your schedule. It changes who you are. Our Identity Exploration Therapy page addresses this deeper question. Retirement Retirement scores 45 on the Holmes-Rahe Scale, the same as marital reconciliation. Research suggests self-reported depression increases by roughly 40 percent during the first few retirement years. Only 48 percent of workers report feeling emotionally prepared for it. Retirement involves the simultaneous loss of vocational identity, daily structure, social networks built through work, and the sense of contributing something that matters. For people whose professional role answered the question "Who am I?", retirement can feel less like freedom and more like free-fall. Off-time retirement, whether forced by health, layoffs, or organizational change, carries an additional layer of grief and loss of control. Moving to Philadelphia Approximately 25.87 million Americans moved in 2024. Philadelphia gained roughly 10,500 residents between July 2023 and July 2024, with a net migration of over 20,000 Gen Z adults in 2023 alone. The city is growing, and many of those new residents are navigating the disorientation that comes with starting over in an unfamiliar place. Relocation involves losing your social network, your familiar environments, your routines, and the identity anchors that a hometown provides. Whether you just moved to Fishtown, are settling into Graduate Hospital, or relocated for a position at Penn, Drexel, CHOP, or Comcast, the adjustment is real. Clinical literature suggests meaningful adjustment to a new city takes 6 to 12 months, with full integration taking one to two years. If you are new to Philadelphia and feeling more isolated or anxious than you expected, that is not a personal failure. It is a predictable response to a significant transition. College Transitions and Quarter-Life Crisis Roughly 75 percent of adults aged 25 to 33 report experiencing a quarter-life crisis. Among current college students, 37 percent report moderate to severe depressive symptoms and 32 percent report moderate to severe anxiety (Healthy Minds Study, 2024-2025). The college-to-adulthood transition is one of the first major identity disruptions most people face: leaving the structure of school, entering a world where the path is no longer prescribed, confronting the gap between expectations and reality. For those who graduated into economic uncertainty, student debt, and a housing market that feels impossible, the disorientation is compounded by structural realities that their parents’ generation did not face. Our Identity Exploration Therapy page addresses this developmental territory in depth. Coming Out and Gender Transition Coming out and gender transition involve multiple simultaneous shifts: social, relational, intrapsychic, and sometimes medical. They are transitions in the fullest sense, involving endings (a closeted identity, certain relationships, a version of yourself that was built to survive), a neutral zone (uncertainty, vulnerability, reconstruction), and new beginnings that unfold at their own pace. Minority stress theory (Meyer, 2003) describes how distal stressors (discrimination, violence) and proximal stressors (concealment, internalized stigma, expectation of rejection) compound the psychological burden of these transitions. Our LGBTQIA+ Affirming Therapy page goes deeper into this work. Leaving a Religion or Faith Tradition When your entire sense of self has been built within a religious framework, losing those beliefs means losing the architecture of your identity. Religious deconstruction involves identity foreclosure disruption, community loss, moral framework dissolution, and a form of disenfranchised grief that most people around you cannot recognize. Research suggests the arc from first questions to a settled new identity takes an average of seven years. Roughly 28 to 29 percent of U.S. adults are now religiously unaffiliated. Our Identity Exploration Therapy page addresses this transition specifically. Loss of a Loved One Grief is its own territory, and our Grief and Loss Therapy page addresses it in depth. What matters here is that the death of someone close to you is also a transition: a reorganization of daily life, relationships, identity, and meaning. Prolonged grief disorder, added to the DSM-5-TR in 2022, affects approximately 10 percent of bereaved individuals. Health Diagnosis Receiving a significant health diagnosis disrupts identity, relationships, career plans, and the narrative you had for your future. Personal injury or illness scores 53 on the Holmes-Rahe Scale. The transition involves mourning the pre-illness self while adapting to a new reality that was not chosen. Post-Military Transition The shift from military to civilian life is a cultural transition as much as a practical one. Veterans experience identity dissonance between military values (collectivism, hierarchy, mission focus) and civilian culture (individualism, ambiguity, self-promotion). Research frames this as a reculturation process, and integration of military and civilian identity produces the healthiest outcomes. Our PTSD and Complex PTSD Therapy page addresses the trauma dimension of military service. Immigration Immigration involves the simultaneous loss of homeland, extended family, language fluency, professional credentials, and cultural identity. Philadelphia gained 21,300 international immigrants between 2023 and 2024, making it one of the fastest-growing immigrant destinations on the East Coast. Acculturative stress (Berry, 1997) describes the psychological burden of navigating between cultures. Our culturally sensitive care approach is designed to hold this complexity. When a Transition Becomes Something More Not every difficult transition requires therapy, and not every therapy client going through a transition has a clinical disorder. But sometimes the distress of a transition crosses a threshold. Adjustment disorder is diagnosed when emotional or behavioral symptoms develop within three months of a stressful event and are disproportionate to the severity of the event or cause significant impairment in functioning. Between 5 and 20 percent of outpatient therapy clients receive this diagnosis. It is the clinical bridge between normal stress and more serious conditions like depression, anxiety, or PTSD. The signs that a transition may benefit from professional support include persistent difficulty functioning at work, in relationships, or in daily activities; symptoms that do not improve after several months; emotional responses that feel disproportionate to the situation; withdrawal from people or activities you used to value; changes in sleep, appetite, or energy that do not resolve; and a pervasive sense of being stuck, lost, or unable to move forward. If any of these describe your experience, therapy is not an overreaction. It is the appropriate response. Transitions do not create our patterns. They reveal them, and make them available for change. How Relational Psychodynamic Therapy Helps With Transitions Most therapeutic approaches to life transitions focus on coping strategies: how to manage stress, regulate emotions, set goals, and build new routines. These are useful. But they address the surface. Relational psychodynamic therapy asks a different set of questions. Not just "How do I cope with this change?" but "Why is this change affecting me the way it is? What does this transition reveal about how I was shaped? What relational patterns are being activated? What parts of my identity were built on ground that is now shifting?" Transitions do not create psychological patterns. They expose them. A divorce does not create abandonment fear. It activates a fear that was already there, encoded in early attachment experiences. A career loss does not create a sense of worthlessness. It strips away the external validation that was holding the worthlessness at bay. A relocation does not create isolation. It removes the social structures that were compensating for an underlying difficulty with connection. This is not about blaming your childhood for your current difficulties. It is about understanding why certain transitions hit you harder than others, and using that understanding as the foundation for building something more solid. Our therapists also draw from EMDR, IFS, DBT, ACT, and somatic approaches when they serve the work, but the relational psychodynamic framework is what gives transitions their meaning and their potential for genuine growth. fees & insurance format In-person at our Old City Philadelphia office (123 Chestnut St) or telehealth for anyone located in Pennsylvania. insurance Aetna, BCBS plans, United Healthcare, and Optum Behavioral Health. Out-of-network support offered. fees $130 to $200 per session for self-pay clients, depending on the therapist. Superbills provided after every session on request. related Identity Exploration Grief Therapy Attachment Therapy Getting Started 01 Complete our short intake A short adaptive form. It asks only what applies to you. 02 We match you, personally Our intake coordinator reviews your response and matches you with the clinician who fits your concern, insurance, and schedule. 03 Meet your therapist Your first session is a clinical consultation, scheduled directly with the right fit. Start your intake → Or call (215) 399-4128 Using Your Insurance for Life Transitions Therapy Therapy for life transitions is covered as a standard outpatient behavioral health benefit under every plan we participate in. Turning Leaf is in-network with Aetna , Highmark Blue Cross , Capital Blue Cross , Anthem , Empire , the Federal Employee Program , Horizon BCBS of New Jersey , United Healthcare , Optum , and Pennsylvania VCAP . You do not need a crisis to qualify for coverage. Adjustment and transition-related distress are covered outpatient concerns, and most in-network clients pay $15 to $50 per session after deductible. We check your benefits before the first appointment. We are not in the Independence Blue Cross, Cigna, Medicare, or Medicaid networks. Those sessions run $130 to $200, and a superbill follows each one for out-of-network reimbursement. Given that transitions often arrive alongside insurance changes, it is worth checking your current plan rather than last year’s. The insurance page explains the path in plain terms. Frequently Asked Questions Is a life transition a reason to go to therapy? + Yes. Life transitions are one of the most common reasons people seek therapy. You do not need a clinical diagnosis to benefit from support during a major change. Transitions involve grief, identity disruption, and the activation of relational patterns, all of which therapy is designed to address. Is it normal to feel anxious or depressed after a positive life change? + Yes. Even wanted changes involve real loss: loss of a former role, routine, identity, or sense of competence. The Holmes-Rahe Stress Scale shows that positive events like marriage, pregnancy, and job changes carry significant stress loads. Feeling conflicted during a positive transition is not ungrateful. It is human. How do I know if I need therapy or just need time? + Time alone can help with some transitions, but if you are still struggling after several months, if the distress is interfering with your daily functioning, or if you find yourself stuck in patterns that are not resolving on their own, therapy can help. Some clients come to therapy for 8 to 12 sessions focused on a specific transition. Others discover that the transition has surfaced deeper patterns they want to explore. What types of life changes bring people to therapy? + Career changes and job loss, divorce and breakups, becoming a parent, empty nest, retirement, relocation, graduating from college, coming out or gender transition, leaving a religion, health diagnoses, military-to-civilian transition, immigration, aging and midlife shifts, and the death of a loved one. Any change that disrupts your sense of identity, routine, or connection can benefit from therapeutic support. What is adjustment disorder? + Adjustment disorder is a clinical diagnosis for when emotional or behavioral symptoms develop within three months of a stressful event and are disproportionate to the situation or cause significant impairment. It affects 5 to 20 percent of outpatient therapy clients. It is distinct from normal stress in degree and duration, and it responds well to therapy. How long does therapy for a life transition take? + This varies depending on the transition, its complexity, and whether it has surfaced deeper patterns. Some clients work through a specific transition in 8 to 12 sessions. Others choose longer-term therapy as the transition reveals attachment patterns, identity questions, or relational dynamics they want to understand more fully. Therapy can also feel harder before it feels better, which is often a sign of the work deepening rather than failing. Do you work with people who just moved to Philadelphia? + Yes. Relocation is one of the most common transitions we support. Whether you moved for work, school, a relationship, or a fresh start, the adjustment to a new city involves real psychological work. We serve clients from across Philadelphia, including Old City, Center City, Fishtown, Northern Liberties, Rittenhouse, Graduate Hospital, University City, and surrounding areas. Telehealth is available for anyone in Pennsylvania, and for New Jersey residents through our NJ-licensed clinicians. How is life transitions therapy different from therapy for anxiety or depression? + Life transitions therapy focuses on the specific changes in your life and what they are bringing to the surface, while anxiety and depression therapy focus on those conditions directly. In practice, there is often significant overlap: transitions frequently produce anxiety and depressive symptoms. Our therapists address both the transition itself and the symptoms it generates. Take the First Step The change already happened. What has not happened yet is the internal transition: the work of letting go, sitting with uncertainty, and building something that fits the life you are actually living rather than the one you left behind. That work does not happen on a timeline. But it does happen, especially when you are not doing it alone. request an appointment Take the first step. The change already happened. The internal transition is the work that remains, and it goes better when you are not doing it alone. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/emdr-therapy-philadelphia/ ===================================================================== Home / Specialties / EMDR Therapy old city, philadelphia EMDR Therapy in Philadelphia That Does Not Stop at the Memory EMDR therapy at Turning Leaf in Old City, Philadelphia, is delivered by four EMDR-trained clinicians who integrate it within a relational psychodynamic frame, processing traumatic memories while the relationship addresses what they meant. Sessions are 53 minutes, in person at 123 Chestnut Street or by telehealth across Pennsylvania. In-network with Aetna, BCBS, United, and Optum; self-pay $130 to $200. The VA’s National Center for PTSD calls EMDR one of the most effective treatments for PTSD. It is not a shortcut, and it is not hypnosis. EMDR (Eye Movement Desensitization and Reprocessing) is one of the most extensively researched trauma treatments in the world. The World Health Organization, the American Psychological Association, and the U.S. Department of Veterans Affairs all recommend it as a frontline treatment for PTSD. Research shows that 84 to 90 percent of single-trauma survivors no longer meet PTSD criteria after just three 90-minute sessions. modalities WHAT WE TREAT HERE Traumatic memories that remain activating in the present INSURANCE In-network with Aetna, Blue Cross plans, United Healthcare, Optum, PA VCAP Typical copay $15 to $50. See all plans SELF-PAY $130 to $200 per session Superbills provided for out-of-network reimbursement. Rates SESSIONS 53 minutes, usually weekly FORMAT In person in Old City Philadelphia, or telehealth Across Pennsylvania, and New Jersey with select clinicians. Telehealth AGES Teens (13 to 17) and adults APPROACH EMDR inside a relational frame Not a standalone protocol NEW CLIENTS We are accepting new clients After your intake form, a coordinator reviews it and verifies your benefits; most people have a first session within about a week. Start your intake → ON THIS PAGE How EMDR Works What Happens in an EMDR Session at Turning Leaf in Philadelphia The Evidence Behind EMDR What EMDR Can Help With Why We Do EMDR Differently The Connection to Attachment What EMDR Is Not EMDR via Telehealth Across Pennsylvania Getting started Using your insurance Frequently Asked Questions Take the First Step At Turning Leaf Therapy in Old City Philadelphia, four of our therapists are trained in EMDR. But we do not offer EMDR as a standalone protocol. We integrate it within a relational psychodynamic framework, which means we use EMDR to process traumatic memories and the therapeutic relationship to address the relational patterns, attachment wounds, and identity disruption that trauma creates. For many people, especially those carrying complex or childhood trauma, this combination is what makes the difference between symptom reduction and genuine healing. How EMDR Works EMDR is built on the Adaptive Information Processing (AIP) model, developed by psychologist Francine Shapiro in 1987. The model holds that your brain has a built-in system for processing and integrating experiences. When something overwhelming happens, that system gets disrupted. The memory does not get processed the way ordinary memories do. Instead, it gets stored in its raw form: the images, the sounds, the body sensations, the emotions, and the beliefs about yourself that formed in that moment ("I am not safe," "It was my fault," "I am powerless"). These unprocessed memories are what drive symptoms. When something in the present resembles the original experience, even slightly, the old memory activates. The fear, the helplessness, the shame flood back as though the event is happening now. EMDR uses bilateral stimulation (BLS) to reactivate and "unstick" the brain’s processing system. BLS can take the form of guided eye movements (following the therapist’s hand or a moving light), alternating taps on the hands or knees, or alternating tones through headphones. Research suggests this works by taxing working memory while the traumatic material is held in mind, reducing the emotional intensity of the memory and allowing the brain to refile it as something that happened in the past rather than something happening now. This is not hypnosis. You remain fully awake, fully in control, and fully able to stop the process at any time. What Happens in an EMDR Session at Turning Leaf in Philadelphia EMDR follows a structured eight-phase protocol. Understanding the phases helps demystify the process. Phase 1: History and treatment planning. Your therapist gathers a thorough history, identifies target memories, and develops a treatment plan. This looks like a typical intake session. Phase 2: Preparation. Your therapist explains how EMDR works, answers your questions, and teaches grounding and calming techniques (breathing exercises, Safe Place visualization, containment strategies). For people with complex trauma, this phase may take several sessions. Rushing it increases the risk of destabilization. Phase 3: Assessment. Together you identify a specific memory to target. You identify the most disturbing image associated with it, the negative belief it created about you ("I am helpless"), the positive belief you would rather hold ("I can handle difficult things"), and your current level of distress on a 0 to 10 scale. Phases 4 through 6: Desensitization, installation, and body scan. This is the core reprocessing work. You hold the target memory in mind while following bilateral stimulation. Each set lasts about 20 to 30 seconds. Between sets, your therapist checks in: "What are you noticing now?" You report whatever comes up: thoughts, feelings, images, body sensations, sometimes things that seem completely unrelated. Over multiple sets, the memory typically loses its emotional charge. When distress reaches zero, your therapist helps strengthen the positive belief. A body scan checks for any residual tension. Phase 7: Closure. Your therapist ensures you leave the session feeling stable and grounded. If the processing is incomplete, containment strategies are used. Phase 8: Reevaluation. Each subsequent session opens with a check on what has shifted, what has maintained, and what needs further attention. You do not need to describe your trauma in extensive detail. EMDR does not require the kind of prolonged verbal retelling that some other trauma therapies use. Many people find this to be one of its most significant advantages. The Evidence Behind EMDR The research base for EMDR is substantial. Over 30 randomized controlled trials support its use for PTSD. Here is what the evidence shows: In a study of single-trauma survivors, 84 to 90 percent no longer met criteria for PTSD after three sessions (Rothbaum, 1997; Wilson et al., 1995). A Kaiser Permanente study found that 100 percent of single-trauma and 77 percent of multiple-trauma participants no longer had PTSD after an average of six sessions. Among combat veterans, 77 percent were free of PTSD after 12 sessions (Carlson et al., 1998). An NIMH-funded study found EMDR superior to fluoxetine (Prozac) for both PTSD and depression, with 91 percent maintaining their gains at follow-up (van der Kolk et al., 2007). A 2020 meta-analysis across 76 trials found EMDR achieved a large effect size (g = 0.93) compared to control conditions (Cuijpers et al., 2020). A 2025 meta-analysis in the British Journal of Psychology found EMDR to be the most cost-effective of 11 interventions assessed for PTSD (Simpson et al., 2025). The organizations that recommend EMDR as a frontline treatment include: The World Health Organization (2013) recommends EMDR and trauma-focused CBT as the only two psychotherapies for PTSD in adults. The WHO specifically notes that EMDR does not require detailed descriptions of the event, direct challenging of beliefs, extended exposure, or homework. The American Psychological Association (2017) conditionally recommends EMDR for PTSD treatment. The VA/DoD Clinical Practice Guidelines (2023) give EMDR their highest recommendation level, alongside Cognitive Processing Therapy and Prolonged Exposure. The International Society for Traumatic Stress Studies gives EMDR a "strong recommendation" for adult PTSD, one of only eight strong recommendations across 125 total. What EMDR Can Help With EMDR was developed for trauma and PTSD, and that remains its strongest evidence base. But research supports its use for a wider range of conditions, particularly when those conditions have roots in disturbing life experiences. PTSD and Complex PTSD The primary indication, with the deepest evidence. Our PTSD and Complex PTSD Therapy page covers this in detail. Anxiety Six randomized controlled trials show significant anxiety reduction with EMDR. When anxiety is rooted in specific experiences (a car accident that produced driving phobia, a medical procedure that created healthcare avoidance, a humiliation that generates social anxiety), EMDR can access the source memory in ways that talk therapy alone may not. Depression A 2024 meta-analysis of 25 randomized controlled trials found EMDR achieves a medium-to-large effect size for depression (Hedges’ g = 0.75). Van der Kolk’s NIMH-funded study found EMDR superior to fluoxetine for depression as well as PTSD. Grief and Loss When grief becomes complicated or stuck, EMDR can help process the specific moments that keep replaying: the phone call, the hospital room, the last conversation. Our Grief and Loss Therapy page addresses grief more broadly. Phobias and Performance Anxiety EMDR is effective for specific phobias (dental, flying, medical procedures) and performance anxiety where the fear is rooted in a specific past experience. Why We Do EMDR Differently This is where our approach parts from most EMDR practices in Philadelphia. EMDR is a powerful tool for processing specific traumatic memories. For people who experienced a single overwhelming event in adulthood (a car accident, an assault, a natural disaster), EMDR alone may be sufficient. The research reflects this: van der Kolk’s landmark 2007 study found that 75 percent of adult-onset trauma survivors achieved asymptomatic functioning through EMDR. But the same study found that only 33 percent of childhood-onset trauma survivors achieved the same outcome. The difference is not about EMDR’s limitations as a technique. It is about the nature of the trauma itself. Complex trauma, the kind that develops from repeated harmful experiences in childhood, from attachment disruption, from growing up in an environment where safety was unpredictable, does not create a single stuck memory. It creates a relational world. It shapes how you understand yourself, how you relate to others, how you experience closeness and conflict and vulnerability. It encodes in patterns that are distributed across thousands of small moments, many of them pre-verbal, none of them stored as a single memory you can point to and say "that is the one." EMDR can process individual memories within that history. But it cannot, on its own, address the relational patterns those memories created. It cannot provide the corrective relational experience that attachment wounds require. This is why we embed EMDR within a relational psychodynamic framework. In our practice, EMDR is not the whole treatment. It is one instrument in a larger therapeutic process. Your therapist works with you over time to build a genuine therapeutic relationship, one characterized by safety, attunement, and consistency. Within that relationship, EMDR becomes more effective because you have the relational ground to go deeper. And between EMDR sessions, the relational work continues: understanding your patterns, exploring how early experiences shaped your current relational life, and gradually building new ways of being in connection with others. Published clinical work supports this integration. Hemda Arad’s Integrating Relational Psychoanalysis and EMDR (Routledge, 2018) demonstrates how EMDR can break through emotional impasses that words alone cannot reach, while relational psychodynamic therapy provides the meaning-making context that EMDR processing alone does not offer. Paul Wachtel argues that EMDR can disrupt relational cycles at the somatic and memory level while psychodynamic work addresses their systemic and relational dimensions. Laurel Parnell developed Attachment-Focused EMDR specifically because standard EMDR, while effective for many, has limitations for clients with attachment difficulties or chronic relational trauma. Germany, notably, requires that EMDR can only be delivered when embedded within one of the major psychotherapeutic frameworks: behavioral, systemic, psychodynamic, or psychoanalytic. This is not a restriction. It is a recognition that trauma processing works best within a larger therapeutic context. The Connection to Attachment If you have read our Attachment Therapy page , you know that roughly 40 percent of adults carry insecure attachment patterns. You also know that attachment patterns can change. Research on "earned secure attachment" shows that adults who experienced insecure childhoods can develop the capacity for secure, satisfying relationships through later corrective relational experiences. EMDR can process the specific memories that created insecure attachment. Relational psychodynamic therapy provides the ongoing corrective relational experience that builds new attachment capacity. Together, they address both what happened to you and how it shaped the way you relate to everyone since. What EMDR Is Not EMDR is not hypnosis. You are fully conscious, aware, and in control throughout. There is no trance, no suggestibility, no altered state. EMDR does not erase memories. It reduces the emotional charge attached to them. After processing, you remember what happened, but it no longer hijacks your nervous system when triggered. EMDR is not a quick fix. While it often works faster than traditional talk therapy, it follows a rigorous, structured protocol. For complex trauma, treatment may span months. You cannot do EMDR on yourself. Self-help apps and YouTube videos claiming to offer EMDR are not EMDR. The protocol requires a trained therapist who can monitor your processing, manage distress, and ensure safety. EMDR via Telehealth Across Pennsylvania Research from 2021 through 2023 consistently shows that telehealth EMDR produces symptom reduction comparable to in-person delivery. Over 80 percent of clients in studied populations reported feeling comfortable with online EMDR. EMDRIA (the EMDR International Association) officially supports telehealth delivery. For telehealth EMDR, bilateral stimulation is delivered through a moving dot or light bar on screen, alternating tones through headphones, or self-administered Butterfly Hug guided by your therapist. You will need a laptop or tablet (not a phone), a stable internet connection, headphones, and a quiet private space. We offer both in-person and telehealth EMDR sessions. Telehealth is available to anyone in Pennsylvania. fees & insurance format In-person at our Old City Philadelphia office (123 Chestnut St) or telehealth for anyone located in Pennsylvania. insurance Aetna, BCBS plans, United Healthcare, and Optum Behavioral Health. Out-of-network support offered. fees $130 to $200 per session for self-pay clients, depending on the therapist. Superbills provided after every session on request. related PTSD & Complex PTSD IFS Therapy Trauma Therapy Attachment Therapy Getting Started 01 Complete our short intake A short adaptive form. It asks only what applies to you. 02 We match you, personally Our intake coordinator reviews your response and matches you with the clinician who fits your concern, insurance, and schedule. 03 Meet your therapist Your first session is a clinical consultation, scheduled directly with the right fit. Start your intake → Or call (215) 399-4128 Using Your Insurance for EMDR Therapy EMDR is billed as ordinary outpatient psychotherapy, not as a premium add-on, so it is covered under the plans we accept exactly as any other therapy session would be. We are in-network with Aetna , Highmark Blue Cross , Capital Blue Cross , Anthem , Empire , FEP , Horizon BCBS NJ , United Healthcare , Optum , and Pennsylvania VCAP . One practical note: because EMDR here is integrated into ongoing relational therapy rather than sold as a separate package, you are not paying twice for two kinds of care. Copays for in-network clients generally fall between $15 and $50 after deductible, and we verify your benefits before you begin. If you carry Independence Blue Cross, Cigna, Medicare, or Medicaid, we are out of network; sessions are $130 to $200 and every session generates a superbill for reimbursement. Start with the insurance page to see how that path works. Frequently Asked Questions What is EMDR therapy? + EMDR (Eye Movement Desensitization and Reprocessing) is an evidence-based psychotherapy that uses bilateral stimulation to help the brain reprocess traumatic memories. It is recommended by the World Health Organization, the American Psychological Association, and the U.S. Department of Veterans Affairs as a frontline treatment for PTSD. Research shows 84 to 90 percent of single-trauma survivors no longer meet PTSD criteria after three sessions. How is EMDR different from talk therapy? + EMDR does not require extensive verbal retelling of your trauma. It targets how memories are stored neurologically rather than changing thoughts through conversation. It also requires no homework. An NIMH-funded study noted that EMDR performed equally well despite less exposure and no homework compared to other trauma therapies. Do I have to describe my trauma in detail? + No. You identify the memory, the worst image, the negative belief, and your distress level. During processing, you follow the bilateral stimulation and report whatever comes up. Your therapist does not need a detailed narrative. How many EMDR sessions will I need? + For a single traumatic event, 6 to 12 sessions total (including preparation) is typical, with reprocessing itself taking 3 to 6 sessions. For complex or childhood trauma, 12 to 24 or more sessions may be needed. Your therapist will discuss an individualized treatment plan during your first sessions. Processing work can also feel more intense before it feels better, and strong emotions surfacing mid-course is often the work deepening, not failing. Can EMDR help with complex trauma and childhood trauma? + Yes, but complex trauma typically requires more preparation, a stronger therapeutic relationship, and integration with other approaches. Research shows that while 75 percent of adult-onset trauma survivors achieve full symptom remission through EMDR, childhood-onset trauma responds better to EMDR embedded within longer-term relational therapy (van der Kolk, 2007). This is why we integrate EMDR within a relational psychodynamic framework. Does insurance cover EMDR therapy? + Yes. EMDR is billed as standard psychotherapy, so your copay or coinsurance is the same as any therapy session. Turning Leaf is in-network with Aetna, United Healthcare, Optum, Pennsylvania VCAP, and these Blue Cross plans: Highmark, Capital Blue Cross, Anthem, Empire, the Federal Employee Program, and Horizon BCBS of New Jersey. We are out-of-network with Independence Blue Cross, Cigna, Medicare, and Medicaid; those sessions are $130 to $200, and for plans with out-of-network benefits we provide a superbill after every session on request. Is EMDR safe? Can it make things worse? + EMDR is considered safe when delivered by a trained therapist following the full eight-phase protocol. Strong emotions may surface temporarily during processing, and some people experience vivid dreams between sessions. For complex trauma, the extended preparation phase is designed to build your capacity to tolerate the reprocessing work safely. This is one of the reasons we prioritize a strong therapeutic relationship before beginning reprocessing. Can EMDR be done via telehealth? + Yes. Research shows telehealth EMDR produces results comparable to in-person sessions. Bilateral stimulation is delivered through visual, auditory, or tactile methods adapted for screen-based work. We offer telehealth EMDR to anyone in Pennsylvania. Is EMDR the same as hypnosis? + No. During EMDR you are fully awake, alert, and in control. There is no trance, no altered state, and no suggestibility. You can stop the process at any time. How does Turning Leaf integrate EMDR with relational therapy? + We use EMDR to process specific traumatic memories within the context of an ongoing relational psychodynamic therapy. The therapeutic relationship provides the safety and attunement that makes deeper processing possible, while the relational work addresses the patterns, attachment wounds, and identity disruption that EMDR alone does not reach. This integrated approach is particularly important for complex and childhood trauma. Take the First Step You do not need to know whether EMDR is right for you before reaching out. That is what the first sessions are for. If you would rather think it through first, our guide Is EMDR right for you? lays out who tends to benefit and who does not. Your therapist will assess your history, discuss your goals, and recommend an approach tailored to your specific experience. For some people, EMDR will be a central part of the work. For others, it will be one tool among several. Either way, the work begins with a relationship built on safety, trust, and genuine understanding. request an appointment Take the first step. You do not need to know whether EMDR is right for you before reaching out. That is what the first sessions are for. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/ifs-therapy-philadelphia/ ===================================================================== Home / Specialties / IFS Therapy old city, philadelphia IFS Therapy in Philadelphia for the System You Built to Survive IFS therapy at Turning Leaf in Old City Philadelphia is parts-based work from nine clinicians, integrated within our relational psychodynamic frame: your internal system in the room, your relational patterns between us. Sessions are 53 minutes, in person or by PA telehealth. In-network with Aetna, BCBS, United, and Optum; self-pay $130 to $200. If you have come across "parts work" or "inner child healing" on social media and felt something click, that recognition matters. What you were responding to are concepts central to Internal Family Systems (IFS) therapy, a model built on a simple and powerful idea: the mind is naturally multiple. You are not one unified thing. You are a system of parts, each with its own feelings, beliefs, and protective strategies, organized around a core Self that is whole, calm, and capable of leading. modalities WHAT WE TREAT HERE Inner conflict, self-criticism, and protective patterns INSURANCE In-network with Aetna, Blue Cross plans, United Healthcare, Optum, PA VCAP Typical copay $15 to $50. See all plans SELF-PAY $130 to $200 per session Superbills provided for out-of-network reimbursement. Rates SESSIONS 53 minutes, usually weekly FORMAT In person in Old City Philadelphia, or telehealth Across Pennsylvania, and New Jersey with select clinicians. Telehealth AGES Teens (13 to 17) and adults APPROACH Internal Family Systems parts work Held inside a relational frame NEW CLIENTS We are accepting new clients After your intake form, a coordinator reviews it and verifies your benefits; most people have a first session within about a week. Start your intake → ON THIS PAGE What IFS Is and How It Works The Parts You Carry What IFS Therapy Actually Looks Like What IFS Can Help With The Evidence Base: What the Research Shows Why We Integrate IFS With Relational Psychodynamic Therapy IFS Is Not What You See on TikTok Getting started Using your insurance Frequently Asked Questions Take the First Step At Turning Leaf Therapy in Old City Philadelphia, nine of our therapists work with IFS and parts work. We integrate IFS within a relational psychodynamic framework, which means we use parts work to understand your inner world and the therapeutic relationship to change how you move through the outer one. Social media introduced you to parts work. A therapist helps you do it safely, in relationship, with someone who can hold what comes up. What IFS Is and How It Works Internal Family Systems therapy was developed by Richard Schwartz, Ph.D., in the early 1980s while working with eating disorder clients who kept describing their inner experiences in terms of conflicting "parts." He noticed these internal parts interacted in patterns that resembled family dynamics: some parts protected, some carried pain, some put out fires, and all of them were trying to help, even when their methods were destructive. He applied family systems theory to this inner landscape and IFS was born. The model rests on three principles. First, the mind is naturally multiple. Having parts is not pathological. It is how human psychology works. You already know this intuitively: "Part of me wants to stay, but another part wants to leave." "Part of me is furious, but another part just feels sad." IFS takes that everyday experience seriously as a description of real internal structure. Second, every part has a positive intent. Even the parts that cause problems, the inner critic, the people-pleaser, the part that numbs out with food or alcohol or scrolling, are trying to protect you from something. Their methods may be extreme or outdated, but their motivation is always protective. Third, beneath all the parts is the Self: your core, undamaged essence. The Self is not a part. It is who you are when your parts relax their grip. It is characterized by what IFS calls the 8 C’s: calmness, curiosity, clarity, compassion, confidence, courage, creativity, and connectedness. The Self does not need to be built or earned. It is already there, waiting for enough safety to emerge. The Parts You Carry IFS identifies three categories of parts. Understanding them is often the first moment of relief in therapy, because what felt like chaos starts to make sense as a system. Exiles Exiles are the wounded parts. They are often young, carrying the pain, shame, fear, or loneliness from experiences that overwhelmed you, usually in childhood. They hold the emotions and beliefs that formed in those moments: "I am not enough," "I am unlovable," "The world is not safe." Exiles are called exiles because the rest of your system has locked them away. Their pain feels too dangerous to let through, so protector parts work around the clock to keep them contained. Managers Managers are the protectors that work proactively. Their job is to prevent exile pain from surfacing in the first place. They do this through control, planning, perfectionism, people-pleasing, self-criticism, overworking, caretaking, and intellectualizing. Manager parts often "feel like they are us" because they run so constantly that we mistake their voice for our own. The inner critic that tells you nothing is ever good enough is a manager. The part that scans every room for signs of disapproval is a manager. The part that says yes to everything because saying no feels dangerous is a manager. Firefighters Firefighters are the protectors that work reactively. When exile pain breaks through despite the managers’ best efforts, firefighters rush in to extinguish it by any means necessary: binge eating, substance use, dissociation, rage, endless scrolling, impulsive spending, self-harm. Firefighters act fast and worry about consequences later. They are the parts most likely to be labeled as "the problem" in therapy, but in IFS, they are understood as emergency responders doing the only thing they know how to do with overwhelming pain. The Cycle These parts create a cycle that many people recognize immediately. An exile gets triggered. A firefighter rushes in to numb the pain. A manager criticizes you for the firefighter’s behavior. The criticism triggers the exile again. The system spins. Understanding that this is a system, not a character flaw, is often the beginning of change. What IFS Therapy Actually Looks Like If you are imagining something strange or theatrical, the reality is more grounded than you might expect. In early sessions, your therapist helps you understand the IFS framework and begin noticing your own parts. There is no pressure to dive into painful material. The work begins with building awareness: which parts show up most often, what triggers them, how they interact. In ongoing sessions, your therapist guides you to turn your attention inward. You might start with a current concern, an emotion, a body sensation, or a thought pattern. The therapist helps you notice which part is activated and then asks a key question: "How do you feel toward this part?" If the answer is something like "I hate it" or "I want it to go away," that is another part talking. When the answer shifts to curiosity or compassion, that is Self. From Self, you can get to know a part: what it does, what it is afraid of, how long it has been doing this job, what it is protecting. Over time, protector parts learn to trust that the Self can lead. Exiles are witnessed, their stories are heard, and their burdens, the painful beliefs and emotions they have been carrying, can be released through a process IFS calls unburdening. You do not have to act anything out. You do not need to perform. Some people describe the process as meditative. Others experience it as deeply emotional. The therapist serves as a guide, not a director. The pace is yours. What IFS Can Help With IFS was developed in the context of eating disorders but has expanded into a broad therapeutic model. Research supports its use across a range of presentations, particularly those rooted in trauma and self-protective patterns. Trauma and PTSD A 2022 pilot study of IFS for adults with PTSD from multiple childhood traumas found that 92 percent of completers no longer met PTSD diagnostic criteria at one-month follow-up (Hodgdon et al., Journal of Aggression, Maltreatment & Trauma). A 2026 randomized controlled trial (the PARTS Study, Cambridge Health Alliance/Harvard affiliate) found IFS produced PTSD symptom reductions comparable to established treatments like CBT and EMDR. Our PTSD and Complex PTSD Therapy page goes deeper into trauma treatment. Anxiety Anxiety often involves manager parts working overtime: scanning for threats, rehearsing worst-case scenarios, controlling situations to prevent vulnerability. IFS helps you develop a relationship with the anxious part rather than fighting it, understanding what it protects and what it needs. Our Anxiety Therapy page addresses anxiety more broadly. Depression IFS was rated "promising" for depression by SAMHSA’s National Registry of Evidence-Based Programs and Practices. A pilot study of IFS for depression in college students found improvements comparable to CBT (Haddock et al., 2017). Depression in IFS is often understood as exile pain leaking through, or as the system’s exhaustion from maintaining protective strategies for too long. Perfectionism and People-Pleasing These are among the most common reasons people seek IFS specifically. In IFS, perfectionism is a manager part, not a personality trait. It learned that being flawless was the safest way to avoid criticism, rejection, or abandonment. People-pleasing is a similar strategy: measuring your worth through your usefulness to others, making sure no one has a reason to leave. The reframe is immediate and often deeply relieving: this is something you have, not something you are. And it can change. The Inner Critic Nearly everyone who enters therapy has a critical internal voice. IFS offers a way to engage with it that is radically different from trying to silence it or argue with it. The question becomes: "What are you afraid would happen if you stopped criticizing me?" The answer almost always involves protecting an exile from something worse: humiliation, failure, rejection. When the critic’s fears are heard, its intensity often softens without a fight. Emotional Eating and Addiction Addictive behaviors are classic firefighter activity: numbing exile pain fast, consequences be damned. IFS does not treat the firefighter as the enemy. It works with the firefighter to understand what it is responding to, then addresses the exile whose pain drives the cycle. A 2013 randomized controlled trial found IFS improved pain, physical functioning, and depression in rheumatoid arthritis patients (Shadick et al., Journal of Rheumatology). Relationships Attachment patterns map directly onto parts dynamics. Anxious attachment involves exile parts terrified of abandonment and manager parts that cling, seek reassurance, or monitor a partner’s every mood shift. Avoidant attachment involves manager parts that suppress vulnerability and maintain distance to prevent the exile from being hurt again. Our Relationship Therapy and Attachment Therapy pages explore these patterns in depth. The Evidence Base: What the Research Shows We believe in being honest about what the research supports and where it is still developing. IFS was listed on SAMHSA’s National Registry of Evidence-Based Programs and Practices (NREPP) in 2015, rated "effective" for general functioning and well-being, and "promising" for anxiety, depression, physical health, and self-concept. Three randomized controlled trials have been published. A 2025 scoping review in the journal Clinical Psychologist (Buys, 2025) examined all 27 peer-reviewed IFS studies and concluded that IFS is a "promising therapeutic approach" while noting the evidence base is still limited in scope compared to longer-established modalities. To put this in context: CBT has hundreds of meta-analyses spanning six decades. EMDR has over 30 randomized controlled trials and is recommended by the World Health Organization and the APA as a frontline PTSD treatment. IFS has 27 total peer-reviewed studies, most with small samples. The results are consistently positive, but independent replication at scale is still needed. What this means in practice: IFS is a well-developed clinical model with strong theoretical foundations, growing research support, and consistently positive outcomes in the studies that exist. It is not experimental, but it is earlier in the research process than some other approaches. Over 45,000 therapists now list IFS on Psychology Today, and the IFS Institute has trained practitioners in over 40 countries, reflecting broad clinical adoption even as the formal evidence base continues to build. We integrate IFS within a broader relational psychodynamic framework that has decades of robust research behind it. This means your treatment is never resting on a single modality. It is grounded in a clinical approach with deep evidence, using IFS as one powerful tool within it. Why We Integrate IFS With Relational Psychodynamic Therapy This is where our approach differs from practices that offer IFS as a standalone model. IFS and relational psychodynamic therapy share more conceptual ground than most people realize. Both work with internal psychological structures: IFS calls them parts; psychodynamic theory calls them internal objects, self-states, or internalized relational patterns. Both trace current emotional reactions to early experiences. Both honor the reality that much of what drives your behavior operates below conscious awareness. The key difference is where the healing happens. In pure IFS, healing occurs primarily in the internal relationship between Self and parts. In relational psychodynamic therapy, healing occurs primarily in the relationship between the client and therapist. We believe both are necessary. Parts do not exist in isolation. They were formed in relationships: with caregivers, with family systems, with cultural environments. A perfectionist manager did not develop in a vacuum. It developed in response to a specific relational context where being perfect was the price of love. An exile carrying shame did not generate that shame alone. It absorbed it from a relational environment where it was transmitted. When IFS is practiced within a relational psychodynamic framework, the therapist does more than guide you to connect with your parts. The therapist also pays attention to what happens between the two of you. You might notice a part that performs for the therapist the way it performs for everyone. You might notice a protector that does not trust the therapist’s compassion because it has never trusted anyone’s compassion. You might notice that you are relating to the therapist the same way an exile learned to relate to its original caregiver. These moments are not interruptions of the work. They are the work. They are where internal patterns and relational patterns meet, and where both can begin to shift. IFS Is Not What You See on TikTok IFS is not the same as having multiple personalities. Dissociative Identity Disorder (DID) involves truly separate identity states with potential amnesia between them. IFS describes the normal psychological experience of multiplicity that everyone has: the part of you that wants the cookie and the part that wants to lose weight. These are not separate identities. They are aspects of one mind. You do not need trauma to benefit from IFS. IFS helps with everyday struggles like anxiety, perfectionism, self-criticism, relationship patterns, and personal growth. It is a framework for understanding how your mind works, not just how it was wounded. Self-guided parts work from social media has limits. Turning inward without a trained therapist can activate exiles prematurely, without sufficient protector consent or Self-energy to hold the experience. This can be destabilizing, particularly for people with trauma histories. Social media can introduce the concepts. A therapist provides the safety, pacing, and relational context to do the deeper work. fees & insurance format In-person at our Old City Philadelphia office (123 Chestnut St) or telehealth for anyone located in Pennsylvania. insurance Aetna, BCBS plans, United Healthcare, and Optum Behavioral Health. Out-of-network support offered. fees $130 to $200 per session for self-pay clients, depending on the therapist. Superbills provided after every session on request. related EMDR Therapy PTSD & Complex PTSD Childhood Emotional Neglect Relational Therapy Getting Started 01 Complete our short intake A short adaptive form. It asks only what applies to you. 02 We match you, personally Our intake coordinator reviews your response and matches you with the clinician who fits your concern, insurance, and schedule. 03 Meet your therapist Your first session is a clinical consultation, scheduled directly with the right fit. Start your intake → Or call (215) 399-4128 Using Your Insurance for IFS Therapy Internal Family Systems work is delivered inside standard psychotherapy sessions, which means it is a covered outpatient behavioral health service under each of our in-network plans rather than a specialty service billed differently. Those plans are Aetna , United Healthcare , Optum , Highmark , Capital Blue Cross , Anthem , Empire , the Federal Employee Program , Horizon of New Jersey , and PA VCAP . Expect a copay in the $15 to $50 range once your deductible is met. Before your first appointment a coordinator checks your plan and tells you the number, so nothing about cost is a surprise later. We do not participate in Independence Blue Cross, Cigna, Medicare, or Medicaid. Those clients pay $130 to $200 per session and receive a superbill each time for out-of-network reimbursement. The insurance overview lays out the steps. Frequently Asked Questions What is IFS therapy? + Internal Family Systems (IFS) is a therapeutic model developed by Richard Schwartz that understands the mind as naturally composed of multiple "parts," each with its own feelings, beliefs, and protective strategies. IFS helps you build a relationship with these parts from a place of Self, your core, undamaged essence characterized by curiosity, compassion, and calm. It was listed as an evidence-based practice by SAMHSA in 2015 and has a growing research base including three randomized controlled trials. What are "parts" in IFS? + Parts are subpersonalities within your internal system. IFS identifies three types: exiles (wounded parts carrying pain from past experiences), managers (proactive protectors that control, plan, and prevent vulnerability), and firefighters (reactive protectors that numb or distract when pain breaks through). Every part has a positive intent, even when its behavior is problematic. What is "Self" in IFS? + Self is your core essence, distinct from any part. It is not created through therapy but is always present, emerging naturally when parts relax their protective roles. Self is characterized by the 8 C’s: calmness, curiosity, clarity, compassion, confidence, courage, creativity, and connectedness. Is IFS the same as having multiple personalities? + No. IFS describes the normal experience of internal multiplicity that everyone has. Dissociative Identity Disorder involves truly separate identity states with amnesia between them. Parts in IFS are aspects of one mind, not separate identities. Is IFS therapy evidence-based? + IFS has a growing evidence base with consistently positive outcomes. It was listed on SAMHSA’s NREPP in 2015. Three RCTs have been published, including a 2026 trial at a Harvard-affiliated hospital. A 2025 scoping review of all 27 peer-reviewed IFS studies concluded it is a "promising therapeutic approach." The evidence base is smaller than CBT or EMDR but is actively expanding. What does an IFS session look like? + Your therapist helps you notice which parts are activated, differentiate them from Self, and build relationships with them. You might close your eyes and turn attention inward, notice body sensations or emotions, and explore what a particular part needs. Sessions can feel meditative or deeply emotional. Your therapist guides the process at your pace. Can IFS help with anxiety? + Yes. In IFS, anxiety is understood as one or more parts working overtime to protect you from perceived threats. Rather than trying to eliminate anxiety, IFS helps you understand what the anxious part is protecting and what it needs from you. This often reduces anxiety more sustainably than approaches that focus only on symptom management. How long does IFS therapy take? + This depends on what you are working with. Some people experience meaningful shifts within the first months as they begin relating to their parts differently. Deeper work, particularly with trauma-related exiles, takes longer. Many of our clients engage in IFS-informed therapy for a year or more. Therapy can also feel harder before it feels better, which is often a sign of the work deepening rather than failing. Do I need to have experienced trauma to benefit from IFS? + No. IFS is helpful for anyone who experiences inner conflict, self-criticism, anxiety, perfectionism, people-pleasing, relationship difficulties, or a desire for deeper self-understanding. You do not need a trauma history to have parts that could benefit from more compassionate leadership. How does Turning Leaf integrate IFS with relational therapy? + We use IFS to help you understand and work with your internal parts, and the therapeutic relationship to address how those parts show up in your connections with others. Parts were formed in relationships and often need relational experiences to fully heal. Our relational psychodynamic framework provides the interpersonal context that purely internal parts work can miss. Take the First Step You have probably been managing your parts for a long time, long before you had language for what they were doing. The perfectionist part. The people-pleasing part. The one that numbs. The one that criticizes. They have all been working hard to keep you safe. Therapy is where they finally get to put some of that weight down. request an appointment Take the first step. The perfectionist part, the people-pleasing part, the one that numbs, the one that criticizes: they have all been working hard to keep you safe. Therapy is where they finally get to put some of that weight down. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/relational-therapy-philadelphia/ ===================================================================== Home / Specialties / Relational Therapy old city, philadelphia Relational Psychodynamic Therapy in Philadelphia Relational psychodynamic therapy at Turning Leaf in Old City Philadelphia is the clinical foundation of our entire practice, depth-oriented, open-ended psychotherapy in which the therapeutic relationship itself is the engine of change. 26 clinicians work from this framework, integrating EMDR, IFS, somatic, DBT, and ACT inside it rather than in place of it. Sessions are 53 minutes, weekly or twice weekly, in person in Old City, Philadelphia, or by secure video across Pennsylvania, and in New Jersey through our NJ-licensed clinicians. In-network with Aetna, BCBS, United, Optum; self-pay $130 to $200. Relational psychodynamic therapy is the clinical method at the heart of everything Turning Leaf does. It is depth-oriented, open-ended psychotherapy grounded in a single conviction: the therapeutic relationship itself is the primary engine of change. Not techniques. Not worksheets. Not symptom-management protocols. A real, sustained, professionally attuned relationship in which the patterns that organize your life can finally become visible and begin to shift. modalities WHAT WE TREAT HERE Depth-oriented psychotherapy where the relationship itself is the method INSURANCE In-network with Aetna, Blue Cross plans, United Healthcare, Optum, PA VCAP Typical copay $15 to $50. See all plans SELF-PAY $130 to $200 per session Superbills provided for out-of-network reimbursement. Rates SESSIONS 53 minutes, usually weekly FORMAT In person in Old City Philadelphia, or telehealth Across Pennsylvania, and New Jersey with select clinicians. Telehealth AGES Teens (13 to 17) and adults APPROACH Relational psychodynamic EMDR, IFS, DBT, and ACT held inside it NEW CLIENTS We are accepting new clients After your intake form, a coordinator reviews it and verifies your benefits; most people have a first session within about a week. Start your intake → ON THIS PAGE What Relational Psychodynamic Therapy Actually Is Where This Approach Comes From How This Is Different From Other Approaches The Concepts Your Therapist Works With What the Evidence Shows What Sessions Actually Look Like Why This Approach, Why Now Getting started Using your insurance Frequently Asked Questions Take the First Step The relationship is not the setting for the work. It is the work. If you have tried therapy before and found that the coping skills did not reach the underlying thing, or that the relief did not last, or that you understood your patterns intellectually but could not stop repeating them, you are describing the limits of approaches that work around the relationship rather than through it. Relational psychodynamic therapy works through it. At Turning Leaf Therapy in Old City Philadelphia, 26 therapists practice from this framework. It is not one of several orientations we offer. It is the foundation beneath every session, every treatment plan, and every specialty we provide, from anxiety and depression to trauma, attachment, grief, relationships, identity, and childhood emotional neglect. Within this relational framework, our therapists draw on complementary modalities including EMDR, IFS, somatic approaches, DBT, and ACT when they serve the work. But these are tools held inside the relationship, not substitutes for it. What Relational Psychodynamic Therapy Actually Is Relational psychodynamic therapy is the contemporary form of the oldest tradition in psychotherapy, updated by six decades of research and clinical refinement into something that looks nothing like what most people picture when they think of "psychoanalysis." You are not lying on a couch. Your therapist is not silent. You are not analyzing dreams for hidden symbols. You are sitting across from another human being who is present, engaged, and trained to notice what is happening between the two of you in real time, because what happens between you is the material that matters most. The approach rests on five core convictions: The relationship is the medicine. Across decades of psychotherapy outcome research, the single strongest predictor of whether therapy helps is not the brand of therapy but the quality of the relationship between you and your therapist. Relational psychodynamic therapy is designed around this finding. Your therapist is not a coach delivering a curriculum. They are a person who will become real to you, and you to them, and the texture of that relationship is itself how change happens. You are organized by your relational history, not by your symptoms. Depression, anxiety, chronic emptiness, self-sabotage, and relationship difficulty are usually not the problem. They are the visible expression of an underlying organization built from the relationships that formed you. Working at the level of symptoms can produce real relief, but it tends not to last when the underlying pattern remains intact. We work at the level of the pattern. The unconscious is real, and it is relational. Most of what runs your life is not in conscious words. It lives in implicit relational knowing: how you learned to expect to be received, what you learned to hide, what you learned was unsafe to need. Therapy brings that material into the room, where it becomes available for revision. The therapist’s subjectivity is part of the work. The classical analyst tried to be a neutral mirror. Decades of practice and research have shown that neutrality is neither possible nor therapeutic. A relational psychodynamic therapist is trained to notice their own reactions to you, to use those reactions as clinical information, and at carefully chosen moments, to share them. This is what clinicians mean by the therapist as participant-observer. The therapist is in the field with you, not above it. Patterns repeat in the room, and that is the point. The way you learned to manage closeness, the way you go quiet when something matters, the way you expect to be misunderstood or dismissed, all of it will eventually show up between you and your therapist. In a relational frame, this is not a problem to be analyzed from the outside. It is the moment the pattern becomes available to be lived through differently, together. This live, here-and-now work is what didactic and skills-based approaches cannot reach. A living tradition, refined across more than a century of clinical work. Where This Approach Comes From Relational psychodynamic therapy did not appear from nowhere. It is the product of a 130-year lineage that began with Freud’s discovery of the unconscious and evolved decisively through four major developments. Object relations theorists (W.R.D. Fairbairn, Donald Winnicott, Melanie Klein) argued in the mid-twentieth century that human beings are not primarily drive-seeking but relationship-seeking, in Fairbairn’s famous phrase, and that personality is built from internalized early relationships. Winnicott contributed the concepts of the holding environment (the reliable, attuned presence that allows a self to emerge), the true self and false self (the compliant facade that develops when a child’s authentic experience is not welcomed), and the good-enough mother (the insight that perfection is not the goal; healing happens through the rhythm of attunement, ordinary failure, and repair). Heinz Kohut’s self psychology added that the self requires sustained mirroring (being seen and reflected), idealizing (having someone to look up to and draw strength from), and twinship (feeling a fundamental alikeness with others) across the entire lifespan. When these needs go unmet in childhood, the result is the chronic emptiness, shame, and hunger for validation that so many of our clients describe. John Bowlby’s attachment theory provided the empirical scaffolding, demonstrating that the quality of early caregiving relationships creates internal working models that shape how we expect all relationships to function. Mary Ainsworth’s research operationalized this into observable attachment patterns, and Mary Main extended it to adults. The implications for therapy were profound: if relational patterns are formed in relationship, they can only be transformed in relationship. The relational turn of the 1980s and 1990s was the decisive shift. Stephen A. Mitchell and Jay Greenberg proposed that all psychoanalytic ideas cluster into two incompatible models: a drive model (one-person psychology, the analyst as neutral observer) and a relational model (two-person psychology, the analyst as participant). Mitchell, Lewis Aron, and Jessica Benjamin, working primarily through the NYU Postdoctoral Program, built relational psychoanalysis into the dominant contemporary American school. Benjamin’s work on mutual recognition, Aron’s work on mutuality, and Robert Stolorow’s critique of "the myth of the isolated mind" reshaped how clinicians understand what happens in a session. Two people are in the room. Both have minds. Both are affected. Therapy works through what unfolds between them. Philadelphia has its own institutional anchors in this tradition, including the Institute for Relational Psychoanalysis of Philadelphia and the Psychoanalytic Center of Philadelphia, which has trained clinicians since 1939. But few practices have translated this lineage into accessible, contemporary clinical care for everyday people seeking therapy. That gap is what Turning Leaf was built to fill. How This Is Different From Other Approaches People often ask how relational psychodynamic therapy compares to other forms of therapy. These comparisons matter because understanding the differences helps you choose what is right for your situation. How It Differs From CBT Cognitive Behavioral Therapy is structured, agenda-driven, often manualized, and typically delivered in 12 to 20 sessions. It focuses on what : the thoughts you are thinking, the behaviors you are doing, the symptoms you are tracking. For circumscribed problems with a clear behavioral component, such as a specific phobia, an OCD ritual, or panic disorder, CBT works well and there is good reason to use it. Relational psychodynamic therapy asks why . Why this thought, why now, what relational history gave rise to it, what it is doing for you, who it has belonged to before. Where CBT changes the thought, depth work understands what the thought is protecting and provides conditions for it to become unnecessary. The claim that CBT is "the evidence-based therapy" and psychodynamic work is not has been formally retired in the research literature. Steinert et al. (2017, American Journal of Psychiatry) used a formal equivalence test across 23 randomized controlled trials and found psychodynamic therapy statistically equivalent to CBT and other established treatments. The 2023 Leichsenring et al. umbrella review in World Psychiatry concluded that psychodynamic therapy warrants a strong recommendation for depressive, anxiety, personality, and somatic symptom disorders. The evidence base is not the question. The question is which approach matches what you need. How It Differs From Classical Psychoanalysis Classical psychoanalysis means four to five sessions per week, on the couch, with an analyst trained to remain comparatively neutral, often for many years. Relational psychodynamic therapy is not that. Sessions are face to face, weekly or twice weekly, with a therapist who is present and engaged. The theoretical foundation is shared. The intensity and structure differ. Most contemporary depth work in the United States is psychodynamic psychotherapy, not classical psychoanalysis, and that is what we offer. How It Relates to EMDR EMDR is a structured eight-phase trauma processing protocol with strong evidence for single-incident PTSD. At Turning Leaf, EMDR is a tool used inside the relational psychodynamic frame, not a replacement for it. EMDR addresses what happened. Relational work addresses what it meant about you, about others, and about being in relationship. For complex trauma, the combination is what makes the difference between symptom reduction and genuine healing. How It Relates to IFS Internal Family Systems shares more with relational psychodynamic therapy than most people realize. Both honor a non-unitary self and the power of the unconscious. IFS "parts" map closely onto concepts from object relations theory: exiles correspond to wounded internalized self-states, managers and firefighters to protective defenses, and Self to something close to Winnicott’s true self. The difference is emphasis. IFS centers on intrapsychic self-leadership. Relational psychodynamic therapy centers on intersubjectivity, the live relationship between you and your therapist as the laboratory for change. Many of our clinicians integrate IFS techniques within the relational frame. How It Differs From Skills-Based Approaches (DBT, ACT) DBT was designed for severe emotion dysregulation and builds affect-regulation scaffolding. ACT builds psychological flexibility through acceptance and values clarification. Both are valuable and both manage symptoms. Relational psychodynamic therapy transforms the underlying organization that produced the symptoms. Some clients benefit from sequencing these approaches: stabilization through skills work, then depth work to address the root. The Concepts Your Therapist Works With You do not need to know any of this vocabulary to do the work. But seeing what we mean when we use these terms can help the process feel less opaque. Transference. The way your characteristic patterns of expecting and engaging others show up in real time with your therapist, who is part of how it shows up. You might begin to experience your therapist as critical, even when they are not being critical, because your nervous system learned to expect criticism from the people it depended on. That is not a distortion. It is information about how your relational world is organized. Countertransference. Your therapist’s full emotional response to you, used as clinical information rather than treated as an obstacle. If your therapist notices they feel careful around you, or protective of you, or subtly pushed away, those reactions often mirror the relational dynamics you produce in the world outside the room. Enactments. Moments when an old relational pattern gets played out between you and your therapist, often before either of you fully recognizes it. A client whose parents were dismissive may begin to dismiss the therapist’s observations. A client who learned to caretake may worry about their therapist’s wellbeing. Working through enactments is where some of the deepest change happens, because the unspoken pattern becomes shared, conscious, and revisable. Repetition compulsion. The unconscious tendency to repeat painful patterns in love, work, and family. People repeat what is familiar even when familiar is painful, because familiarity is a form of survival. Understanding why you keep recreating the same relational dynamics is the first step toward creating different ones. Defenses as adaptations. Hypervigilance, intellectualization, people-pleasing, withdrawal, perfectionism. These are not pathology. They are intelligent solutions a younger version of you found to a real situation. Therapy does not strip them away. It makes them understandable, lowers their cost, and makes other possibilities available. Rupture and repair. Research by Jeremy Safran and J. Christopher Muran has shown that successful repair of inevitable misattunements between client and therapist is one of the most reliable predictors of outcome. Therapy is not ruptureless connection. It is the experience that ruptures can be named, survived, and worked through together. For many clients, this is a genuinely new experience. The corrective emotional experience. Healing through the actual experience of being met, witnessed, and responded to in ways your early caregivers could not provide. In contemporary relational practice, this is not engineered by the therapist. It happens because a real, repeated, attuned relationship offers something the original ones did not. What the Evidence Shows The claim that psychodynamic therapy lacks empirical support is no longer credible. The following findings represent the strongest evidence in the field. Jonathan Shedler’s landmark 2010 review in the American Psychologist found that psychodynamic therapy produces effect sizes of 0.97 at termination, growing to 1.51 at long-term follow-up. This growth after therapy ends is called the sleeper effect: patients continue to improve after psychodynamic therapy concludes, in a way not consistently observed after symptom-focused treatments. For comparison, the typical effect size for antidepressant medication is approximately 0.31. The Tavistock Adult Depression Study (Fonagy et al., 2015, World Psychiatry) tested long-term psychoanalytic psychotherapy for treatment-resistant depression, patients who had been depressed for at least two years and failed at least two prior treatments. At the 42-month follow-up, partial remission rates were 30 percent in the psychoanalytic group versus 4.4 percent in treatment as usual. For a population that conventional approaches had already failed, these results are remarkable. Driessen et al. (2010, 2015, Clinical Psychology Review) found short-term psychodynamic psychotherapy significantly more effective than control conditions for depression, with within-group effect sizes of 1.34, and concluded that it does not differ from other psychotherapies on depression outcomes. Leichsenring and Rabung (2008, JAMA; 2011, British Journal of Psychiatry) demonstrated that long-term psychodynamic psychotherapy is superior to less intensive forms of psychotherapy for complex mental disorders, including personality disorders and chronic depression. Steinert et al. (2017, American Journal of Psychiatry) conducted a formal equivalence test across 23 randomized controlled trials and found psychodynamic therapy statistically equivalent to CBT and other established treatments. Leichsenring et al. (2023, World Psychiatry) published an umbrella review using updated empirically supported treatment criteria and concluded that psychodynamic therapy warrants a strong recommendation for depressive, anxiety, personality, and somatic symptom disorders. The APA’s 2012 Resolution on Psychotherapy Effectiveness, adopted by the Council of Representatives, explicitly recognizes that therapy benefits "often endure, but continue to improve following therapy completion," citing Shedler’s work. When patients are given a real choice, they often choose depth. Markowitz et al. (2016) found that 50 percent of chronic PTSD patients preferred a relationally oriented treatment versus 26 percent who preferred a CBT-based exposure protocol. People who understand their options often choose the relationship. Fifty minutes, weekly or twice weekly, with no agenda but what is on your mind. What Sessions Actually Look Like Sessions are 53 minutes, weekly or twice weekly, face to face, in our Old City office at 123 Chestnut Street, Suite 304, or via secure telehealth for anyone in Pennsylvania. There is no homework. There are no worksheets. There is no agenda we hand you at the door. You begin with what is on your mind. Your therapist follows. They listen for what is being said, what is not being said, what shows up in the texture of how you are speaking, what arises between you. Over time, themes appear. Patterns become visible. Material that has been outside your awareness comes forward. Your therapist names things, asks questions, sometimes shares their own reaction to what is happening. The work is conversational, but the listening underneath is trained and specific. The therapy is open-ended. Most depth work runs from one to several years. Some clients with more contained presentations finish in less. We do not promise an arbitrary number of sessions because the goal is not symptom suppression on a deadline. The goal is structural change in how you are organized, change that, on the evidence, tends to deepen after therapy ends. Why does it take longer than 12 sessions? Because the patterns that brought you here were learned over years inside relationships that mattered, and the new patterns will be learned the same way. Character is not built in eight sessions and does not reorganize in eight sessions. People are done with surface fixes. They want work that reaches the roots. Why This Approach, Why Now Something has shifted in the broader culture around therapy. Bessel van der Kolk’s The Body Keeps the Score has spent over 376 weeks on the New York Times bestseller list and sold more than three million copies, teaching a generation that trauma lives in the body and implicit memory, not in the rational mind. Lori Gottlieb’s Maybe You Should Talk to Someone showed the public what depth therapy actually looks like from the inside. Attached by Levine and Heller, No Bad Parts by Richard Schwartz, and Pete Walker’s Complex PTSD are perennial bestsellers. Attachment theory, inner child work, parts work, and "why am I like this" content have generated hundreds of millions of views on social media. The vocabulary the public has absorbed (attachment, parts, the unconscious, intergenerational trauma, the therapeutic relationship) is psychodynamic vocabulary. The frameworks people are searching for are the ones this tradition has been refining for over a century. At the same time, there is growing dissatisfaction with manualized, short-term, "toolbox" therapy. Many of the clients who walk through our door arrive having tried something else first. They did CBT and found the worksheets did not reach the deeper thing. They read every attachment book and watched every video and still cannot change the pattern. They want therapy that takes them seriously as people with histories, not as disorders with protocols. That is what we do here. fees & insurance format In-person at our Old City Philadelphia office (123 Chestnut St) or telehealth for anyone located in Pennsylvania. insurance Aetna, BCBS plans, United Healthcare, and Optum. (Note: We do not accept Independence Blue Cross) . fees $130 to $200 per session for self-pay clients, depending on the therapist. Superbills provided after every session on request. related Attachment Therapy Trauma Therapy EMDR Therapy IFS Therapy Getting Started 01 Complete our short intake A short adaptive form. It asks only what applies to you. 02 We match you, personally Our intake coordinator reviews your response and matches you with the clinician who fits your concern, insurance, and schedule. 03 Meet your therapist Your first session is a clinical consultation, scheduled directly with the right fit. Start your intake → Or call (215) 399-4128 Using Your Insurance for Relational Psychodynamic Therapy Therapy for depth-oriented relational work is covered as a standard outpatient behavioral health benefit under every plan we participate in. Turning Leaf is in-network with Aetna , Highmark Blue Cross , Capital Blue Cross , Anthem , Empire , the Federal Employee Program , Horizon BCBS of New Jersey , United Healthcare , Optum , and Pennsylvania VCAP . Open-ended therapy is still ordinary outpatient care as far as your plan is concerned; there is no separate code for depth. In-network clients generally pay $15 to $50 per session after deductible, and because this work is measured in months rather than weeks, we verify your benefits before the first session so the cost is known up front. For Independence Blue Cross, Cigna, Medicare, and Medicaid we are out of network. Sessions are $130 to $200, and because this work is ongoing rather than brief, the superbill we issue after each session matters: submitted regularly, out-of-network reimbursement can meaningfully change the arithmetic. The insurance page explains the path in plain terms. Frequently Asked Questions What is relational psychodynamic therapy? + Relational psychodynamic therapy is a depth-oriented, open-ended form of psychotherapy in which the therapeutic relationship itself is the primary vehicle for change. It draws on object relations, self psychology, attachment theory, and the contemporary relational tradition associated with Stephen Mitchell, Lewis Aron, and Jessica Benjamin. The core conviction is that people are organized by their relational histories, that much of what shapes us operates outside conscious awareness, and that a real, sustained, attuned therapeutic relationship is what allows underlying patterns to be understood and revised. How is psychodynamic therapy different from CBT? + CBT focuses on changing the thoughts you are thinking and the behaviors you are doing. It is structured, agenda-driven, and typically delivered in 12 to 20 sessions. Psychodynamic therapy focuses on the patterns underneath the symptoms: where they came from, what they are doing for you, and how they show up in your relationships including with your therapist. Both are effective. Meta-analytic research has shown them to be roughly equivalent in outcomes, with psychodynamic gains tending to grow after treatment ends. Is psychodynamic therapy evidence-based? + Yes. Shedler’s 2010 review in the American Psychologist documented effect sizes of 0.97 at termination growing to 1.51 at follow-up. Steinert et al. (2017) demonstrated formal equivalence with CBT. The 2023 Leichsenring umbrella review in World Psychiatry concluded that psychodynamic therapy warrants a strong recommendation for depressive, anxiety, personality, and somatic symptom disorders. How long does psychodynamic therapy take? + Most depth work runs from one to several years, with sessions weekly or twice weekly. Shorter work is possible for more contained presentations. Why longer? Because relational patterns were built over years inside relationships that mattered, and durable change tends to require time. Research indicates roughly 50 percent recovery by session 8 and 75 percent by session 26, with longer durations associated with better outcomes for complex presentations. Therapy can also feel harder before it feels better, which is often a sign of the work deepening rather than failing. What happens in a psychodynamic therapy session? + Sessions are 53 minutes, face to face, with no structured agenda. You begin with what is on your mind. Your therapist listens carefully, asks questions, notices patterns, and sometimes shares their own reactions to what is unfolding. Over time, themes emerge, defenses become understandable, and the relationship between you and your therapist becomes a place where old patterns can be lived through differently. Do I need to talk about my childhood? + You will probably want to eventually, because your formative relationships shape how you experience the present. But there is no requirement. We follow what is on your mind. Childhood material tends to arise on its own when it is relevant. Your therapist will not direct you there before you are ready. Is psychodynamic therapy the same as psychoanalysis? + No. Classical psychoanalysis means four to five sessions per week, on the couch, with an analyst trained to remain comparatively neutral. Psychodynamic therapy is face to face, weekly or twice weekly, with a present and engaged therapist. The theoretical foundation is shared. The intensity and structure differ. What is the therapeutic relationship and why does it matter? + The therapeutic relationship is the actual relationship that develops between you and your therapist over time. It is the strongest single predictor of whether therapy helps, regardless of theoretical orientation. Relational psychodynamic therapy is built around this finding. The relationship is not a backdrop for the real work. It is the real work. The patterns that organize your emotional life will show up in the room, and the experience of working through them with another person is what produces lasting change. How is relational psychodynamic therapy different from "regular" psychodynamic therapy? + Classical psychodynamic therapy inherited from Freud the idea of the analyst as a relatively neutral observer: a one-person psychology. The relational turn of the 1980s and 1990s established a two-person psychology in which the therapist’s subjectivity is acknowledged as part of the field. Both members of the dyad shape what unfolds. The therapist is a participant-observer rather than a blank screen. We name this distinction explicitly because the framework matters. Is relational psychodynamic therapy good for trauma? + Yes, particularly for developmental and relational trauma where the original injuries occurred within attachment relationships. Healing from this kind of trauma usually requires a sustained, attuned relationship in which earlier patterns can be felt, named, and revised. We integrate trauma-specific tools including EMDR and IFS within the relational frame. See our Trauma Therapy page for the broader picture. Take the First Step You may have spent years learning about yourself through books, social media, and previous therapy. You may understand your patterns clearly and still find yourself repeating them. That gap between knowing and changing is not a failure of insight. It is evidence that knowing is not enough. Patterns learned in relationship change in relationship. That is the work we offer: not a program, not a protocol, but a real relationship with a trained person who can hold what you are carrying and help you put it down. request an appointment Take the first step. Patterns learned in relationship change in relationship. Not a program, not a protocol: a real relationship with a trained person who can hold what you are carrying. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/insurance/ ===================================================================== Home / Insurance old city, philadelphia Therapy in Philadelphia that takes your insurance Turning Leaf Therapy is in-network with Aetna, Blue Cross Blue Shield plans including Highmark, Horizon BCBSNJ, Capital, Anthem, Empire, and the Federal Employee Program, United Healthcare, Optum Behavioral Health, and Pennsylvania VCAP. We are out-of-network with Independence Blue Cross, Cigna, Medicare, and Medicaid, and we provide superbills for out-of-network reimbursement. Most in-network clients pay a copay of $15 to $50 per session after any deductible. Without insurance, sessions are $130 to $200. A coordinator verifies your benefits before your first session, so you know your cost in advance, whether you meet in person in Old City, Philadelphia, or by secure video across Pennsylvania and New Jersey. Which plans we take IN NETWORK OUT OF NETWORK, WITH SUPERBILLS Aetna Independence Blue Cross Highmark Blue Cross Cigna Capital Blue Cross Medicare and Medicaid Anthem Blue Cross Blue Shield Empire Blue Cross Blue Shield BCBS Federal Employee Program Horizon BCBS of New Jersey United Healthcare Optum Pennsylvania VCAP If your plan appears in the right column, we are out of network with it. That does not mean you cannot work with us: we provide a superbill after every session that you can submit to your insurer for out-of-network reimbursement. What you will actually pay With an in-network plan, your cost per session is normally a copay between $15 and $50 once any deductible has been met. Some plans waive the deductible for outpatient behavioral health entirely, which means the copay applies from your very first appointment. Others apply the plan’s negotiated rate until the deductible is satisfied, and that negotiated rate is typically lower than our self-pay fee. Your deductible is the amount you pay out of pocket each plan year before your insurer begins sharing costs. A copay is the flat per-session amount after that; some plans use coinsurance instead, a percentage of the session rate. These are the three numbers that determine your cost, and they are specific to your plan rather than to us. Without insurance, sessions are $130 to $200 depending on the clinician’s license level and experience, and you can pay with an HSA or FSA card. Every session is 53 minutes and most clients meet weekly. Full details are on the rates page . Our cost guide walks through copays, deductibles, and superbills in plain English. What to ask your plan You are welcome to let us do this for you. If you would rather call yourself, these five questions get you everything that matters: Do I have an outpatient mental health benefit, and is a referral required? What is my copay or coinsurance for an outpatient therapy session? What is my deductible, and how much of it have I met this year? Is telehealth covered at the same rate as an in-person visit? If I use an out-of-network provider, what is my out-of-network deductible and reimbursement rate? What we treat, covered Each of the concerns below is covered as a standard outpatient behavioral health benefit under the plans we participate in. Anxiety , including panic, social anxiety, and chronic worry. Depression , low mood, and burnout. Trauma and PTSD , including complex and developmental trauma. Grief and loss , including traumatic and perinatal loss. Life transitions , from divorce to parenthood to retirement. Relationships and the patterns you carry into them. If we are out of network with your plan We are out of network with Independence Blue Cross, Cigna, Medicare, and Medicaid. In that case you pay the session fee of $130 to $200 at the time of service, and we give you a superbill: an itemized receipt with your diagnosis, the service provided, and the CPT codes your insurer needs. You submit it to your plan, usually through a member portal, and any reimbursement comes back to you directly. Whether your plan reimburses, and how much, depends entirely on your out-of-network benefits. We will not quote you a percentage, because we cannot know it. Ask your insurer whether you have out-of-network outpatient mental health coverage and what your out-of-network deductible is, and you will have your answer in one call. How in-network coverage works If we are in-network with your plan, you pay a copay, typically $15 to $50 per session after your deductible is met, and we bill your insurer for the rest. Sessions are 53 minutes, in person in Old City or by secure video across Pennsylvania. Telehealth is covered at parity with in-person care by the plans we accept. In-network Aetna All plans Highmark BCBS Blue Cross, Western & Central PA Blue Cross Blue Shield The BCBS family, explained United Healthcare All plans Optum Behavioral Health & EAP Horizon BCBSNJ Blue Cross, New Jersey Capital Blue Cross Blue Cross, Central PA Anthem BCBS Via BlueCard Empire BCBS Via BlueCard FEP BCBS Federal Employee Program PA VCAP Victims Compensation Not in-network Independence Blue Cross Out-of-network guide Cigna Out-of-network guide Medicare & Medicaid Self-pay guidance Out-of-network, explained plainly A superbill is a detailed receipt that includes your diagnosis, the service provided, and CPT codes, which you submit to your insurer for out-of-network reimbursement. If your plan has out-of-network benefits, most PPO plans reimburse 50 to 80 percent of the allowed amount for each session after you meet your out-of-network deductible. We provide a superbill after every session on request, and reimbursement typically arrives within two to four weeks of submission. Verify your benefits in one call Call the member services number on your insurance card and ask five questions: Do I have outpatient mental health benefits? What is my copay or coinsurance? What is my deductible, and how much of it have I met? Is there a session limit? Do I need a referral? In-network Out-of-network Your cost per session $15 to $50 copay after deductible $130 to $200 up front Paperwork None; we bill your insurer Superbill provided after every session on request; you submit it Reimbursement Not needed 50 to 80 percent of the allowed amount after your out-of-network deductible, typically within two to four weeks For the longer version, including what to ask your insurer and how superbills work, read how to use your insurance for therapy in PA and NJ . Frequently asked questions Do you take Independence Blue Cross? + No. We are out of network with Independence Blue Cross, including Keystone Health Plan East. Sessions are $130 to $200 and we provide a superbill after every session that you can submit for out-of-network reimbursement. Whether your plan reimburses, and at what rate, depends on your out-of-network benefits, which your insurer can confirm in one call. Do you take Medicare or Medicaid? + No. We are out of network with both Medicare and Medicaid, and out-of-network reimbursement generally does not apply to these plans, so care with us would be self-pay at $130 to $200 per session. If that is not workable, tell our intake team and they will point you toward lower-cost options in the region rather than leave you searching alone. How do I know what my copay will be? + Your copay is set by your plan, not by us, and it typically falls between $15 and $50 per session for in-network clients after any deductible. The fastest way to know your exact number is to send the intake form and let a coordinator verify your benefits, which happens before your first appointment. Do you verify my benefits for me? + Yes. Tell us your plan when you reach out and a coordinator confirms your outpatient mental health benefit, your copay or coinsurance, and your deductible status before your first session. You will know your expected per-session cost before you commit to anything. Is telehealth covered the same as in person? + Under the plans we accept, telehealth sessions are covered at parity with in-person visits for Pennsylvania residents, with the same copay. New Jersey clients should confirm telehealth benefits with their plan; Horizon BCBS of New Jersey members are in network with us. What if I want to pay privately instead of using insurance? + That is a legitimate choice, and some people prefer it for privacy since insurance billing requires a diagnosis. Self-pay sessions are $130 to $200 depending on the clinician, payable by credit, debit, HSA, or FSA card. Under the No Surprises Act you are entitled to a Good Faith Estimate of expected charges, which we provide. request an appointment Request your match. Name your plan in the intake and we will confirm your coverage before you schedule. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/insurance/aetna/ ===================================================================== Home / Insurance / Aetna in-network, old city philadelphia Aetna Therapy in Philadelphia Turning Leaf Therapy is in-network with Aetna for individual therapy in Old City Philadelphia and via telehealth across Pennsylvania. Most Aetna members pay a $15 to $50 copay per session after their deductible. Our team of 24 relational, trauma-trained clinicians treats anxiety, depression, trauma, and more. How coverage works with Aetna We accept all Aetna plan types, including employer-sponsored plans, marketplace plans, and student health plans. No referral is required for outpatient therapy. Aetna covers telehealth sessions with our clinicians at parity with in-person care for Pennsylvania residents. What you will typically pay A copay is a flat fee per session, typically $15 to $50 with Aetna, after your deductible is met. Some plans use coinsurance instead, a percentage of the session cost. Your deductible is the amount you pay out of pocket each year before your plan begins paying; many plans waive it for outpatient mental health. One call to Aetna member services settles which applies to you. One thing Aetna members should know Independence Blue Cross is a separate company, not an Aetna product. If your card says Independence Blue Cross or Keystone Health Plan East, see our Independence Blue Cross page for out-of-network guidance. Verify your benefits Call the number on your Aetna card and ask: Do I have outpatient mental health benefits? What is my copay or coinsurance? What is my deductible, and how much is met? Is there a session limit? Do I need a referral? What we treat with Aetna coverage Anxiety Worry that does not switch off, panic, social anxiety, and the perfectionism and people-pleasing that often sit underneath it are all covered under Aetna as outpatient behavioral health. Our anxiety therapy does not stop at coping skills; clinicians work relationally to understand what the alarm is responding to, which is what tends to keep the relief from wearing off. Depression Persistent low mood, loss of interest, burnout, and the flat exhaustion that outlasts a stressful season are covered Aetna behavioral health concerns. In depression therapy here, depression is treated as a signal about your emotional and relational life rather than a checklist of symptoms to suppress, which is why the work goes to the pattern underneath. Trauma and PTSD Single-incident trauma, developmental trauma, and complex PTSD are covered under Aetna as standard outpatient care. Our trauma-informed therapy is phase-based: safety and stabilization first, then processing at a pace you set, with EMDR, parts work, and somatic approaches available inside a relational frame rather than as standalone protocols. Grief and loss Bereavement, traumatic loss, perinatal loss, and the losses no one throws a funeral for are all covered Aetna outpatient concerns. Grief therapy here does not run on a timeline or a stage model; the work is to have the full weight of the loss witnessed by someone who will not rush you through it. Life transitions Career change, divorce, new parenthood, relocation, empty nest, and retirement are covered under Aetna when the adjustment is affecting your functioning. Life transitions therapy treats these moments as revealing rather than causing: transitions expose the patterns you already carry, which makes them unusually workable in therapy. Relationships Repeating relational patterns, difficulty with boundaries, fear of closeness, and the aftermath of betrayal are covered Aetna outpatient behavioral health concerns. Our relationship therapy is individual work: rather than coaching one conversation, it examines the blueprint you bring into every connection and how it can change. three places to start Anxiety Therapy Depression Therapy Trauma Therapy For the longer version, including what to ask your insurer and how superbills work, read using your Aetna benefits for therapy, step by step . Getting started Start the intake (about 5 minutes), get matched personally within 1 to 2 business days, and meet your therapist. Request your match , or call (215) 399-4128 . Frequently asked questions Does Aetna cover therapy in Pennsylvania? + Yes. Turning Leaf Therapy is in-network with Aetna in Pennsylvania. Most Aetna members pay a $15 to $50 copay per session after their deductible. How much is a therapy copay with Aetna? + Typically between $15 and $50 per session after your deductible, depending on your specific plan. Does Aetna cover online therapy? + Yes, Aetna covers telehealth sessions with our clinicians for Pennsylvania residents at parity with in-person sessions. Do I need a referral to see a therapist with Aetna? + No. Outpatient therapy with Aetna does not require a referral. request an appointment Request your match. Mention your Aetna plan in the intake and we will confirm your coverage before you schedule. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/insurance/highmark-blue-cross/ ===================================================================== Home / Insurance / Highmark in-network, old city philadelphia Highmark Blue Cross Blue Shield Therapy in Philadelphia Turning Leaf Therapy is in-network with Highmark Blue Cross Blue Shield for individual therapy in Old City Philadelphia and via telehealth across Pennsylvania. Most Highmark members pay a $15 to $50 copay per session after their deductible. Our team of 24 relational, trauma-trained clinicians treats anxiety, depression, trauma, and more. How coverage works with Highmark We are in-network with Highmark Blue Cross Blue Shield, the Blue plan serving Western and Central Pennsylvania. If you are a Highmark member seeing us in Philadelphia, the BlueCard program applies: you use your Highmark benefits with our practice just as you would at home. No referral is required for outpatient therapy, and telehealth is covered at parity for Pennsylvania residents. What you will typically pay A copay is a flat fee per session, typically $15 to $50 with Highmark, after your deductible is met. Some plans use coinsurance instead, a percentage of the session cost. Your deductible is the amount you pay out of pocket each year before your plan begins paying; many plans waive it for outpatient mental health. One call to Highmark member services settles which applies to you. One thing Highmark members should know Highmark is a separate company from Independence Blue Cross, even though both carry the Blue Cross name. If your card says Independence Blue Cross or Keystone Health Plan East, see our Independence Blue Cross page for out-of-network guidance. Verify your benefits Call the number on your Highmark card and ask: Do I have outpatient mental health benefits? What is my copay or coinsurance? What is my deductible, and how much is met? Is there a session limit? Do I need a referral? What we treat with Highmark coverage Anxiety Under Highmark Blue Cross, anxiety is a covered outpatient behavioral health diagnosis, whether it shows up as panic, social anxiety, chronic worry, or physical symptoms with no medical cause. Anxiety therapy at our practice treats those symptoms as adaptive rather than defective and works on the relational history that trained them. Depression Major depression and long-running low mood are covered Highmark Blue Cross conditions. Our depression therapy is not a course of thought-correction; it examines what the depression is protecting you from feeling and what in your relationships keeps the pattern in place, which is where lasting change tends to come from. Trauma and PTSD Trauma treatment is covered under Highmark Blue Cross as outpatient behavioral health, from a single overwhelming event to years of an unsafe childhood. Our trauma-informed approach asks what happened to you rather than what is wrong with you, and paces processing so treatment does not become another overwhelming experience. Grief and loss Loss of any kind, including the deaths that do not get bereavement leave, is covered under Highmark Blue Cross. Grief therapy here is not about reaching acceptance on schedule; it is about being accompanied while you carry something that has changed the shape of your life. Life transitions Transition-related distress is a covered Highmark Blue Cross outpatient concern, and it does not require a crisis to qualify. Life transitions therapy attends to the internal work that lags behind the external change, which is usually why a wanted change can still feel like grief. Relationships Relational difficulty, including the patterns that follow you from one relationship to the next, is covered under Highmark Blue Cross. Our relationship therapy is individual and attachment-focused, aimed at the template rather than the last argument, and it often shifts a relationship without the other person ever entering the room. three places to start Anxiety Therapy Depression Therapy Trauma Therapy For the longer version, including what to ask your insurer and how superbills work, read our walkthrough of using insurance for therapy in PA and NJ . Getting started Start the intake (about 5 minutes), get matched personally within 1 to 2 business days, and meet your therapist. Request your match , or call (215) 399-4128 . Frequently asked questions Does Highmark cover therapy in Pennsylvania? + Yes. Turning Leaf Therapy is in-network with Highmark Blue Cross Blue Shield in Pennsylvania. Most Highmark members pay a $15 to $50 copay per session after their deductible. How much is a therapy copay with Highmark? + Typically between $15 and $50 per session after your deductible, depending on your specific plan. Does Highmark cover online therapy? + Yes, Highmark covers telehealth sessions with our clinicians for Pennsylvania residents at parity with in-person sessions. Do I need a referral to see a therapist with Highmark? + No. Outpatient therapy with Highmark does not require a referral. request an appointment Request your match. Mention your Highmark plan in the intake and we will confirm your coverage before you schedule. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/insurance/blue-cross-blue-shield/ ===================================================================== Home / Insurance / BCBS in-network, old city philadelphia Blue Cross Blue Shield Therapy in Philadelphia Turning Leaf Therapy is in-network with the Blue Cross Blue Shield family for individual therapy in Old City Philadelphia and via telehealth across Pennsylvania, including Highmark, Horizon BCBSNJ, Capital, Anthem, Empire, and the Federal Employee Program. Most BCBS members pay a $15 to $50 copay per session after their deductible. The one exception is Independence Blue Cross, explained below. How coverage works with BCBS We accept Blue Cross Blue Shield plans across the family: Highmark , Horizon BCBSNJ , Capital Blue Cross , Anthem , Empire , the Federal Employee Program , and standard BCBS plans. Members from other states are seen through the BlueCard program. No referral is required for outpatient therapy, and telehealth is covered at parity for Pennsylvania residents. What you will typically pay A copay is a flat fee per session, typically $15 to $50 with BCBS, after your deductible is met. Some plans use coinsurance instead, a percentage of the session cost. Your deductible is the amount you pay out of pocket each year before your plan begins paying; many plans waive it for outpatient mental health. One call to BCBS member services settles which applies to you. The one exception: Independence Blue Cross Independence Blue Cross (IBX), Philadelphia's local Blue plan, is the exception: we are out-of-network with IBX and its Keystone Health Plan East product. If your card says Independence Blue Cross, our Independence Blue Cross guide explains how superbill reimbursement works and what your options are. Verify your benefits Call the number on your BCBS card and ask: Do I have outpatient mental health benefits? What is my copay or coinsurance? What is my deductible, and how much is met? Is there a session limit? Do I need a referral? What we treat with BCBS coverage Anxiety Blue Cross Blue Shield covers anxiety treatment as ordinary outpatient behavioral health, including generalized worry, panic attacks, social anxiety, and health anxiety. In anxiety therapy at Turning Leaf, clinicians treat the symptom as information: what your nervous system learned to expect, and why it still braces. That is slower than a worksheet and considerably more durable. Depression Depression, dysthymia, and the depleted numbness that follows long stretches of stress are covered under Blue Cross Blue Shield. Depression therapy here is depth-oriented and relational, which means the sessions attend to the history and relationships that keep generating the low mood, not only to the mood itself. Trauma and PTSD PTSD and complex PTSD are covered Blue Cross Blue Shield outpatient conditions, including trauma that began in childhood. Our trauma-informed care begins with stabilization rather than with the story, and clinicians integrate EMDR, IFS, and body-based work where they fit the person in front of them. Grief and loss Grief after a death, a stillbirth, a suicide, or an estrangement is covered under Blue Cross Blue Shield as outpatient behavioral health. Grief work here holds two layers at once: the loss in front of you, and the older losses it tends to reopen, which is often why a grief response feels larger than the event. Life transitions Adjustment difficulty around a move, a divorce, a diagnosis, a new baby, or a retirement is a covered Blue Cross Blue Shield concern. Life transitions therapy gives the in-between period somewhere to go, so the disorientation becomes something you can think about rather than something you have to outrun. Relationships Attachment patterns, chronic conflict, people-pleasing, and the difficulty of trusting after betrayal are covered under Blue Cross Blue Shield. Our individual relationship therapy works on your side of the dynamic, which is the part you can actually change, and it does not require a partner to participate. three places to start Anxiety Therapy Depression Therapy Trauma Therapy For the longer version, including what to ask your insurer and how superbills work, read how deductibles, copays, and superbills actually work . Getting started Start the intake (about 5 minutes), get matched personally within 1 to 2 business days, and meet your therapist. Request your match , or call (215) 399-4128 . Frequently asked questions Which Blue Cross Blue Shield plans does Turning Leaf accept? + We are in-network with Highmark BCBS, Horizon BCBSNJ, Capital BCBS, Anthem BCBS, Empire BCBS, the BCBS Federal Employee Program, and standard BCBS plans. We are out-of-network with Independence Blue Cross and Keystone Health Plan East. How much is a therapy copay with BCBS? + Typically between $15 and $50 per session after your deductible, depending on your specific plan. Does BCBS cover online therapy? + Yes, the BCBS plans we accept cover telehealth sessions with our clinicians for Pennsylvania residents at parity with in-person sessions. My BCBS plan is from another state. Can I still use it? + Usually yes. Out-of-state Blue plans are honored through the BlueCard program, which lets you use your home-state benefits with our Philadelphia practice. Reach out and we can help you verify. request an appointment Request your match. Mention your BCBS plan in the intake and we will confirm your coverage before you schedule. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/insurance/united-healthcare/ ===================================================================== Home / Insurance / UHC in-network, old city philadelphia United Healthcare Therapy in Philadelphia Turning Leaf Therapy is in-network with United Healthcare for individual therapy in Old City Philadelphia and via telehealth across Pennsylvania. Most UHC members pay a $15 to $50 copay per session after their deductible. Our team of 24 relational, trauma-trained clinicians treats anxiety, depression, trauma, and more. How coverage works with UHC We accept all United Healthcare plans for individual therapy, including UHC through employer-sponsored plans. UHC behavioral health benefits may be administered through Optum; either way, you are covered here. No referral is required for outpatient therapy, and telehealth is covered at parity for Pennsylvania residents. What you will typically pay A copay is a flat fee per session, typically $15 to $50 with UHC, after your deductible is met. Some plans use coinsurance instead, a percentage of the session cost. Your deductible is the amount you pay out of pocket each year before your plan begins paying; many plans waive it for outpatient mental health. One call to UHC member services settles which applies to you. United Healthcare and Optum If your card mentions Optum, your behavioral health benefits are administered by Optum Behavioral Health , which we also accept, including EAP referrals. The coverage works the same way from your side: a copay or coinsurance after any deductible. Verify your benefits Call the number on your UHC card and ask: Do I have outpatient mental health benefits? What is my copay or coinsurance? What is my deductible, and how much is met? Is there a session limit? Do I need a referral? What we treat with UHC coverage Anxiety Panic, social anxiety, chronic worry, and the perfectionism that often accompanies them are covered under United Healthcare as outpatient behavioral health. Anxiety therapy here goes past symptom management to the relational history that trained the alarm, which is generally why the relief holds rather than fading after a few weeks. Depression Low mood, loss of interest, and long-running depletion are covered United Healthcare conditions. Our depression therapy treats depression as a signal rather than a defect, attending to what it is protecting you from feeling and to the relationships that keep the pattern running. Trauma and PTSD United Healthcare covers PTSD and complex PTSD as outpatient behavioral health. Our trauma-informed therapy is phase-based, beginning with safety rather than the story, and clinicians draw on EMDR, IFS, and somatic work inside a relational frame instead of running a protocol at you. Grief and loss Bereavement, traumatic loss, perinatal loss, and unrecognized grief are covered under United Healthcare. Grief therapy here follows no stage model and imposes no timeline; the work is to have the loss fully witnessed rather than tidied up. Life transitions Divorce, career change, new parenthood, relocation, and retirement are covered United Healthcare concerns when the adjustment is affecting daily life. Life transitions therapy treats the change as exposing the patterns you already carry, which makes this an unusually productive moment for therapy. Relationships Recurring relational patterns, boundary difficulty, and rebuilding trust after betrayal are covered under United Healthcare. Our relationship therapy is individual rather than couples work, aimed at the blueprint you bring into every connection. three places to start Anxiety Therapy Depression Therapy Trauma Therapy For the longer version, including what to ask your insurer and how superbills work, read our plain-English guide to using insurance for therapy . Getting started Start the intake (about 5 minutes), get matched personally within 1 to 2 business days, and meet your therapist. Request your match , or call (215) 399-4128 . Frequently asked questions Does UHC cover therapy in Pennsylvania? + Yes. Turning Leaf Therapy is in-network with United Healthcare in Pennsylvania. Most UHC members pay a $15 to $50 copay per session after their deductible. How much is a therapy copay with UHC? + Typically between $15 and $50 per session after your deductible, depending on your specific plan. Does UHC cover online therapy? + Yes, UHC covers telehealth sessions with our clinicians for Pennsylvania residents at parity with in-person sessions. Do I need a referral to see a therapist with UHC? + No. Outpatient therapy with UHC does not require a referral. request an appointment Request your match. Mention your UHC plan in the intake and we will confirm your coverage before you schedule. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/insurance/optum/ ===================================================================== Home / Insurance / Optum in-network, old city philadelphia Optum Therapy in Philadelphia Turning Leaf Therapy is in-network with Optum for individual therapy in Old City Philadelphia and via telehealth across Pennsylvania. Most Optum members pay a $15 to $50 copay per session after their deductible. Our team of 24 relational, trauma-trained clinicians treats anxiety, depression, trauma, and more. How coverage works with Optum We accept Optum Behavioral Health plans, including behavioral health benefits Optum administers for United Healthcare members, and Optum EAP referrals. No referral is required for standard outpatient therapy, and telehealth is covered at parity for Pennsylvania residents. What you will typically pay A copay is a flat fee per session, typically $15 to $50 with Optum, after your deductible is met. Some plans use coinsurance instead, a percentage of the session cost. Your deductible is the amount you pay out of pocket each year before your plan begins paying; many plans waive it for outpatient mental health. One call to Optum member services settles which applies to you. How Optum EAP referrals work If your employer offers an Optum Employee Assistance Program, request an EAP authorization and session allotment from Optum, then share the authorization code during intake. Your authorized sessions may be fully covered, with no copay, until the allotment is used, and we will talk through options with you before it runs out. Verify your benefits Call the number on your Optum card and ask: Do I have outpatient mental health benefits? What is my copay or coinsurance? What is my deductible, and how much is met? Is there a session limit? Do I need a referral? What we treat with Optum coverage Anxiety Under Optum, anxiety treatment is standard covered outpatient care, whether it presents as panic, avoidance, health worry, or physical symptoms with no medical explanation. In anxiety therapy our clinicians read the symptom as adaptive and work on what it has been protecting. Depression Depression and persistent low mood are covered Optum behavioral health conditions. Depression therapy here is relational and depth-oriented: the sessions go after the emotional and relational sources of the mood rather than only the mood itself. Trauma and PTSD Trauma and complex PTSD, including trauma that began in childhood, are covered under Optum. Our trauma-informed care paces processing carefully so treatment does not become another overwhelming experience, with EMDR and parts work available where they fit. Grief and loss Grief is a covered Optum outpatient concern, including losses that receive no social acknowledgment. Grief therapy attends to both the present loss and the older ones it reopens, which is often why grief feels bigger than the event that triggered it. Life transitions Transition-related distress is covered under Optum and does not require a crisis to qualify. Life transitions therapy gives the in-between somewhere to go, so a wanted change that still feels like loss becomes thinkable rather than confusing. Relationships Relational patterns, fear of closeness, and chronic people-pleasing are covered Optum concerns. Our individual relationship therapy works on your side of the dynamic, which is the part available to change, without requiring a partner in the room. three places to start Anxiety Therapy Depression Therapy Trauma Therapy For the longer version, including what to ask your insurer and how superbills work, read using your behavioral health benefits, explained step by step . Getting started Start the intake (about 5 minutes), get matched personally within 1 to 2 business days, and meet your therapist. Request your match , or call (215) 399-4128 . Frequently asked questions Does Optum cover therapy in Pennsylvania? + Yes. Turning Leaf Therapy is in-network with Optum Behavioral Health in Pennsylvania. Most Optum members pay a $15 to $50 copay per session after their deductible. Are Optum EAP sessions fully covered? + Under an Optum EAP referral, your authorized session allotment may be fully covered, with no copay. Bring your authorization code to intake and we will confirm the details. Does Optum cover online therapy? + Yes, Optum covers telehealth sessions with our clinicians for Pennsylvania residents at parity with in-person sessions. Do I need a referral to see a therapist with Optum? + No referral is needed for standard outpatient therapy. EAP sessions use an authorization code from Optum instead. request an appointment Request your match. Mention your Optum plan in the intake and we will confirm your coverage before you schedule. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/insurance/horizon-bcbs-nj/ ===================================================================== Home / Insurance / Horizon BCBSNJ in-network, old city philadelphia Horizon Blue Cross Blue Shield of New Jersey Therapy in Philadelphia Turning Leaf Therapy is in-network with Horizon Blue Cross Blue Shield of New Jersey. NJ members meet our eight NJ-licensed clinicians by secure video, or come to Old City Philadelphia in person. Most Horizon members pay a $15 to $50 copay per session after their deductible. How coverage works with Horizon BCBSNJ We are in-network with Horizon BCBSNJ for New Jersey members. You can see us by secure video with our NJ-licensed clinicians from anywhere in New Jersey, or in person at 123 Chestnut Street in Old City, a short PATCO ride from South Jersey. Most Horizon plans cover telehealth; confirm your plan\u2019s telehealth benefit with member services. What you will typically pay A copay is a flat fee per session, typically $15 to $50 with Horizon BCBSNJ, after your deductible is met. Some plans use coinsurance instead, a percentage of the session cost. Your deductible is the amount you pay out of pocket each year before your plan begins paying; many plans waive it for outpatient mental health. One call to Horizon BCBSNJ member services settles which applies to you. Our New Jersey clinicians Eight clinicians see New Jersey residents by video: Anne Miller-Uueda , Tara Bailey , Tori Mittelman , Aldis Gamble , Emily Sullivan , Leah Fogel , Christine Meusz , and Isabelle Dewyngaert . Verify your benefits Call the number on your Horizon BCBSNJ card and ask: Do I have outpatient mental health benefits? What is my copay or coinsurance? What is my deductible, and how much is met? Is there a session limit? Do I need a referral? What we treat with Horizon BCBSNJ coverage Anxiety Under Horizon Blue Cross Blue Shield of New Jersey, anxiety treatment is standard covered outpatient care, whether it presents as panic, avoidance, health worry, or physical symptoms with no medical explanation. In anxiety therapy our clinicians read the symptom as adaptive and work on what it has been protecting. Depression Depression and persistent low mood are covered Horizon Blue Cross Blue Shield of New Jersey behavioral health conditions. Depression therapy here is relational and depth-oriented: the sessions go after the emotional and relational sources of the mood rather than only the mood itself. Trauma and PTSD Trauma and complex PTSD, including trauma that began in childhood, are covered under Horizon Blue Cross Blue Shield of New Jersey. Our trauma-informed care paces processing carefully so treatment does not become another overwhelming experience, with EMDR and parts work available where they fit. Grief and loss Grief is a covered Horizon Blue Cross Blue Shield of New Jersey outpatient concern, including losses that receive no social acknowledgment. Grief therapy attends to both the present loss and the older ones it reopens, which is often why grief feels bigger than the event that triggered it. Life transitions Transition-related distress is covered under Horizon Blue Cross Blue Shield of New Jersey and does not require a crisis to qualify. Life transitions therapy gives the in-between somewhere to go, so a wanted change that still feels like loss becomes thinkable rather than confusing. Relationships Relational patterns, fear of closeness, and chronic people-pleasing are covered Horizon Blue Cross Blue Shield of New Jersey concerns. Our individual relationship therapy works on your side of the dynamic, which is the part available to change, without requiring a partner in the room. three places to start Anxiety Therapy Depression Therapy Trauma Therapy For the longer version, including what to ask your insurer and how superbills work, read using your insurance for therapy in New Jersey and Pennsylvania . Getting started Start the intake (about 5 minutes), get matched personally within 1 to 2 business days, and meet your therapist. Request your match , or call (215) 399-4128 . Frequently asked questions Does Horizon BCBSNJ cover therapy at Turning Leaf? + Yes. We are in-network with Horizon Blue Cross Blue Shield of New Jersey. Most Horizon members pay a $15 to $50 copay per session after their deductible. Can I do therapy from New Jersey? + Yes. Eight of our clinicians are licensed in New Jersey and see NJ residents by secure video. You are also welcome in person in Old City. Does Horizon cover online therapy? + Most Horizon plans cover telehealth. Confirm your telehealth benefit with the member services number on your card, and we can help you verify. Do I need a referral with Horizon BCBSNJ? + No. Outpatient therapy with Horizon BCBSNJ does not require a referral. request an appointment Request your match. Mention your Horizon BCBSNJ plan in the intake and we will confirm your coverage before you schedule. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/insurance/capital-blue-cross/ ===================================================================== Home / Insurance / Capital Blue Cross in-network, old city philadelphia Capital Blue Cross Therapy in Philadelphia Turning Leaf Therapy is in-network with Capital Blue Cross for individual therapy in Old City Philadelphia and via telehealth across Pennsylvania. Most Capital Blue Cross members pay a $15 to $50 copay per session after their deductible. Our team of 24 relational, trauma-trained clinicians treats anxiety, depression, trauma, and more. How coverage works with Capital Blue Cross We are in-network with Capital Blue Cross, the Blue plan serving Central Pennsylvania. Members seeing us in Philadelphia are covered through the BlueCard program, using your Capital benefits with our practice just as you would at home. No referral is required for outpatient therapy, and telehealth is covered at parity for Pennsylvania residents. What you will typically pay A copay is a flat fee per session, typically $15 to $50 with Capital Blue Cross, after your deductible is met. Some plans use coinsurance instead, a percentage of the session cost. Your deductible is the amount you pay out of pocket each year before your plan begins paying; many plans waive it for outpatient mental health. One call to Capital Blue Cross member services settles which applies to you. Verify your benefits Call the number on your Capital Blue Cross card and ask: Do I have outpatient mental health benefits? What is my copay or coinsurance? What is my deductible, and how much is met? Is there a session limit? Do I need a referral? What we treat with Capital Blue Cross coverage Anxiety Worry that does not switch off, panic, social anxiety, and the perfectionism and people-pleasing that often sit underneath it are all covered under Capital Blue Cross as outpatient behavioral health. Our anxiety therapy does not stop at coping skills; clinicians work relationally to understand what the alarm is responding to, which is what tends to keep the relief from wearing off. Depression Persistent low mood, loss of interest, burnout, and the flat exhaustion that outlasts a stressful season are covered Capital Blue Cross behavioral health concerns. In depression therapy here, depression is treated as a signal about your emotional and relational life rather than a checklist of symptoms to suppress, which is why the work goes to the pattern underneath. Trauma and PTSD Single-incident trauma, developmental trauma, and complex PTSD are covered under Capital Blue Cross as standard outpatient care. Our trauma-informed therapy is phase-based: safety and stabilization first, then processing at a pace you set, with EMDR, parts work, and somatic approaches available inside a relational frame rather than as standalone protocols. Grief and loss Bereavement, traumatic loss, perinatal loss, and the losses no one throws a funeral for are all covered Capital Blue Cross outpatient concerns. Grief therapy here does not run on a timeline or a stage model; the work is to have the full weight of the loss witnessed by someone who will not rush you through it. Life transitions Career change, divorce, new parenthood, relocation, empty nest, and retirement are covered under Capital Blue Cross when the adjustment is affecting your functioning. Life transitions therapy treats these moments as revealing rather than causing: transitions expose the patterns you already carry, which makes them unusually workable in therapy. Relationships Repeating relational patterns, difficulty with boundaries, fear of closeness, and the aftermath of betrayal are covered Capital Blue Cross outpatient behavioral health concerns. Our relationship therapy is individual work: rather than coaching one conversation, it examines the blueprint you bring into every connection and how it can change. three places to start Anxiety Therapy Depression Therapy Trauma Therapy For the longer version, including what to ask your insurer and how superbills work, read our guide to therapy deductibles, copays, and superbills . Getting started Start the intake (about 5 minutes), get matched personally within 1 to 2 business days, and meet your therapist. Request your match , or call (215) 399-4128 . Frequently asked questions Does Capital Blue Cross cover therapy in Pennsylvania? + Yes. Turning Leaf Therapy is in-network with Capital Blue Cross in Pennsylvania. Most Capital Blue Cross members pay a $15 to $50 copay per session after their deductible. How much is a therapy copay with Capital Blue Cross? + Typically between $15 and $50 per session after your deductible, depending on your specific plan. Does Capital Blue Cross cover online therapy? + Yes, Capital Blue Cross covers telehealth sessions with our clinicians for Pennsylvania residents at parity with in-person sessions. Do I need a referral to see a therapist with Capital Blue Cross? + No. Outpatient therapy with Capital Blue Cross does not require a referral. request an appointment Request your match. Mention your Capital Blue Cross plan in the intake and we will confirm your coverage before you schedule. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/insurance/anthem-bcbs/ ===================================================================== Home / Insurance / Anthem in-network, old city philadelphia Anthem Blue Cross Blue Shield Therapy in Philadelphia Turning Leaf Therapy is in-network with Anthem Blue Cross Blue Shield for individual therapy in Old City Philadelphia and via telehealth across Pennsylvania. Most Anthem members pay a $15 to $50 copay per session after their deductible. Our team of 24 relational, trauma-trained clinicians treats anxiety, depression, trauma, and more. How coverage works with Anthem We are in-network with Anthem Blue Cross Blue Shield. Anthem members from other states are seen through the BlueCard program, which lets you use your home-state Blue benefits with our Philadelphia practice. No referral is required for outpatient therapy, and telehealth is covered at parity for Pennsylvania residents. What you will typically pay A copay is a flat fee per session, typically $15 to $50 with Anthem, after your deductible is met. Some plans use coinsurance instead, a percentage of the session cost. Your deductible is the amount you pay out of pocket each year before your plan begins paying; many plans waive it for outpatient mental health. One call to Anthem member services settles which applies to you. Verify your benefits Call the number on your Anthem card and ask: Do I have outpatient mental health benefits? What is my copay or coinsurance? What is my deductible, and how much is met? Is there a session limit? Do I need a referral? What we treat with Anthem coverage Anxiety Anthem Blue Cross Blue Shield covers anxiety treatment as ordinary outpatient behavioral health, including generalized worry, panic attacks, social anxiety, and health anxiety. In anxiety therapy at Turning Leaf, clinicians treat the symptom as information: what your nervous system learned to expect, and why it still braces. That is slower than a worksheet and considerably more durable. Depression Depression, dysthymia, and the depleted numbness that follows long stretches of stress are covered under Anthem Blue Cross Blue Shield. Depression therapy here is depth-oriented and relational, which means the sessions attend to the history and relationships that keep generating the low mood, not only to the mood itself. Trauma and PTSD PTSD and complex PTSD are covered Anthem Blue Cross Blue Shield outpatient conditions, including trauma that began in childhood. Our trauma-informed care begins with stabilization rather than with the story, and clinicians integrate EMDR, IFS, and body-based work where they fit the person in front of them. Grief and loss Grief after a death, a stillbirth, a suicide, or an estrangement is covered under Anthem Blue Cross Blue Shield as outpatient behavioral health. Grief work here holds two layers at once: the loss in front of you, and the older losses it tends to reopen, which is often why a grief response feels larger than the event. Life transitions Adjustment difficulty around a move, a divorce, a diagnosis, a new baby, or a retirement is a covered Anthem Blue Cross Blue Shield concern. Life transitions therapy gives the in-between period somewhere to go, so the disorientation becomes something you can think about rather than something you have to outrun. Relationships Attachment patterns, chronic conflict, people-pleasing, and the difficulty of trusting after betrayal are covered under Anthem Blue Cross Blue Shield. Our individual relationship therapy works on your side of the dynamic, which is the part you can actually change, and it does not require a partner to participate. three places to start Anxiety Therapy Depression Therapy Trauma Therapy For the longer version, including what to ask your insurer and how superbills work, read how to put your insurance to work for therapy in PA and NJ . Getting started Start the intake (about 5 minutes), get matched personally within 1 to 2 business days, and meet your therapist. Request your match , or call (215) 399-4128 . Frequently asked questions Does Anthem cover therapy in Pennsylvania? + Yes. Turning Leaf Therapy is in-network with Anthem Blue Cross Blue Shield in Pennsylvania. Most Anthem members pay a $15 to $50 copay per session after their deductible. How much is a therapy copay with Anthem? + Typically between $15 and $50 per session after your deductible, depending on your specific plan. Does Anthem cover online therapy? + Yes, Anthem covers telehealth sessions with our clinicians for Pennsylvania residents at parity with in-person sessions. Do I need a referral to see a therapist with Anthem? + No. Outpatient therapy with Anthem does not require a referral. request an appointment Request your match. Mention your Anthem plan in the intake and we will confirm your coverage before you schedule. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/insurance/empire-bcbs/ ===================================================================== Home / Insurance / Empire in-network, old city philadelphia Empire Blue Cross Blue Shield Therapy in Philadelphia Turning Leaf Therapy is in-network with Empire Blue Cross Blue Shield for individual therapy in Old City Philadelphia and via telehealth across Pennsylvania. Most Empire members pay a $15 to $50 copay per session after their deductible. Our team of 24 relational, trauma-trained clinicians treats anxiety, depression, trauma, and more. How coverage works with Empire We are in-network with Empire Blue Cross Blue Shield, the New York Blue plan. Empire members in Philadelphia, whether you have relocated or split time between the two cities, are covered through the BlueCard program. No referral is required for outpatient therapy, and telehealth is covered at parity for Pennsylvania residents. What you will typically pay A copay is a flat fee per session, typically $15 to $50 with Empire, after your deductible is met. Some plans use coinsurance instead, a percentage of the session cost. Your deductible is the amount you pay out of pocket each year before your plan begins paying; many plans waive it for outpatient mental health. One call to Empire member services settles which applies to you. Verify your benefits Call the number on your Empire card and ask: Do I have outpatient mental health benefits? What is my copay or coinsurance? What is my deductible, and how much is met? Is there a session limit? Do I need a referral? What we treat with Empire coverage Anxiety Under Empire Blue Cross Blue Shield, anxiety is a covered outpatient behavioral health diagnosis, whether it shows up as panic, social anxiety, chronic worry, or physical symptoms with no medical cause. Anxiety therapy at our practice treats those symptoms as adaptive rather than defective and works on the relational history that trained them. Depression Major depression and long-running low mood are covered Empire Blue Cross Blue Shield conditions. Our depression therapy is not a course of thought-correction; it examines what the depression is protecting you from feeling and what in your relationships keeps the pattern in place, which is where lasting change tends to come from. Trauma and PTSD Trauma treatment is covered under Empire Blue Cross Blue Shield as outpatient behavioral health, from a single overwhelming event to years of an unsafe childhood. Our trauma-informed approach asks what happened to you rather than what is wrong with you, and paces processing so treatment does not become another overwhelming experience. Grief and loss Loss of any kind, including the deaths that do not get bereavement leave, is covered under Empire Blue Cross Blue Shield. Grief therapy here is not about reaching acceptance on schedule; it is about being accompanied while you carry something that has changed the shape of your life. Life transitions Transition-related distress is a covered Empire Blue Cross Blue Shield outpatient concern, and it does not require a crisis to qualify. Life transitions therapy attends to the internal work that lags behind the external change, which is usually why a wanted change can still feel like grief. Relationships Relational difficulty, including the patterns that follow you from one relationship to the next, is covered under Empire Blue Cross Blue Shield. Our relationship therapy is individual and attachment-focused, aimed at the template rather than the last argument, and it often shifts a relationship without the other person ever entering the room. three places to start Anxiety Therapy Depression Therapy Trauma Therapy For the longer version, including what to ask your insurer and how superbills work, read a step-by-step guide to using insurance for therapy . Getting started Start the intake (about 5 minutes), get matched personally within 1 to 2 business days, and meet your therapist. Request your match , or call (215) 399-4128 . Frequently asked questions Does Empire cover therapy in Pennsylvania? + Yes. Turning Leaf Therapy is in-network with Empire Blue Cross Blue Shield in Pennsylvania. Most Empire members pay a $15 to $50 copay per session after their deductible. How much is a therapy copay with Empire? + Typically between $15 and $50 per session after your deductible, depending on your specific plan. Does Empire cover online therapy? + Yes, Empire covers telehealth sessions with our clinicians for Pennsylvania residents at parity with in-person sessions. Do I need a referral to see a therapist with Empire? + No. Outpatient therapy with Empire does not require a referral. request an appointment Request your match. Mention your Empire plan in the intake and we will confirm your coverage before you schedule. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/insurance/fep-bcbs/ ===================================================================== Home / Insurance / FEP in-network, old city philadelphia Blue Cross Blue Shield Federal Employee Program Therapy in Philadelphia Turning Leaf Therapy is in-network with Blue Cross Blue Shield Federal Employee Program for individual therapy in Old City Philadelphia and via telehealth across Pennsylvania. Most FEP members pay a $15 to $50 copay per session after their deductible. Our team of 24 relational, trauma-trained clinicians treats anxiety, depression, trauma, and more. How coverage works with FEP We are in-network with the Blue Cross Blue Shield Federal Employee Program, serving federal employees and their families on both FEP Standard and FEP Basic. No referral is required for outpatient therapy, and telehealth is covered at parity for Pennsylvania residents. What you will typically pay A copay is a flat fee per session, typically $15 to $50 with FEP, after your deductible is met. Some plans use coinsurance instead, a percentage of the session cost. Your deductible is the amount you pay out of pocket each year before your plan begins paying; many plans waive it for outpatient mental health. One call to FEP member services settles which applies to you. Verify your benefits Call the number on your FEP card and ask: Do I have outpatient mental health benefits? What is my copay or coinsurance? What is my deductible, and how much is met? Is there a session limit? Do I need a referral? What we treat with FEP coverage Anxiety Panic, social anxiety, chronic worry, and the perfectionism that often accompanies them are covered under the Federal Employee Program as outpatient behavioral health. Anxiety therapy here goes past symptom management to the relational history that trained the alarm, which is generally why the relief holds rather than fading after a few weeks. Depression Low mood, loss of interest, and long-running depletion are covered the Federal Employee Program conditions. Our depression therapy treats depression as a signal rather than a defect, attending to what it is protecting you from feeling and to the relationships that keep the pattern running. Trauma and PTSD the Federal Employee Program covers PTSD and complex PTSD as outpatient behavioral health. Our trauma-informed therapy is phase-based, beginning with safety rather than the story, and clinicians draw on EMDR, IFS, and somatic work inside a relational frame instead of running a protocol at you. Grief and loss Bereavement, traumatic loss, perinatal loss, and unrecognized grief are covered under the Federal Employee Program. Grief therapy here follows no stage model and imposes no timeline; the work is to have the loss fully witnessed rather than tidied up. Life transitions Divorce, career change, new parenthood, relocation, and retirement are covered the Federal Employee Program concerns when the adjustment is affecting daily life. Life transitions therapy treats the change as exposing the patterns you already carry, which makes this an unusually productive moment for therapy. Relationships Recurring relational patterns, boundary difficulty, and rebuilding trust after betrayal are covered under the Federal Employee Program. Our relationship therapy is individual rather than couples work, aimed at the blueprint you bring into every connection. three places to start Anxiety Therapy Depression Therapy Trauma Therapy For the longer version, including what to ask your insurer and how superbills work, read how federal employees can use their benefits for therapy . Getting started Start the intake (about 5 minutes), get matched personally within 1 to 2 business days, and meet your therapist. Request your match , or call (215) 399-4128 . Frequently asked questions Does FEP cover therapy in Pennsylvania? + Yes. Turning Leaf Therapy is in-network with Blue Cross Blue Shield Federal Employee Program in Pennsylvania. Most FEP members pay a $15 to $50 copay per session after their deductible. How much is a therapy copay with FEP? + Typically between $15 and $50 per session after your deductible, depending on your specific plan. Does FEP cover online therapy? + Yes, FEP covers telehealth sessions with our clinicians for Pennsylvania residents at parity with in-person sessions. Do I need a referral to see a therapist with FEP? + No. Outpatient therapy with FEP does not require a referral. request an appointment Request your match. Mention your FEP plan in the intake and we will confirm your coverage before you schedule. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/insurance/vcap/ ===================================================================== Home / Insurance / PA VCAP victims compensation assistance program VCAP Coverage for Therapy in Philadelphia Turning Leaf Therapy works with the Pennsylvania Victims Compensation Assistance Program (VCAP), which covers therapy costs for victims of crime, including survivors of assault, domestic violence, and other traumatic experiences. Where approved, sessions may be fully covered, with no copay burden. How VCAP coverage works VCAP is a Pennsylvania program that can pay for counseling for victims of crime and their families. If you are eligible, VCAP can cover the cost of your sessions here. Where approved, there is no copay burden. Our intake coordinator will help you understand what applies to your situation and take as much of the paperwork off your shoulders as possible. The care itself Most people who reach us through VCAP are carrying the aftermath of something that should not have happened. That is the work our practice was built for: phase-based, relational, trauma-informed care, at your pace. Our PTSD and Complex PTSD therapy page describes how we approach it. What we treat with VCAP coverage Anxiety Hypervigilance, panic, and the constant scanning that follows a crime are covered under VCAP as outpatient behavioral health when your claim is approved. Anxiety therapy here treats that vigilance as an adaptation your nervous system made for good reason, and works to help it stand down rather than simply suppressing it. Depression The flatness, withdrawal, and exhaustion that often follow victimization are covered VCAP concerns. Our depression therapy does not treat that as weakness or as a separate problem from what happened; it treats it as part of the aftermath and works at that level. Trauma and PTSD This is the center of what VCAP exists to cover. PTSD and complex PTSD are covered outpatient conditions, and our trauma-informed therapy is phase-based: safety and stabilization first, processing only at a pace you set, with EMDR and parts work available when they fit. Grief and loss Where a crime involved the death of someone you love, grief and trauma arrive together. VCAP covers that outpatient care, and grief therapy here is built to hold both at once rather than treating them in sequence. Life transitions The disruption after a crime often includes moving, leaving a job, or restructuring a family. These adjustment difficulties are covered under VCAP, and life transitions therapy gives that upheaval a place to be thought about rather than only survived. Relationships Trust, boundaries, and closeness are frequently the longest-lasting casualties. VCAP covers this outpatient work, and our relationship therapy is individual, focused on rebuilding your own sense of safety in connection at whatever pace that takes. For the longer version, including what to ask your insurer and how superbills work, read how insurance and benefits work for therapy in PA and NJ . Getting started Questions about eligibility belong to VCAP directly; questions about starting therapy belong to us. Begin the five-minute intake or call (215) 399-4128 and mention VCAP. Frequently asked questions Does Turning Leaf accept VCAP? + Yes. We work with the Pennsylvania Victims Compensation Assistance Program. If you are eligible, your sessions may be fully covered. What does VCAP cover? + VCAP covers therapy costs for victims of crime, including survivors of assault, domestic violence, and other traumatic experiences. Where approved, sessions may be fully covered, with no copay burden. How do I start? + Begin the five-minute intake or call (215) 399-4128 and mention VCAP. Our intake coordinator will walk you through what applies to your situation. request an appointment When you are ready, we are here. Begin the intake or call (215) 399-4128 and mention VCAP. Our intake coordinator will handle the details with care. Begin the intake → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/insurance/independence-blue-cross/ ===================================================================== Home / Insurance / Independence Blue Cross out-of-network guide Using Independence Blue Cross for Therapy in Philadelphia (Out-of-Network) Turning Leaf Therapy is not in-network with Independence Blue Cross, including its Keystone Health Plan East product, but many IBX PPO members with out-of-network benefits are reimbursed 50 to 80 percent of the allowed amount per session after their out-of-network deductible. We provide a superbill after every session on request, which you submit for reimbursement, typically paid within two to four weeks. Why this page exists Independence Blue Cross covers 55 percent of Philadelphia County's insured population, nearly triple the next-largest carrier (Mark Farrah Associates, County Health Coverage data as of June 30, 2024). If you have IBX, you are not alone, and you still have options here. How superbill reimbursement works Three steps. First, you pay the session fee ($130 to $200, depending on the clinician) at time of service. Second, we provide a superbill, a detailed receipt with your diagnosis, the service provided, and CPT codes (90791 or 90837). Third, you submit it to IBX through your member portal; if your plan includes out-of-network benefits, reimbursement typically arrives within two to four weeks. Check whether your IBX plan reimburses Call the number on your card and ask: Do I have out-of-network outpatient mental health benefits? What is my out-of-network deductible, and how much is met? What percentage of the allowed amount is reimbursed? Is there a session limit? Where do I submit superbills? Note: Keystone Health Plan East is an HMO and generally has no out-of-network benefits. Other ways to make it work HSA and FSA cards are accepted and can pay for sessions with pre-tax dollars. A limited number of reduced-fee spots exist for financial hardship. And if reimbursement matters more than fit, we will say so plainly: an in-network IBX practice may serve you better, though few offer this depth of specialty care. What we treat, and how payment works with Independence Blue Cross We are out of network with Independence Blue Cross. Sessions are $130 to $200 self-pay, and we provide a superbill after every session that you can submit for out-of-network reimbursement. We make no promises about what any plan will pay back; your insurer is the only source for that. Anxiety Panic, social anxiety, chronic worry, and the perfectionism underneath them are what anxiety therapy addresses here, working past coping skills to the history that trained the alarm. Because we are out of network with Independence Blue Cross, these sessions are self-pay with a superbill provided each time. Depression Persistent low mood, loss of interest, and long-running depletion are treated in depression therapy as signals about your emotional and relational life rather than a symptom list. Self-pay applies, and each session generates a superbill you can submit to Independence Blue Cross. Trauma and PTSD PTSD and complex PTSD are treated through phase-based trauma-informed therapy : stabilization first, then processing at your pace, with EMDR and parts work where they fit. Sessions are self-pay under Independence Blue Cross, with superbills issued after each one. Grief and loss Bereavement, traumatic loss, perinatal loss, and grief no one else names are held in grief therapy without a timeline or a stage model. As an out-of-network practice for Independence Blue Cross, we bill you directly and give you the paperwork to seek reimbursement. Life transitions Divorce, career change, parenthood, relocation, and retirement are the territory of life transitions therapy , which treats the change as exposing patterns you already carry. Self-pay rates apply, with a superbill after every session. Relationships Recurring relational patterns, boundaries, and rebuilding trust after betrayal are the focus of our individual relationship therapy . Because Independence Blue Cross is out of network with us, you pay the session rate and submit superbills yourself. Frequently asked questions Does Turning Leaf accept Independence Blue Cross? + No. We are out-of-network with IBX and Keystone Health Plan East. IBX PPO members with out-of-network benefits can submit our superbills for partial reimbursement. How much will IBX reimburse for therapy? + Many IBX PPO plans reimburse 50 to 80 percent of the allowed amount per session after the out-of-network deductible. Call IBX to confirm your plan's specifics. Why are you not in-network with IBX? + Staying out-of-network with some carriers is what lets us keep longer sessions, careful matching, and depth-oriented work sustainable. We offset it with superbills after every session on request and in-network access to Aetna, BCBS plans, United, and Optum. What is a superbill? + A superbill is a detailed receipt that includes your diagnosis, the service provided, and CPT codes, which you submit to your insurer for out-of-network reimbursement. request an appointment Request your match. Tell the intake you have IBX and we will walk you through the numbers before you schedule. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/insurance/cigna/ ===================================================================== Home / Insurance / Cigna out-of-network guide Using Cigna for Therapy in Philadelphia (Out-of-Network) Turning Leaf Therapy is not in-network with Cigna, but many Cigna PPO members with out-of-network benefits are reimbursed 50 to 80 percent of the allowed amount per session after their out-of-network deductible. We provide a superbill after every session on request, which you submit for reimbursement, typically paid within two to four weeks. How superbill reimbursement works Three steps. First, you pay the session fee ($130 to $200, depending on the clinician) at time of service. Second, we provide a superbill, a detailed receipt with your diagnosis, the service provided, and CPT codes (90791 or 90837). Third, you submit it to Cigna through your member portal; if your plan includes out-of-network benefits, reimbursement typically arrives within two to four weeks. Check whether your Cigna plan reimburses Call the number on your card and ask: Do I have out-of-network outpatient mental health benefits? What is my out-of-network deductible, and how much is met? What percentage of the allowed amount is reimbursed? Is there a session limit? Where do I submit superbills? HMO and EPO plans generally have no out-of-network benefits; PPO plans usually do. Other ways to make it work HSA and FSA cards are accepted and can pay for sessions with pre-tax dollars. A limited number of reduced-fee spots exist for financial hardship. And if reimbursement matters more than fit, we will say so plainly: an in-network Cigna practice may serve you better, though few offer this depth of specialty care. What we treat, and how payment works with Cigna We are out of network with Cigna. Sessions are $130 to $200 self-pay, and we provide a superbill after every session that you can submit for out-of-network reimbursement. We make no promises about what any plan will pay back; your insurer is the only source for that. Anxiety Anxiety in its many forms, from panic to avoidance to health worry, is what anxiety therapy works on, treating the symptom as adaptive rather than defective. Since we do not participate in Cigna, these are self-pay sessions accompanied by superbills. Depression Depression and long-running low mood are addressed in depression therapy at the level of what the depression is protecting you from feeling. Self-pay rates apply because we are not in the Cigna network, and you receive a superbill each session. Trauma and PTSD Trauma treatment here begins with safety rather than the story, and our trauma-informed care integrates EMDR, IFS, and somatic work inside a relational frame. As an out-of-network provider for Cigna, we bill you and document each session for reimbursement claims. Grief and loss Grief work here attends to both the present loss and the older losses it reopens, which is often why grief feels larger than the event. Sessions are self-pay under Cigna, with a superbill after each. See grief therapy for how the work unfolds. Life transitions Adjustment distress after a move, a diagnosis, a divorce, or a retirement is the focus of life transitions therapy . Because Cigna is out of network, you pay directly and we provide reimbursement paperwork every time. Relationships Attachment patterns, people-pleasing, and difficulty trusting are treated in individual relationship therapy rather than couples work. These sessions are self-pay for Cigna members, with superbills provided. Frequently asked questions Does Turning Leaf accept Cigna? + No. We are out-of-network with Cigna. Cigna PPO members with out-of-network benefits can submit our superbills for partial reimbursement. How much will Cigna reimburse for therapy? + Many Cigna PPO plans reimburse 50 to 80 percent of the allowed amount per session after the out-of-network deductible. Call Cigna to confirm your plan's specifics. Why are you not in-network with Cigna? + Staying out-of-network with some carriers is what lets us keep longer sessions, careful matching, and depth-oriented work sustainable. We offset it with superbills after every session on request and in-network access to Aetna, BCBS plans, United, and Optum. What is a superbill? + A superbill is a detailed receipt that includes your diagnosis, the service provided, and CPT codes, which you submit to your insurer for out-of-network reimbursement. request an appointment Request your match. Tell the intake you have Cigna and we will walk you through the numbers before you schedule. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/insurance/medicare/ ===================================================================== Home / Insurance / Medicare what to know Using Medicare for Therapy in Philadelphia (What to Know) Turning Leaf Therapy does not accept Medicare or Medicaid, and out-of-network reimbursement generally does not apply to these plans, so care with us is self-pay at $130 to $200 per session. Note that the No Surprises Act Good Faith Estimate requirements do not apply to enrollees in Medicare, Medicaid, the Indian Health Service, Veterans Affairs health care, or TRICARE, which have their own billing protections (Centers for Medicare and Medicaid Services). What self-pay looks like here Sessions run $130 to $200 per 53-minute session depending on the clinician, with exact rates shared during intake, before scheduling. Payment is by credit, debit, HSA, or FSA card at the time of service. Where your HSA or FSA is eligible, it can pay for therapy with pre-tax dollars. A limited number of reduced-fee spots exist for clients experiencing financial hardship. Availability varies; if cost is a barrier, reach out so we can discuss options. Why we do not suggest superbills for Medicare For commercial PPO plans, we provide superbills for out-of-network reimbursement. Out-of-network reimbursement generally does not apply to Medicare or Medicaid, so we will not point you toward a paperwork path that does not pay. Self-pay with us is a clear-eyed choice, and we would rather you make it with accurate expectations. If self-pay is not workable Lower-cost care exists in Philadelphia, including community mental health centers that accept Medicare and Medicaid. And if you are in crisis, do not navigate coverage at all: call or text 988 , or call the Philadelphia Crisis Line at (215) 685-6440 . For the full picture of fees, payment, and the Good Faith Estimate, see our rates page and getting started . What we treat, and how payment works with Medicare and Medicaid We are out of network with Medicare and Medicaid. Sessions are $130 to $200 self-pay, and we provide a superbill after every session that you can submit for out-of-network reimbursement. We make no promises about what any plan will pay back; your insurer is the only source for that. Anxiety Panic, social anxiety, chronic worry, and the perfectionism underneath them are what anxiety therapy addresses here, working past coping skills to the history that trained the alarm. Because we are out of network with Medicare and Medicaid, these sessions are self-pay with a superbill provided each time. Depression Persistent low mood, loss of interest, and long-running depletion are treated in depression therapy as signals about your emotional and relational life rather than a symptom list. Self-pay applies, and each session generates a superbill you can submit to Medicare and Medicaid. Trauma and PTSD PTSD and complex PTSD are treated through phase-based trauma-informed therapy : stabilization first, then processing at your pace, with EMDR and parts work where they fit. Sessions are self-pay under Medicare and Medicaid, with superbills issued after each one. Grief and loss Bereavement, traumatic loss, perinatal loss, and grief no one else names are held in grief therapy without a timeline or a stage model. As an out-of-network practice for Medicare and Medicaid, we bill you directly and give you the paperwork to seek reimbursement. Life transitions Divorce, career change, parenthood, relocation, and retirement are the territory of life transitions therapy , which treats the change as exposing patterns you already carry. Self-pay rates apply, with a superbill after every session. Relationships Recurring relational patterns, boundaries, and rebuilding trust after betrayal are the focus of our individual relationship therapy . Because Medicare and Medicaid is out of network with us, you pay the session rate and submit superbills yourself. Frequently asked questions Does Turning Leaf accept Medicare or Medicaid? + No. We do not accept Medicare or Medicaid, and out-of-network reimbursement generally does not apply to these plans. Care with us is self-pay at $130 to $200 per session. Does the Good Faith Estimate apply to Medicare enrollees? + The No Surprises Act Good Faith Estimate requirements do not apply to enrollees in Medicare, Medicaid, the Indian Health Service, Veterans Affairs health care, or TRICARE, which have their own billing protections (Centers for Medicare and Medicaid Services). What are my options if I cannot afford self-pay? + Ask about our limited reduced-fee spots, or look to Philadelphia community mental health centers that accept Medicare and Medicaid. In crisis, call or text 988, or call the Philadelphia Crisis Line at (215) 685-6440. request an appointment Request your match. If cost is a concern, say so in the intake and we will talk it through plainly. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/rates/ ===================================================================== Home / Rates old city, philadelphia Therapy Fees, Insurance, and Payment at Turning Leaf Therapy You are here because you are weighing an important decision. You want to know what therapy costs, whether your insurance will help, and whether it is worth the investment. Those are the right questions. Here are the straightforward answers. Start your intake → self-pay rates $130 to $200 per session Depending on the therapist's credentials and experience. in-network Aetna, BCBS, UHC, Optum, VCAP You typically only pay your copay/coinsurance. out-of-network Superbills after every session Provided on request. Many plans reimburse 50 to 80 percent of the allowed amount after your out-of-network deductible. payment methods Credit, debit, HSA, FSA Accepted at the time of service. What Therapy Costs at Turning Leaf Therapy Individual therapy sessions at Turning Leaf Therapy range from $130 to $200 per session, depending on session length and the therapist's credentials and experience level. If you are using an in-network insurance plan, your out-of-pocket cost will typically be your copay or coinsurance, which for most plans falls between $15 and $50 per session after your deductible is met. We believe in transparency. The cost of therapy should never be a surprise. Your therapist and our intake team will discuss fees and insurance coverage before your first session so you know exactly what to expect. For a plain-English walkthrough of copays, deductibles, and what a session costs across the city, read our 2026 guide to therapy costs in Philadelphia . Insurance Plans We Accept We are in-network providers with the following insurance plans. If your plan is listed below, you can use your benefits to cover the cost of therapy at our practice. Aetna We accept all Aetna plans for individual therapy, including Aetna through employer-sponsored plans, marketplace plans, and student health plans. Blue Cross Blue Shield (BCBS) We accept Blue Cross Blue Shield plans across multiple states, including Anthem Blue Cross Blue Shield , Capital Blue Cross , Empire BlueCross BlueShield , Highmark Blue Cross Blue Shield , BlueCross BlueShield standard plans, and the Federal Employee Program (FEP) . Please note: we do not accept Independence Blue Cross (IBX). If you have a different BCBS plan and are unsure whether we are in-network, reach out and we can help you verify. United Healthcare and Optum Behavioral Health We accept United Healthcare and Optum Behavioral Health plans for individual therapy, including UHC through employer-sponsored plans and Optum EAP referrals. Victims Compensation Assistance Program (VCAP) We collaborate with the Pennsylvania Victims Compensation Assistance Program , which covers therapy costs for victims of crime, including survivors of assault, domestic violence, and other traumatic experiences. If you are eligible for VCAP, your sessions may be fully covered. HSA and FSA You can use your Health Savings Account (HSA) or Flexible Spending Account (FSA) to pay for therapy sessions. Therapy is a qualified medical expense under IRS guidelines. Out-of-Network Insurance Reimbursement If your insurance plan is not listed above, you may still be able to receive reimbursement for therapy through your out-of-network benefits. Many insurance companies reimburse 50 to 80 percent of the allowed amount after your out-of-network deductible for out-of-network mental health providers. Here is how it works: 01 Step 1. You pay the full session fee at the time of your appointment. 02 Step 2. You request a superbill from your therapist. A superbill is a detailed receipt that includes your diagnosis, the service provided, CPT codes, and all the information your insurance company needs to process a claim. Superbills are provided after every session on request. 03 Step 3. You submit the superbill to your insurance company (most plans accept submissions online, by mail, or through a mobile app). Your insurance reimburses you directly, typically within two to four weeks. To find out what your out-of-network benefits cover, call the member services number on the back of your insurance card and ask these questions: Do I have out-of-network mental health benefits? What is my annual deductible for out-of-network mental health services, and how much of it have I met? What percentage of the session fee will my plan reimburse for the following services with a licensed mental health provider: CPT Code 90791 (initial diagnostic evaluation) and CPT Code 90837 (53-minute individual therapy session)? Is there a limit on the number of sessions covered per year? Is there a specific claim form I need to use, and where do I get it? Your Right to a Good Faith Estimate Under the No Surprises Act, which took effect January 1, 2022, health care providers are required to give patients who do not have insurance or who are not using insurance an estimate of expected charges before services are provided. This is called a Good Faith Estimate. You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency health care services, including therapy. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. For questions or more information about your right to a Good Faith Estimate, visit cms.gov/nosurprises or call 800-985-3059. Payment Methods We accept credit cards, debit cards, HSA cards, and FSA cards. Payment is collected at the time of service. We do not accept cash or checks. Frequently Asked Questions About Therapy Costs and Insurance How much does therapy cost at Turning Leaf Therapy? + Individual therapy sessions range from $130 to $200 per session, depending on session length and therapist. If you are using an in-network insurance plan (Aetna, BCBS, United Healthcare, or Optum), your cost will typically be your copay or coinsurance, which most clients find falls between $15 and $50 per session. What insurance plans does Turning Leaf Therapy accept? + We are in-network with Aetna, United Healthcare, Optum, Pennsylvania VCAP (the Victims Compensation Assistance Program), and these Blue Cross plans: Highmark, Capital Blue Cross, Anthem, Empire, the Federal Employee Program, and Horizon BCBS of New Jersey. We are out-of-network with Independence Blue Cross, Cigna, Medicare, and Medicaid; those sessions are $130 to $200, and for plans with out-of-network benefits we provide a superbill after every session on request. How much does therapy cost in Philadelphia? + The average cost of therapy in Philadelphia ranges from approximately $120 to $250 per session for individual therapy with a licensed therapist. Costs vary based on the therapist's credentials, session length, and whether you are using insurance. At Turning Leaf Therapy, sessions range from $130 to $200 before insurance. Most in-network clients pay significantly less out of pocket. Does insurance cover therapy? + Yes. Mental health services, including individual therapy, are considered essential health benefits under the Affordable Care Act. If you have health insurance through an employer, the marketplace, or Medicaid, your plan is required to cover mental health treatment. Your specific out-of-pocket cost depends on your plan's copay, coinsurance, and deductible structure. What is a superbill? + A superbill is a detailed receipt your therapist provides after every session on request. It includes your diagnosis, the type of service provided, the CPT code, the date, the fee charged, and the provider's credentials and license number. You submit this document to your insurance company to receive reimbursement for out-of-network therapy sessions. Just ask your therapist or our administrative team and we will prepare one for you. What is the difference between in-network and out-of-network therapy? + In-network means your therapist has a contract with your insurance company and has agreed to accept negotiated rates. You pay your copay or coinsurance, and insurance covers the rest. Out-of-network means the therapist does not have a contract with your insurer, but your plan may still reimburse a portion of the cost (typically 50 to 80 percent of the allowed amount after your out-of-network deductible) after you submit a superbill. Can I use my HSA or FSA to pay for therapy? + Yes. Therapy is a qualified medical expense under IRS guidelines. You can use your Health Savings Account or Flexible Spending Account to pay for sessions, including copays and self-pay fees. How do I verify my insurance benefits before starting therapy? + Call the member services number on the back of your insurance card and ask: Am I eligible for outpatient mental health benefits? What is my copay or coinsurance for a licensed therapist? Do I have a deductible, and how much of it have I met? Is there a limit on the number of sessions per year? If you have questions after calling, reach out to us and we can help you navigate your coverage. Do you accept Independence Blue Cross (IBX)? + No. We do not currently accept Independence Blue Cross. If you have IBX, you may still be able to see us using your out-of-network benefits. Many IBX plans reimburse 50 to 80 percent of the allowed amount after your out-of-network deductible for out-of-network mental health providers. Call the number on the back of your card and ask about your out-of-network outpatient mental health benefits. Do you offer sliding scale fees? + We offer a limited number of reduced-fee spots for clients experiencing financial hardship. Availability varies. If cost is a barrier, we encourage you to reach out so we can discuss options. What is a Good Faith Estimate? + A Good Faith Estimate is a written estimate of expected charges for non-emergency health care services, required under the No Surprises Act for patients who are uninsured or choosing not to use their insurance. You have the right to receive this estimate before your first session. What forms of payment do you accept? + We accept credit cards, debit cards, HSA cards, and FSA cards. Payment is collected at the time of service. How often do therapy sessions happen? + Most clients begin with weekly sessions. Your therapist will discuss a recommended frequency based on your needs and goals. Some clients eventually transition to biweekly sessions as their work progresses. Investing in Therapy Research consistently shows that therapy works. About 75 percent of people who enter psychotherapy show some benefit, according to the American Psychological Association, which notes that in one classic study half of patients improved after eight sessions and 75 percent improved after six months (APA, "Understanding psychotherapy and how it works"). Consider what the challenge you are facing is already costing you: in sleep, in relationships, in your ability to be present at work or with your family, in the weight of carrying it alone. Therapy is not an added expense on top of everything else. It is the investment that begins to reduce all the other costs. Start your intake → the closing details practice Turning Leaf Therapy address 123 Chestnut Street, Suite 304, Old City, Philadelphia, PA 19106 hours Monday to Friday, 8 AM to 9 PM If you are in crisis, call or text 988 , or call the Philadelphia Crisis Line at (215) 685-6440 . request an appointment Start Your Journey. A five-minute intake, a personal review, and clear numbers before you ever schedule. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/telehealth-pennsylvania/ ===================================================================== Home / Telehealth pennsylvania & new jersey Online Therapy Across Pennsylvania and New Jersey Turning Leaf Therapy offers HIPAA-secure video therapy to adults, teens, and children anywhere in Pennsylvania, and to New Jersey residents through eight NJ-licensed clinicians. Sessions are 53 minutes with the same therapist, the same relational depth, and the same insurance coverage as in-person care. In-network plans cover telehealth at parity. How online therapy works You meet your therapist over an encrypted video platform from any private space with a stable connection. The work is identical to our office work: weekly 53-minute sessions, the same clinician throughout, the same care plan. Many clients alternate between Suite 304 and video as life requires. Who online therapy suits People outside Philadelphia, parents without childcare margins, professionals with unforgiving calendars, clients with mobility or health constraints, and anyone whose consistency improves when the commute disappears. Depth work travels well; what matters is privacy and continuity. What you need A private room, a device with a camera, and a reliable connection. We will send the session link before each appointment. If a connection drops, your therapist will call you and continue by phone where clinically appropriate. Insurance and online therapy in Pennsylvania and New Jersey The plans we accept, Aetna, the BCBS family, United Healthcare, and Optum, cover telehealth with our clinicians at parity with in-person sessions for Pennsylvania residents. New Jersey clients should confirm telehealth benefits with their plan; Horizon BCBSNJ members are in-network. Frequently asked questions Is online therapy covered by insurance in Pennsylvania? + Yes. The plans we accept cover teletherapy (virtual sessions) at parity with in-person care for Pennsylvania residents, with the same copay. Can I see a Turning Leaf therapist from New Jersey? + Yes, eight of our clinicians are licensed in New Jersey and see NJ residents by video. Is online therapy as effective as in-person? + For most concerns and most people, yes; consistency and privacy matter more than the room. Our intake team will flag the cases where in-person care is the better recommendation. request an appointment Request your match. Tell the intake you prefer telehealth and we will match you accordingly. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/getting-started/ ===================================================================== Home / Getting Started old city, philadelphia Getting Started: What to Expect Starting therapy here takes three steps: a short adaptive intake that takes about five minutes, a personal match from our intake coordinator team within 1 to 2 business days, and a first session that works like a clinical consultation. No bots, no waitlist purgatory, no forms that ask everything and promise nothing. Step one: tell us about you The intake asks what brings you in, what you are looking for, your insurance or self-pay preference, and your schedule. About five minutes. Share as much or as little as you want; there are no wrong answers. Step two: a person reads it Our intake coordinator team reviews every request personally and matches you with the clinician whose specialties, style, and openings fit. You will hear from us within 1 to 2 business days. If insurance needs verifying, we will walk you through it. For the plan-by-plan detail, see our guide to finding a therapist in Philadelphia who takes your insurance . Step three: the first session Your first 53-minute session is a working consultation: your therapist asks what brought you in and what you want to be different, and you get a feel for how they work. Fit matters more than anything else we can measure, and if it is not right, we will rematch you without ceremony. Curious what actually happens in that first hour? Read what to expect in your first therapy session . After that Most clients meet weekly. Some work with us for a season, many for longer; depth work is not a sprint, and things that grow slowly tend to grow well. If you are in crisis now, do not wait for an intake: call or text 988 , or call the Philadelphia Crisis Line at (215) 685-6440 . Frequently asked questions How long until I see a therapist? + You will hear from our intake coordinator team within 1 to 2 business days, and most clients have a first session within the same week or the next, depending on schedules. What if my therapist is not the right fit? + Tell us, or tell them. Rematching is normal here and nobody will be offended. Do I need a diagnosis or referral to start? + No. You need only the five-minute intake, or a phone call to (215) 399-4128. request an appointment Request your match. The intake takes about five minutes and asks only what applies to you. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/old-city-philadelphia-therapy/ ===================================================================== Home / Old City Philadelphia old city, philadelphia, 19106 Therapy in Old City Philadelphia Turning Leaf Therapy sees clients in person at 123 Chestnut Street, Suite 304, Philadelphia, PA 19106, a quiet suite two flights up from Chestnut in Old City, and by secure video across Pennsylvania. Sessions run 53 minutes, Monday to Friday, 8 AM to 9 PM. In-network with Aetna, BCBS plans, United Healthcare, and Optum. The office Suite 304 is a calm, plant-heavy floor above the noise of 2nd Street: soft light, quiet rooms, no waiting-room fluorescence. Suite 304, Old City. In-person sessions Monday to Friday. Getting here By train: 2nd Street Station on the Market-Frankford Line is 2 blocks away; Franklin Square on the PATCO line is 4 blocks. By car: metered parking on 2nd and Chestnut, and the Bourse Garage at 4th and Ranstead. the practical details address 123 Chestnut Street, Suite 304, Philadelphia, PA 19106 transit 2nd Street (MFL), 2 blocks. Franklin Square (PATCO), 4 blocks. parking Metered on 2nd & Chestnut. Bourse Garage, 4th & Ranstead. hours Monday to Friday, 8 AM to 9 PM Open in Google Maps Who we serve in person Old City neighbors, and clients from Society Hill, Washington Square West, Queen Village, Northern Liberties, Fishtown, and Center City, a short walk or one train stop away. Between the Betsy Ross House and Independence Mall, we are easy to find and easy to reach after work; evening sessions run until 9 PM on weekdays. If the commute is the obstacle Every clinician also sees Pennsylvania clients by secure video, and eight are licensed in New Jersey. See online therapy across Pennsylvania and New Jersey . Frequently asked questions Where is Turning Leaf located? + 123 Chestnut Street, Suite 304, Philadelphia, PA 19106, in Old City, 2 blocks from 2nd Street Station on the Market-Frankford Line. Is parking available? + Metered street parking on 2nd and Chestnut, and the Bourse Garage at 4th and Ranstead, one block west. Do you see clients outside Old City? + Yes, in person from across the city and by telehealth anywhere in Pennsylvania, plus New Jersey with our NJ-licensed clinicians. request an appointment Request your match. In person in Old City, or by secure video anywhere in Pennsylvania. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/faq/ ===================================================================== Home / FAQ old city, philadelphia Frequently Asked Questions Whether you're considering therapy for the first time or looking for the right practice in Philadelphia, we've answered the most common questions below. If you don't see your question here, contact us . We're happy to help. Cost and Insurance How much does therapy cost at Turning Leaf? + Session fees range from $130 to $200 depending on the therapist's level of training and licensure. Licensed Social Workers (LSWs) typically start at $130 per session, while doctoral-level Clinical Psychologists and senior clinicians charge $175 to $200. Exact rates are listed on each therapist's individual profile page. Our guide to what therapy costs in Philadelphia walks through the full math. Does Turning Leaf Therapy accept insurance? + Yes. Turning Leaf is in-network with Aetna, United Healthcare, Optum, Pennsylvania VCAP, and these Blue Cross plans: Highmark, Capital Blue Cross, Anthem, Empire, the Federal Employee Program, and Horizon BCBS of New Jersey. Most in-network clients pay a copay of $15 to $50 after any deductible. We are out-of-network with Independence Blue Cross, Cigna, Medicare, and Medicaid; those sessions are $130 to $200, and for plans with out-of-network benefits we provide a superbill after every session on request. Not every clinician is credentialed with every plan, so name your plan in the intake and a coordinator will match you with a clinician who accepts it. Specialties and Approach What kinds of concerns do your therapists treat? + Our therapists work with a broad range of mental health concerns. The most common include: Trauma & PTSD , treated by nearly every therapist on our team using evidence-based approaches including EMDR, Prolonged Exposure, Cognitive Processing Therapy, and IFS Anxiety , generalized anxiety, social anxiety, panic, perfectionism, and performance anxiety Depression , including persistent depression, grief-related depression, and postpartum depression Relationship difficulties , interpersonal patterns, attachment, communication Identity exploration , gender identity, sexual orientation, racial and cultural identity, life stage transitions Grief & loss , bereavement, relationship loss, pregnancy loss, and complicated grief Life transitions , college, career change, relocation, new parenthood, divorce Eating concerns & body image , including eating disorders and body-focused concerns OCD , obsessive-compulsive disorder and body-focused repetitive behaviors (BFRBs) Dissociative disorders , including complex dissociation and DID Perinatal & postpartum mental health , prenatal anxiety, birth trauma, postpartum depression, infertility grief ADHD & neurodivergence , affirming therapy for neurodivergent individuals Do you specialize in trauma therapy? + Yes, trauma-informed care is at the core of everything we do. Every therapist at Turning Leaf approaches their work through a trauma-informed lens, meaning we understand how past experiences shape present-day thoughts, feelings, behaviors, and relationships. Several of our clinicians have advanced specializations in trauma, including complex PTSD, childhood trauma, intergenerational trauma, narcissistic abuse, and dissociative disorders. We offer a range of trauma-specific treatments including EMDR, Prolonged Exposure (PE), Cognitive Processing Therapy (CPT), Trauma-Focused CBT (TF-CBT), IFS/Parts Work, and Clinical Hypnosis. Learn more on our Trauma Therapy page . Do you offer EMDR therapy? + Yes. Several of our therapists are trained in Eye Movement Desensitization and Reprocessing (EMDR), a highly researched and effective treatment for trauma and PTSD. EMDR helps the brain process distressing memories so they lose their emotional charge and no longer feel overwhelming. Please visit our Our Team page to see which therapists currently offer EMDR. Do you offer LGBTQIA+ affirming therapy? + Absolutely. Affirming care for LGBTQIA+ individuals is a core value of our practice. More than half of our therapists have specific experience and training in working with LGBTQIA+ clients, including issues related to gender identity, sexual orientation, coming out, family rejection, and the mental health impacts of discrimination and minority stress. Our team includes clinicians who write letters in support of gender-affirming surgeries for clients who need them. Please contact us to discuss this process. Do you provide therapy for teens? + Yes. We work with teens ages 13 to 17, with parents and caregivers involved as partners in the work. If you're looking for support for a younger child, reach out and we'll help you figure out the right fit. Do you offer postpartum and perinatal mental health support? + Yes. We have therapists with specialized training in perinatal mental health, including birth trauma, postpartum depression and anxiety, pregnancy loss, infertility grief, and the emotional challenges of the transition to parenthood. Visit our Our Team page to find therapists who specialize in this area. Do you have therapists who specialize in eating disorders and body image? + Yes. Several of our clinicians have specialized training and experience working with eating disorders, body image concerns, and self-injurious behaviors. This work is often integrated with trauma-informed and identity-focused care. Visit our Our Team page to find the right fit. Do you offer therapy for athletes and sports performance anxiety? + Yes, this is a unique specialty at Turning Leaf. We have clinicians with specific experience working with athletes on the mental health side of performance, identity, and the psychological role of sports in their lives, integrating body-based mindfulness with psychodynamic and relational approaches. Do you offer therapy for first responders? + Yes. We have therapists with backgrounds in crisis mental health settings who bring direct experience supporting first responders navigating trauma, burnout, compassion fatigue, and the emotional demands of their work. Do you offer therapy for immigrants, refugees, and multicultural clients? + Yes. Culturally sensitive and affirming care is central to our practice. Several of our clinicians have direct experience working with immigrant and refugee populations, including acculturation stress, cultural identity, and intergenerational trauma. We hold the impact of systemic oppression and intersecting identities with care across our entire team. Learn more on our Culturally Sensitive Care page . Do you offer therapy for creatives and artists? + Yes, and this is one of our standout specialties. Several of our therapists have backgrounds in the arts and integrate creative and expressive arts approaches into their clinical work. We welcome artists, performers, writers, and other creative professionals who are looking for a therapist who truly understands the creative life. Do you offer clinical supervision for social workers and counselors? + Yes. We have multiple doctoral-level and licensed senior clinicians available for clinical supervision. We offer supervision for LSWs pursuing their LCSW licensure and LAPCs pursuing their LPC. We also have a formal LSW/LAPC Training Program. Visit our Supervision page to learn more. What therapeutic approaches do you use? + Our therapists draw from a wide range of evidence-based and relational approaches, tailored to each individual client. The foundation of our work is relational and psychodynamic therapy. Nearly every therapist on our team is trained in this approach, which emphasizes understanding how past experiences and relationship patterns shape present-day feelings and behaviors. We also integrate many other modalities depending on client needs, including: Cognitive Behavioral Therapy (CBT) , practical skills for changing unhelpful thought and behavior patterns Internal Family Systems (IFS) / Parts Work , exploring different "parts" of the self with curiosity and compassion Dialectical Behavior Therapy (DBT) , emotion regulation, distress tolerance, and interpersonal effectiveness skills EMDR , trauma processing through bilateral stimulation Acceptance & Commitment Therapy (ACT) , building psychological flexibility and values-based living Somatic / body-based approaches , integrating body awareness into the healing process Art & expressive arts therapy , creative pathways to self-expression and healing Mindfulness-based approaches , present-moment awareness and nervous system regulation Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT) , structured trauma treatments for PTSD Narrative therapy , reauthoring the stories we tell about ourselves What is IFS (Internal Family Systems) therapy? + Internal Family Systems (IFS) is a powerful, evidence-based therapy that views the mind as made up of different "parts", each with its own perspective, feelings, and role. Rather than fighting against difficult thoughts or behaviors, IFS helps you get curious about these parts, understand what they are protecting, and heal from the inside out. IFS and parts-based approaches are among the most widely offered modalities across our team, making it one of our core areas of expertise. It is particularly effective for trauma, anxiety, perfectionism, and self-criticism. Do you offer somatic or body-based therapy? + Yes. Many of our therapists integrate somatic and body-based approaches into their work, recognizing that trauma and stress are stored in the body as much as in the mind. Several of our clinicians have backgrounds in yoga, bodywork, and mindfulness practices that inform their therapeutic approach, supporting clients in developing deeper body awareness and nervous system regulation as part of the healing process. What is the difference between in-person and online therapy? Which is better? + Both in-person and online therapy can be equally effective when conducted in a secure, private setting with a skilled therapist. The best format depends on your personal preference, schedule, and comfort level. In-person therapy at our Philadelphia office can feel more grounded and immersive for some clients. Online therapy offers greater flexibility and removes the barrier of commuting, making it easier to maintain consistency. Many of our clients successfully use telehealth from home, and some choose to mix both formats over time. Telehealth is available for residents of Pennsylvania and New Jersey. Logistics and Location Where is Turning Leaf Therapy located? Do you offer telehealth? + Our office is located at 123 Chestnut Street, Suite 304, Philadelphia, PA 19106, in the heart of Old City, easily accessible by public transit and with nearby parking. Yes, we offer secure, HIPAA-compliant telehealth for residents of Pennsylvania and New Jersey. Many of our therapists offer both in-person and virtual options, and some clients choose to alternate between the two. Telehealth sessions are conducted through a secure video platform, no app download required. How long does therapy typically last? + This varies widely based on the individual, their goals, and the nature of what they're working on. Some clients come for a focused period of a few months around a specific life stressor or transition. Others engage in longer-term, deeper work, particularly those working through complex trauma, longstanding relationship patterns, or significant life changes. Your therapist will work collaboratively with you to define your goals and revisit them over time. How often will I meet with my therapist? + Most clients begin by meeting weekly, which helps build momentum and develop the therapeutic relationship. Over time, some clients transition to biweekly sessions as they progress toward their goals. Your therapist will discuss what frequency makes the most sense for you. Will my sessions be confidential? + Yes. Confidentiality is a cornerstone of the therapeutic relationship. Everything discussed in sessions is kept strictly private with limited exceptions required by law (such as imminent safety concerns or mandated reporting obligations). Your therapist will explain all confidentiality policies clearly during your first session and in our intake documentation. Our telehealth platform is fully HIPAA-compliant, ensuring your privacy is protected in online sessions as well. Getting Started What is Turning Leaf Therapy and what makes it different? + Turning Leaf Therapy LLC is a full-service private practice located in Old City Philadelphia at 123 Chestnut Street, Suite 304. We are a team of licensed therapists, including Clinical Psychologists, LCSWs, LPCs, and Licensed Social Workers, who share a deep commitment to trauma-informed, relationally-grounded care. What sets us apart is the depth and breadth of our team's expertise. Nearly every clinician specializes in trauma-informed therapy, and together we cover a wide range of concerns, from anxiety and depression to dissociative disorders, eating concerns, LGBTQIA+ affirming care, athletic performance anxiety, perinatal mental health, and more. We offer both in-person sessions in Philadelphia and virtual therapy for residents of Pennsylvania and New Jersey. How do I get started with a therapist at Turning Leaf? + Getting started is simple. Fill out our contact form or call us at 215-399-4128. Our intake team will reach out to learn a bit about what you're looking for, discuss availability, and help match you with a therapist who is the right fit for your needs and goals. We understand that finding the right therapist matters, and we take the matching process seriously. You're welcome to ask questions before committing to an initial appointment. If you are wondering what a first session involves, our guide to your first therapy session walks through it. What if I'm not sure what type of therapy I need? + That's completely okay, and very common. You don't need to arrive knowing exactly what kind of therapy is right for you. Our intake process is designed to help us understand your needs, and your therapist will collaboratively discuss approaches with you during early sessions. The most important factor is finding a therapist you feel comfortable with and can trust. request an appointment Ready to get started? We'd love to hear from you. Fill out our contact form or call us at (215) 399-4128 to take the first step. Our team is here to help you find the right therapist and begin your journey. Start the intake → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/supervision/ ===================================================================== Home / Supervision old city, philadelphia Supervision and Consultation Services Our therapists are licensed as Clinical Psychologists, Licensed Professional Counselors, or Licensed Clinical Social Workers and specialize in the provision of Trauma-Informed Therapy. A select group of our clinicians are qualified and skilled at providing specialized, trauma-informed clinical supervision and/or consultation services to other mental health professionals. Each of these supervisors has their own areas of specialization and can provide focused clinical supervision or consultation for a variety of presenting problems. Supervision here is built the same way our therapy is: around the relationship. We pay attention to what happens between supervisor and supervisee, because the patterns that surface there are usually the ones that matter in the room with your clients. What we offer Individual supervision One-to-one supervision for pre-licensed clinicians accruing hours toward full licensure. Sessions follow your caseload: case formulation, the therapeutic relationship, transference and countertransference, pacing trauma work, and the moments where you feel stuck. Meetings are typically weekly or every other week, set with your supervisor. Group supervision A small, consistent group of clinicians meeting with one supervisor. Group supervision adds something individual work cannot: hearing how colleagues think, presenting a case to more than one set of eyes, and noticing the parallel process that plays out in the group itself. Groups form as interest and schedules allow. Consultation for licensed clinicians Focused consultation for therapists who are already licensed and want a second mind on difficult work, whether that is a single case or an ongoing arrangement. Complex trauma, developmental trauma, and dissociative disorders are the areas we are asked about most, and each supervisor brings their own further specializations. Who it is for Supervision is for Licensed Social Workers (LSW) working toward the LCSW and Licensed Associate Professional Counselors (LAPC) working toward the LPC in Pennsylvania, whether you practice here or elsewhere. Consultation is for fully licensed clinicians: LCSWs, LPCs, and psychologists who want trauma-informed, relationally grounded input on their work. We also run a formal in-house training program for the LSW and LAPC clinicians on our own team, which combines weekly individual supervision, weekly group supervision, and didactic seminars. Who provides it Supervision at Turning Leaf is led by Dr. Alison Tripptree , our Director of Supervision, who oversees training for our early-career clinicians. Clinical supervisors on the team include Tara Bailey, LCSW , a certified relational psychoanalyst whose supervision centers on complex trauma and dissociative disorders; Anne Miller-Uueda, LCSW , who supervises LSWs pursuing the LCSW; Dr. Katelyn Vala ; and Dr. John Machalaba , our Director of Clinical Services. Not every clinician here supervises. The ones who do have chosen it as a specialty. Format and fees Individual supervision and consultation are scheduled directly with the supervisor, in person at 123 Chestnut Street, Suite 304, or by secure video. Group supervision meets on a regular schedule agreed by the group. Fees are set by the individual supervisor and confirmed before your first meeting, so there is nothing to work out afterward. To get started, call (215) 399-4128 and leave a message for the supervisor you would like to work with, or send a note through our contact page with your license type and what you are looking for. Someone from the team will follow up to talk through fit and availability. *Please note, we are not currently offering clinical placements for practicums or internships. reach a supervisor phone (215) 399-4128 hours Monday to Friday, 8 AM to 9 PM Frequently asked questions Do you supervise LSWs and LAPCs working toward full licensure? + Yes. We provide clinical supervision for Licensed Social Workers working toward the LCSW and for Licensed Associate Professional Counselors working toward the LPC in Pennsylvania. Supervision is relational, psychodynamic, and trauma-informed, and it can be arranged individually or in a small group. Fees are set by the supervisor and confirmed before you begin. Do you offer consultation for clinicians who are already licensed? + Yes. Licensed clinicians can arrange focused case consultation, individually or as a group, with a supervisor whose specialization fits the work. Complex trauma and dissociative disorders are the areas we are asked about most often, though each supervisor has their own areas of depth. Do you take practicum or internship students? + Not at this time. We are not currently offering clinical placements for practicums or internships. Supervision here is for clinicians who already hold a Pennsylvania license or associate license, and consultation is for clinicians who are fully licensed. ===================================================================== URL: https://turningleaftherapyservices.com/contact/ ===================================================================== Home / Contact old city, philadelphia Connect With Us! Reach out and our intake coordinator team will personally review what you share, never a bot. The form takes about five minutes and asks only what applies to your situation. You will hear back within one to two business days with a clinician recommendation that fits your concern, insurance, and schedule. Start Your Journey Today → Or call (215) 399-4128 Quick and interactive (takes just a couple of minutes) 100% Secure & Confidential We'll reach out within 1 to 2 business days to get you scheduled. How to Get Started 01 Tell Us About You Complete our quick, interactive form to request a specific therapist or share what you're looking for. 02 Review & Connect Our intake team will personally review your request to connect you with your chosen clinician or find the perfect match. 03 Start Healing We'll reach out promptly to schedule your first session. Read what to expect in that first session . An intake coordinator team, not a bot. Every request that comes through our form is read personally by our intake coordinator team. They take the time to get to know each individual in order to match them with the most appropriate clinician, ensuring that you receive the highest quality of care from the very first conversation. You can also call us at 215-399-4128 . Find us in Old City Two blocks from the 2nd Street station on the Market-Frankford Line, four blocks from PATCO Franklin Square, a short walk from the Betsy Ross House and Independence Mall. ADDRESS 123 Chestnut Street, Suite 304 Philadelphia, PA 19106 PHONE (215) 399-4128 HOURS Monday to Friday, 8 AM to 9 PM TRANSIT 2nd Street (MFL), 2 blocks. Franklin Square (PATCO), 4 blocks. PARKING Metered on 2nd & Chestnut. Bourse Garage, 4th & Ranstead. COORDINATES 39.9485232, -75.1437297 Tap to open in Google Maps or your maps app Open in Google Maps → Get directions If you are in crisis, call or text 988 , or call the Philadelphia Crisis Line at (215) 685-6440 . request an appointment Request your match. Start your intake → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/careers/ ===================================================================== Home / Careers careers, philadelphia, pa (hybrid) Licensed Psychotherapist Turning Leaf Therapy | Philadelphia, PA (Hybrid) Licensed Therapist, Licensed Clinical Psychologist, LCSW, LPC Apply Now: Email aMillerU@tltherapy.com → compensation $75k to $110k+ Base Annually. $90k to $150K Total Comp Package. (W-2, fee-for-service) caseload 25 to 27+ sessions/week. Mix of in-person & telehealth. Includes 2 early morning or evening shifts. benefits Full Benefits Package. Health, earned PTO, 401(k) with match, dental, vision, paid CEs & more. About the role Join a thriving, trauma-informed group practice specializing in trauma, complex trauma, PTSD, and dissociative disorders. We value relational, attachment-focused, psychodynamic/psychoanalytic work and welcome integrative approaches (e.g., IFS, EMDR). We offer a warm, connected team culture with opportunities for CEs, social gatherings, and consultations. What you'll do Maintain a 25 to 27+ session/week caseload (mix of in-person + telehealth). Treat adults and/or children/teens; space for additional specialties (e.g., eating disorders, couples, identity). Provide at least 2 early morning or evening shifts/week. Participate in a weekly peer consultation group and team meetings. Compensation & benefits structure We operate on a W-2, fee-for-service model (not salary). We offer competitive per-session rates plus paid administrative and professional time (consultation, team meetings, CEs). The typical annual range is $75,000 to $110,000+, depending heavily on caseload and licensure. Benefits (Based on Caseload) 25+ sessions/week: All benefits, except health insurance. 27+ sessions/week: Full benefits, including health insurance. Package includes: Earned PTO, 401(k) with 3% match, dental & vision, FSAs (healthcare/commuter/dependent care), paid CEs, weekly consultation groups, strong clinical support, fully furnished office, and job supplies. Who we are looking for Ideal Candidate Drawn to relational/depth-oriented therapy; open to integrative modalities (IFS, EMDR, etc.). Skilled in trauma, complex trauma, developmental/attachment trauma, PTSD, and dissociation. Collaborative, growth-minded, and comfortable with a full caseload of trauma-focused work. Desire to be part of the team and to participate in collegial relationships. Requirements Active PA independent license: Clinical Psychologist, LCSW, LPC. 2+ years post-licensure experience strongly preferred. Ability to sustain 25 to 27 sessions/week and two morning/evening shifts. Able to commute to Old City (19106) for in-person sessions. Appropriate home office or off-site location for providing telehealth sessions. Post-Doc Experience Available Candidates seeking a Post-Doc experience are encouraged to apply! We will work with you to ensure you meet post-doc requirements in other states, if needed. Must still hold an active PA independent license as a Clinical Psychologist. You may opt in to receive 1 hour of Relational, Psychodynamic, and Trauma-Informed: Weekly Individual Supervision Weekly Group Supervision Monthly Didactic Seminars Timeline We are seeking an immediate hire. Your official start follows insurance credentialing (typically up to 90 days). You'll integrate with the team during credentialing to launch smoothly into a full caseload. How to Apply Please email your resume alongside a brief cover letter describing your clinical background, trauma expertise, and fit for a relational practice. Apply Now: Email aMillerU@tltherapy.com → *We are not accepting applicants at the pre-licensed or associate level license at this time. ===================================================================== URL: https://turningleaftherapyservices.com/policies-and-forms/ ===================================================================== Home / Policies and Forms the practical part Policies and Forms Intake paperwork, practice policies, and consent forms are provided electronically before your first session. If you would like copies in advance, or in another format, call us at (215) 399-4128 and we will send them along. what to expect notice of privacy practices Provided with your intake paperwork and available any time on request. good faith estimate Self-pay clients receive a Good Faith Estimate of expected charges before the first session, as required by the No Surprises Act. More at cms.gov/nosurprises or 800-985-3059. superbills Provided after every session on request, for out-of-network reimbursement. payment Credit, debit, HSA, and FSA cards, collected at the time of service. No cash or checks. If you are in crisis, call or text 988 , or call the Philadelphia Crisis Line at (215) 685-6440 . request an appointment Ready to begin? The intake takes about five minutes, and the paperwork follows once you are matched. Request your match → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/blog/ ===================================================================== Home / Blog from the practice The blog. Essays and guides from our clinicians: trauma, parenting, relationships, and the thinking behind depth-oriented care. GETTING STARTED What to expect at your first therapy session A structured getting-to-know-you conversation, 53 minutes, no couch and no requirement to tell your hardest story on day one. Here is how intake and the first session actually work. Kaycee Beglau, PsyD TRAUMA & EMDR Is EMDR Right for You? An Honest Guide EMDR is everywhere on social media. An EMDR-trained clinician on what it does well, where it falls short, and how to choose what your healing actually needs. Kaycee Beglau, PsyD INSURANCE How to Find a Therapist in Philadelphia Who Takes Your Insurance Ghost networks, full caseloads, and the Blue Cross confusion, sorted. A step-by-step guide to finding an in-network therapist in Philadelphia. Kaycee Beglau, PsyD INSURANCE Using insurance for therapy in PA and NJ: deductibles, copays and superbills, explained simply Yes, PA and NJ plans cover therapy. Deductibles, copays and superbills explained simply, plus scripts for calling your insurer. Kaycee Beglau, PsyD KAYCEE BEGLAU, PSYD How Much Does Therapy Cost in Philadelphia? What therapy really costs in Philadelphia in 2026: self-pay $130 to $200, most in-network clients pay a $15 to $50 copay, plus five ways to pay less. KAYCEE BEGLAU, PSYD Transform a Tantrum: 3 Powerful Steps to Calm an Out-of-Control Child A 3-step co-regulation approach to calming a meltdown, without punishment, threats, or timeouts. KAYCEE BEGLAU, PSYD 6 Steps to Help Someone Get Out of a Flashback A first aid kit for flashbacks: concrete grounding steps to help a loved one return to the present. KAYCEE BEGLAU, PSYD 5 Steps to Find the Courage to Get the Help You Need After Abuse or Trauma How to safely choose a therapist after abuse or trauma: vet credentials, trust your gut, and stay in control. KAYCEE BEGLAU, PSYD Trauma: A Word with Different Meanings Big-T and little-t trauma explained, and why both deserve care even when the world does not call them trauma. KAYCEE BEGLAU, PSYD “It’s All My Fault”: Why Do I Blame Myself for My Trauma? Self-blame after trauma is a protective illusion of control. Understanding it is the first step toward releasing it. KAYCEE BEGLAU, PSYD The Lost Childhood: Role Reversal and the Parentified Child When a child becomes the parent’s caretaker, the costs follow them into adulthood. Healing is possible. KAYCEE BEGLAU, PSYD The Differences and Useful Benefits of Seeing a Pre-Licensed Professional What a pre-licensed therapist is, how supervision works, and why it can make quality therapy more affordable. SAMARA PEREZ, LPC Trauma Responses After Sexual Assault, Explained Hypervigilance, dissociation, sleep changes: why the body responds this way, and what healing can look like. KATIE FRIES, LCSW, RPT (GUEST) How to Help Your Child with Transitions Starting middle school or facing a big change? Three ways parents can help tweens cross the bridge with confidence. ALISA STAMPS, MSS, LCSW (GUEST) Gaslighting: The Artistry of a Narcissist What gaslighting is, why narcissists use it, and how targets can learn to trust their own reality again. ALISA STAMPS, MSS, LCSW (GUEST) Boundaries: A Narcissist’s Scorched Earth Why saying no feels impossible after narcissistic abuse, and how to start holding the line anyway. ===================================================================== URL: https://turningleaftherapyservices.com/blog/therapy-cost-philadelphia/ ===================================================================== Home / Blog / Therapy Cost in Philadelphia FROM THE BLOG How much does therapy cost in Philadelphia? A 2026 guide to rates, copays & insurance Written by Kaycee Beglau, PsyD Reviewed and updated July 2026. ON THIS PAGE Therapy costs at a glance (Turning Leaf, 2026) What determines the price of therapy in Philadelphia What you will actually pay with insurance If we are not in-network with your plan (IBX, Cigna, Medicare, Medicaid) Five ways to make therapy more affordable in Philadelphia What you are actually paying for Getting started (and what happens after you reach out) Frequently asked questions The short answer: In Philadelphia, private-practice therapy generally runs about $120 to $250 per session. At Turning Leaf Therapy, sessions are $130 to $200 self-pay , depending on your clinician’s license level, and most clients who use in-network insurance pay far less: a $15 to $50 copay per session once their deductible is met. The longer answer depends on your insurance plan, the clinician you work with, and how you structure your care, so this guide walks through every number in plain English. And if you would rather skip the math: our intake team verifies your exact benefits for free before your first session, and you will be matched with a therapist within 1 to 2 business days. Therapy costs at a glance (Turning Leaf, 2026) How you pay What a session costs In-network insurance, after deductible Typically a $15 to $50 copay Self-pay, associate-level clinicians (LSWs, LAPCs) Starting at $130 Self-pay, senior and doctoral-level clinicians $175 to $200 Your exact cost depends on your plan and clinician, and we confirm your numbers before you book anything. Full details on our rates page . What determines the price of therapy in Philadelphia Three things move the number more than anything else. Your clinician’s license level. Therapy is delivered by professionals at different career stages: associate-level clinicians (in Pennsylvania, licenses like LSW and LAPC) practicing under senior supervision, fully licensed therapists, and doctoral-level psychologists. At Turning Leaf, that is why our range runs from $130 to $200: you can choose the level that fits your budget without leaving the practice. Specialization. Clinicians with advanced training in areas like trauma, eating disorders, or grief often charge toward the top of a practice’s range. That training matters when your concern is specific: it is the difference between general support and someone who has seen your exact situation many times. What kind of therapy it is. Brief, skills-focused work and longer-term, depth-oriented work are priced per session the same way, but they play out differently over time. Turning Leaf practices relational, depth-oriented therapy , the kind aimed at the patterns underneath the symptoms, and we would rather be upfront: for some people that is a few months of work; for others it is longer. Your therapist will talk timeline with you honestly, starting in the first sessions. What you will actually pay with insurance Turning Leaf is in-network with: Aetna, United Healthcare / Optum, Highmark BCBS, Capital Blue Cross, Anthem, Empire & FEP BCBS, and Horizon BCBS NJ. Typical copay: $15 to $50 per session after deductible. We are not in-network with Independence Blue Cross or Cigna , and we provide superbills for out-of-network reimbursement (details below). Insurance language is where most people give up, so here is the 60-second version: Deductible: the amount you pay out of pocket each year before your plan starts sharing costs. Until you hit it, you may pay your plan’s negotiated session rate (usually lower than the self-pay price). Copay: the flat amount you pay per session once the deductible is met. For most of our in-network clients, this lands between $15 and $50. Coinsurance: some plans use a percentage instead of a flat copay (say, 20 percent of the session rate). An example (illustrative, every plan differs): Sarah has an Aetna plan with a $1,500 deductible and a $30 copay for outpatient mental health. Early in the year, she pays the plan’s negotiated rate per session until her deductible is met. After that, every session is $30. Some plans skip the deductible for mental-health visits entirely and start at the copay from day one, which is why the only numbers that matter are yours . You do not have to figure this out alone. Tell our intake team your plan when you reach out , and we will verify your benefits and tell you your expected per-session cost before your first appointment. For a deeper walkthrough of deductibles, superbills, and the questions to ask your insurer, see our insurance guide . If we are not in-network with your plan (IBX, Cigna, Medicare, Medicaid) Independence Blue Cross is the biggest commercial insurer in the Philadelphia region, and we want to be straightforward: we are not in-network with IBX , or with Cigna, Medicare, or Medicaid. If that is your plan, you still have a real option: the superbill . Here is how it works: You pay the session rate directly ($130 to $200). We give you a superbill, an itemized receipt with everything your insurer needs. You submit it to your plan. Many PPO plans with out-of-network benefits reimburse 50 to 80 percent of the allowed amount after your out-of-network deductible, and your insurer can tell you the exact percentage in one phone call. Ask your plan two questions: “Do I have out-of-network outpatient mental health benefits?” and “What is my out-of-network deductible and reimbursement rate?” Our intake team can walk you through what the answers mean. Five ways to make therapy more affordable in Philadelphia 1. Start with your in-network benefits. If your plan is on the list above, your realistic cost is likely a $15 to $50 copay, not the sticker price. This is the single biggest lever, and checking takes one message to our intake team. 2. Ask about associate-level clinicians. Sessions with our associate-level therapists (LSWs and LAPCs, supervised by senior clinicians) start at $130, and at many practices this tier is where some of the most dedicated, current, carefully supervised care happens. 3. Use HSA or FSA dollars. Psychotherapy is generally an eligible expense, which means you can pay with pre-tax money, an effective discount for many people depending on your tax bracket. Check with your plan administrator. 4. Talk frequency with your therapist. Most people start weekly to build momentum; some later move to biweekly as things stabilize. That is a clinical conversation, not a billing one, but it is yours to have, openly, at any time. 5. Choose telehealth when it helps. Online sessions cost the same and are covered the same by in-network plans, but they eliminate commuting, parking, and childcare costs, which for a weekly appointment adds up fast. We see clients via secure telehealth across Pennsylvania and New Jersey. If cost is the thing standing between you and starting, tell our intake team. We also keep a limited number of reduced-fee spots for clients experiencing financial hardship, and they will lay out every option your situation allows. What you are actually paying for A fair question. A therapy session is a protected 53 minutes with a licensed professional whose full attention is on one thing: understanding how your mind and your history work, and helping you change what is not working. About 75 percent of people who enter psychotherapy show some benefit, according to the American Psychological Association, which also finds that the quality of the therapist-client relationship is one of the strongest predictors of results. That last part is why we structure the practice the way we do: 26 clinicians with distinct specialties, and an intake process built to match you with the right one rather than the first one available. Whether you come in for anxiety , depression, trauma, or something you cannot quite name yet, the fit is the investment. Getting started (and what happens after you reach out) 1 Reach out. Use the button below or call 215-399-4128 . Forms sent tonight are answered first thing the next business day. 2 A short intake conversation. A real person, not a bot, learns what is going on and verifies your insurance benefits. 3 You are matched. Within 1 to 2 business days, you are paired with a clinician whose specialty and style fit you, at our Old City office (123 Chestnut Street, Suite 304, two blocks from the 2nd Street Market-Frankford Line station) or via telehealth anywhere in Pennsylvania and New Jersey. NOW ACCEPTING NEW CLIENTS Start your intake A short, adaptive form: it asks only what applies to you, including your insurance plan and what brings you in. About five minutes. Our intake team reviews it personally and verifies your benefits before your first session. Get matched → Call 215-399-4128 Want to see who you might work with first? Meet the team , 26 clinicians filterable by specialty. Frequently asked questions How much does therapy cost with insurance in Philadelphia? With an in-network plan at Turning Leaf, most clients pay a $15 to $50 copay per session after their deductible, and some plans start at the copay immediately. We verify your exact benefits for free before your first session. Do you offer a sliding scale? Our rates run $130 to $200 by clinician level. The most affordable paths are in-network insurance (a $15 to $50 copay for most), associate-level clinicians starting at $130, and HSA or FSA pre-tax dollars. We also keep a limited number of reduced-fee spots for clients experiencing financial hardship; if cost is the thing standing between you and starting, tell our intake team and they will lay out every option your situation allows. Is online therapy cheaper than in-person? The session rate and insurance coverage are the same, but telehealth saves the commute, parking, and childcare costs around a weekly appointment. Research finds online therapy is as effective as in-person for most concerns. Is therapy worth the cost? The honest answer: it depends on fit and engagement, which is exactly why we invest so much in matching. Most people begin weekly, many notice real shifts within the first couple of months, and deeper pattern-level change takes longer. What you are buying is not a session, it is a different relationship with the things that keep costing you. Do I need a diagnosis for insurance to pay? In-network plans generally require a clinical diagnosis for reimbursement, and your therapist will discuss this with you transparently. Our insurance guide covers what that means for privacy and records. Turning Leaf Therapy at a glance: Depth-oriented, trauma-informed therapy in Old City, Philadelphia (123 Chestnut Street, Suite 304) and via secure telehealth across Pennsylvania and New Jersey. In-network with Aetna, United Healthcare / Optum, Highmark BCBS, Capital Blue Cross, Anthem / Empire / FEP BCBS, and Horizon BCBS NJ; typical copays $15 to $50 after deductible. Self-pay $130 to $200. Matched with a therapist within 1 to 2 business days. 215-399-4128. This article is educational and is not a substitute for professional care, diagnosis, or individualized financial advice. If you are in crisis or thinking about harming yourself, call or text 988 (Suicide and Crisis Lifeline), text HOME to 741741 (Crisis Text Line), call the Philadelphia Crisis Line at 215-685-6440, or go to your nearest emergency room. Request your match → Or call (215) 399-4128 ===================================================================== URL: https://turningleaftherapyservices.com/blog/find-a-therapist-philadelphia-insurance/ ===================================================================== Home / Blog / Find a Therapist Who Takes Insurance FROM THE BLOG How to find a therapist in Philadelphia who takes your insurance (Aetna, United, Highmark & more) Written by Kaycee Beglau, PsyD Reviewed and updated July 2026. ON THIS PAGE Why finding an in-network therapist feels impossible (it's not you) Step 1: Decode your insurance card (60 seconds) Step 2: Ask any practice these three questions before you book Step 3: Get your real costs verified before your first session Plan-by-plan: what to know in Philadelphia If your plan is not listed (IBX, Cigna, Medicare, Medicaid) Skip the search: tell us your plan and we will do the rest Frequently asked questions The short answer: finding an in-network therapist in Philadelphia comes down to three steps: know what is actually on your insurance card, ask any practice three specific questions before you book, and get your benefits verified in writing before your first session. If your plan is Aetna, United Healthcare / Optum, Highmark BCBS, Capital Blue Cross, Anthem / Empire / FEP BCBS, or Horizon BCBS NJ, Turning Leaf Therapy is in-network. Tell us your plan and we will verify your benefits and match you with a therapist within 1 to 2 business days. If you have already spent an evening calling names off a directory and getting voicemails, this guide is for you. Why finding an in-network therapist feels impossible (it's not you) Here is what usually happens: you search your insurer’s directory, find fifteen therapists “in-network, near you,” and start calling. Half never call back. A few are not taking new clients. One left that insurance network two years ago. This is so common it has a name: ghost networks. A 2023 U.S. Senate Finance Committee secret-shopper study of insurer directories found that a large share of listed mental-health providers were unreachable, out of network, or not accepting new patients. So if the search has felt discouraging, nothing is wrong with you; the directories are broken. What works better is flipping the process: instead of calling solo practitioners one by one, contact a group practice with many clinicians and let them do the matching. A practice like ours has 26 therapists across specialties, from anxiety and depression to trauma and grief, which means “accepting new patients” is almost always true for someone who fits you. Step 1: Decode your insurance card (60 seconds) Three things on your card matter more than everything else: The carrier and plan name — not just “Blue Cross” but which Blue Cross (this matters enormously in Philadelphia, see below). The plan type — PPO, HMO, EPO. Most plans cover outpatient therapy without a referral, though some HMOs have extra steps. The behavioral health number on the back. Some plans route mental-health benefits through a separate company than medical care. The classic example is a UnitedHealthcare card whose therapy benefits actually run through Optum. If your card lists a separate behavioral or mental health line, that is the network that counts for therapy. You do not need to master any of this; you just need to be able to read it off the card to whoever is verifying your benefits. Step 2: Ask any practice these three questions before you book 1. “Are you in-network with my exact plan? I have [carrier and plan name].” A good answer is specific: “Yes, we are in-network with Aetna, and we will verify your individual benefits before your first session.” A red flag is vague: “We take most insurance.” 2. “Are you accepting new patients, and how long until I am actually seen?” A good answer has a number in it. At Turning Leaf, you are matched with a clinician within 1 to 2 business days, and your first session is scheduled directly with them based on mutual availability. “We will put you on the waitlist” is an answer too, just not one you have to settle for. 3. “Who on your team specializes in what I am coming in for?” In-network only matters if the fit is right. A good practice matches you to a clinician by specialty and style, not to whoever has an opening. You can meet our clinicians on the team page . Step 3: Get your real costs verified before your first session “In-network” tells you a therapist is covered; it does not tell you your number. Depending on your deductible and copay, in-network therapy at Turning Leaf typically lands between $15 and $50 per session. The full math, including what happens before your deductible is met, is in our Philadelphia therapy cost guide . The verification itself should not be your job. Tell our intake team your plan when you reach out , and we confirm your expected per-session cost before you commit to anything. For the deeper insurance mechanics, deductibles, superbills, and the questions to ask your insurer, see our insurance guide . Plan-by-plan: what to know in Philadelphia Aetna Turning Leaf is in-network with Aetna plans. Most Aetna clients at our practice pay a copay in the $15 to $50 range after deductible, and many Aetna plans apply the copay from the first session. We verify your specific plan before you start. United Healthcare & Optum In-network. Here is the detail that trips people up: UnitedHealthcare typically administers therapy benefits through Optum. Your card may say UHC while your therapist gets listed in the Optum network, same coverage, different name on the directory. If you have been searching “UHC therapist Philadelphia” and finding chaos, this is why. We are in-network on the Optum side, which is what counts. Highmark & the Blue Cross family (read this if your card says “Blue”) This is Philadelphia’s biggest insurance confusion, so plainly: “Blue Cross” is not one network. Highmark BCBS and Independence Blue Cross (IBX) are different companies with different networks, and in the five-county Philadelphia region, many people carry IBX. In-network with us: Highmark BCBS, Capital Blue Cross, Anthem BCBS, Empire BCBS, and FEP BCBS (the federal employee program). Not in-network: Independence Blue Cross (IBX). We would rather tell you in paragraph one than after you have filled out a form. If you have IBX, the out-of-network route below can still make care workable. Check your card for the company name in small print; that one detail saves you a week of misdirected calls. Horizon BCBS (New Jersey) In-network, and because select Turning Leaf clinicians are licensed in New Jersey, Horizon members can see us via secure telehealth from anywhere in NJ, no trip across the bridge required. South Jersey residents: this is the shortcut. A note for crime victims (PA VCAP) Pennsylvania’s Victims Compensation Assistance Program can cover counseling costs for eligible crime victims, and Turning Leaf accepts VCAP. If this applies to you, mention it when you reach out and our intake team will walk you through it with care. If your plan is not listed (IBX, Cigna, Medicare, Medicaid) We are not in-network with IBX, Cigna, Medicare, or Medicaid, but out-of-network does not automatically mean unaffordable. If your plan includes out-of-network mental health benefits (many PPOs do), you pay the session rate, we hand you a superbill, an itemized receipt built for reimbursement, and your insurer pays a portion back after your out-of-network deductible. One call to your insurer answers the two questions that matter: “Do I have out-of-network outpatient mental-health benefits?” and “What is my reimbursement rate?” The full walkthrough, plus five other ways to lower the cost, is in our cost guide . Skip the search: tell us your plan and we will do the rest 1 Reach out using the button below or call 215-399-4128 . Forms sent tonight are answered first thing the next business day. 2 A real person verifies your benefits. You will know your expected per-session cost before you commit. 3 You are matched within 1 to 2 business days with one of our 26 clinicians, by specialty and style, not by who happens to have a gap, at our Old City office (123 Chestnut Street, Suite 304) or via telehealth anywhere in Pennsylvania and New Jersey. NOW ACCEPTING NEW CLIENTS Skip the directory. Tell us your plan. A short, adaptive form: it asks only what applies to you, including your insurance plan and what brings you in. About five minutes. Our intake team reviews it personally and verifies your benefits before your first session. Get matched → Call 215-399-4128 Want to see who you might work with first? Meet the team , 26 clinicians filterable by specialty. Frequently asked questions Does insurance cover online therapy in Pennsylvania? Generally yes. The in-network plans we accept cover telehealth sessions the same as in-person, with the same copays. That applies across PA and, for Horizon members and other NJ plans we accept, across New Jersey. My card says UnitedHealthcare, but the therapist directory says Optum. Which is right? Both. Optum administers behavioral health for most UHC plans, so therapists appear in Optum’s directory. If a practice says it is in-network with Optum, your UHC therapy benefits almost certainly apply, and verification confirms it. Can I switch therapists without restarting my deductible? Yes. Deductibles belong to your plan year, not to a provider. Anything you have already paid toward it counts, whether you switch therapists within a practice or change practices entirely. Within Turning Leaf, switching to a better-fit clinician is a normal, no-hard-feelings request. Do you take Medicaid, Medicare, or Independence Blue Cross? Not in-network, and we believe in saying so clearly. For IBX and Medicare plans with out-of-network benefits, superbill reimbursement can meaningfully offset costs. If superbills will not work for your situation, ask our intake team and they can point you toward reputable local options rather than leave you searching alone. How fast can I actually be seen? You are matched with a clinician within 1 to 2 business days of reaching out. Your first appointment is then scheduled directly with your therapist based on your mutual availability, and evening and telehealth options can speed that up. Turning Leaf Therapy at a glance: Depth-oriented, trauma-informed therapy in Old City, Philadelphia (123 Chestnut Street, Suite 304) and via secure telehealth across Pennsylvania and New Jersey. In-network with Aetna, United Healthcare / Optum, Highmark BCBS, Capital Blue Cross, Anthem / Empire / FEP BCBS, and Horizon BCBS NJ; typical copays $15 to $50 after deductible. Not in-network with Independence Blue Cross or Cigna (superbills provided). Matched with a therapist within 1 to 2 business days. 215-399-4128. This article is educational and is not a substitute for professional care or individualized insurance advice; always confirm benefits with your plan. If you are in crisis or thinking about harming yourself, call or text 988 (Suicide and Crisis Lifeline), text HOME to 741741 (Crisis Text Line), call the Philadelphia Crisis Line at 215-685-6440, or go to your nearest emergency room. Request your match → Or call (215) 399-4128 ===================================================================== URL: https://turningleaftherapyservices.com/privacy-policy/ ===================================================================== Home / Privacy Policy legal Privacy Policy Turning Leaf Therapy, LLC protects the privacy of everyone who visits this site and everyone we treat. Our full Notice of Privacy Practices, which describes how protected health information may be used and disclosed under HIPAA and how you can access your records, is provided with your intake paperwork and is available any time on request. For questions about how information you share through our intake form is handled, or to request a copy of the Notice of Privacy Practices, call us at (215) 399-4128 . ===================================================================== URL: https://turningleaftherapyservices.com/terms-of-service/ ===================================================================== Home / Terms of Service legal Terms of Service The content on this website is provided for general information about our practice. It is not medical advice, diagnosis, or treatment. Using this site does not create a therapist-client relationship. That relationship begins only after you complete intake and consent paperwork with one of our clinicians. If you are in crisis, do not use this website to seek help: call or text 988 , or call the Philadelphia Crisis Line at (215) 685-6440 . Questions about these terms can be directed to us by phone at (215) 399-4128 or through our contact form . ===================================================================== URL: https://turningleaftherapyservices.com/accessibility/ ===================================================================== Home / Accessibility our commitment Accessibility Turning Leaf Therapy is committed to a website that everyone can use. This site is built to meet WCAG 2.1 AA: semantic structure, full keyboard operability, visible focus states, text contrast of at least 4.5:1, descriptive alternative text on meaningful images, labeled forms, and respect for reduced-motion preferences. It is tested with keyboard-only navigation and screen readers. If any part of this site is difficult for you to use, tell us and we will fix it or provide the content in a format that works for you: call us at (215) 399-4128 . Our office at 123 Chestnut Street, Suite 304, is two flights up; contact us before your first visit and we will discuss access arrangements or arrange telehealth instead. ===================================================================== URL: https://turningleaftherapyservices.com/transform-a-tantrum-3-powerful-steps-to-calm-an-out-of-control-child/ ===================================================================== Home / Blog / Transform a Tantrum FROM THE BLOG Transform a Tantrum: 3 Powerful Steps to Calm an Out-of-Control Child Written by Kaycee Beglau, PsyD Reviewed and updated August 2026. ON THIS PAGE 1. Stay Calm 2. Wait 3. Offer Co-Regulation Questions people ask Tantrums are most often communication of an unmet need that arises in response to a child’s nervous system being activated and going into fight-or-flight. Once you understand this, you will also understand that the child does not need to be punished in order for the tantrum to end (and that actually this can cause them to shut down when they really need your support). But you may be wondering what to do instead. I am going to break this approach down into 3 basic steps, as a place to start for anyone who is trying to understand how to “break the cycle” and parent differently in a more considerate and respectful way. Why Tantrums Happen The truth is, and this may be shocking for anyone who grew up with discipline and behavior-focused parents, that tantrums are literally a stress response in your child’s nervous system. Whatever the original trigger is, this has set off a stress response (aka, the fight-or-flight response) in their nervous system. Their little bodies are totally overwhelmed and they feel completely out of control when this is happening and they are unable to calm down or even process what you are saying in the heat of the moment. What does this mean? It means that they need help from you in order to calm down first before anything else can happen. When they are having a meltdown, and someone is yelling at them or making threats to take something away if they don’t stop, they literally cannot “hear” this or process it and then simply choose to do something different in that moment, no matter how much they might want to. Being placed in a time-out means they are forced to be alone to calm themselves down when in reality, little children do not yet have this ability (developmentally speaking). They require co-regulation, or help from a safe, secure “other,” in order to calm their bodies and to be able to hear and think and process again. 1. Stay Calm If this is the only thing you can accomplish, then this is a lot! Staying calm is most often the hardest and most important part of the process. Any activation in your nervous system will feed into the activation in your child’s body and nervous system. It’s like pouring fuel on the fire. So, do whatever it is that you need to do to keep yourself calm, to refrain from raising your voice, or even making passive-aggressive or shaming comments or non-verbal sounds or facial expressions (we all know the eye roll or the loud sigh, don’t we?). 2. Wait Get down on their level in a non-threatening way. Sit on the floor with your legs crossed and your arms in an open, non-threatening position. You can offer validation of their emotions, not of their behavior. For example, stating something like, “I can see you’re feeling really angry. It’s not ok to throw your blocks, but I get that you’re upset and that’s ok.” If validation seems to increase their emotional reactivity, just be silent but present. You can model for them how to take some deep breaths by doing this yourself if you feel like you must “do something.” But really, the child just needs to know you are there with them, they are safe in your presence, and you are there waiting to reconnect with them once they are ready. 3. Offer Co-Regulation Offer to give a hug. If they reject the hug, say “that’s ok, I am here when you are ready.” Give the child some space by remaining present and quiet, and then you can say “are you ready for a hug, now? Let me know when you would like a hug.” Don’t force the hug, but continue to let them know you are here to help them and that you aren’t mad at them and they aren’t in trouble. Often the child just needs a moment to feel their feelings and then they will eventually gladly accept the hug. Hugs are often a magical way to calm the body and reconnect. If your child doesn’t want a hug, you can try offering another calming activity that you know they will find helpful. For example, saying “do you want to blow the angries out with me?” and demonstrating taking some deep breaths and blowing the air out through your mouth or blowing actual bubbles with them. Maybe they want to color really hard with a crayon of their choice or squeeze a teddy bear really hard. This part takes some trial and error, but finding strategies to help the child release the emotional energy that they are feeling in their body, along with you as their safe and secure base , can help them re-regulate the intensity of the emotions that they are experiencing. Once the child is in a more regulated state, you can then talk to them about what happened that got them so upset in the first place. Maybe you want to explain a boundary to them or teach them that certain behaviors are not acceptable, such as throwing items or hitting their sibling. Whatever it is that you want to teach them, the time to do it is after they are fully regulated and feel reconnected to you. Then, they can actually listen, process, and integrate the lesson you want to teach them. Of course, in real life, these three simple steps are often much more difficult to implement than what a blog might imply. It takes time to try things out, to find what works for your specific child, and to also understand that the effectiveness of solutions like this build gradually over time (meaning, this is not meant to be a quick-fix solution). But, with practice over time, your child will be building new neural pathways through the co-regulation process with you, so that as they get older, they will eventually be able to self-regulate and feel confident and connected with you as their parent. If you are struggling with knowing how to respond to your child in a responsive, assertive, but connected way, it can be really helpful to work with a child and family therapist that can demonstrate, model, and coach you through this process. If you are looking for such support, our therapists specialize in helping parents do just this. Learn more about child therapy at Turning Leaf or contact us to schedule an appointment. RELATED READING How to Help Your Child with Transitions → Questions people ask What is co-regulation? Co-regulation means calming your child's nervous system by borrowing the steadiness of yours: staying calm, getting on their level, and offering comfort until their body settles. Young children cannot self-regulate yet, so they need a calm adult to do it with them. What if my child refuses a hug during a meltdown? That is okay. Stay near, keep your voice warm, and let them know you are there when they are ready. You can offer another kind of release, like taking deep breaths together, coloring hard, or squeezing a stuffed animal. Should I punish my child for tantrums? Punishment does not reach a tantrum, because a tantrum is a stress response, not a choice. In the moment your child cannot process consequences; they need help calming their nervous system first, and any teaching comes after they are regulated. When is a tantrum a sign of something more? Occasional meltdowns are developmentally normal. Consider extra support if tantrums are unusually intense or frequent, last well beyond the toddler years, or come alongside other changes in mood, sleep, or behavior. Request your match → Or call (215) 399-4128 ===================================================================== URL: https://turningleaftherapyservices.com/6-steps-to-help-someone-get-out-of-a-flashback/ ===================================================================== Home / Blog / Helping With Flashbacks FROM THE BLOG 6 Steps to Help Someone Get Out of a Flashback Written by Kaycee Beglau, PsyD Reviewed and updated July 2026. ON THIS PAGE What to Look For What to Do Key Points to Keep in Mind Questions people ask Whether it’s a friend, relative, or partner, we sometimes find ourselves with someone who suddenly begins to experience the acute effects of trauma . This typically presents as sudden fear or panic, flashbacks, intrusive negative thoughts related to the trauma, or dissociative states where the person appears to “not really be there” anymore. Of course, these experiences may be frightening, confusing, and overwhelming for the person experiencing them, and they may also be for the person witnessing them as well. If you are in a relationship with someone who frequently experiences these symptoms in your presence, it may be beneficial and empowering to have a sense of what might be helpful for the person in that situation. However, it is important to note that the purpose of this article is to highlight some quick and concrete strategies to help the person re-orient or “ground” during or after an acute trauma reaction, and it is not intended to imply that anyone in a personal relationship with another trauma survivor should take on the role of being an actual therapist. Think of the information in this article as a “first aid kit” for flashbacks: it’s to help you when you need it and should not be used in place of actual treatment from a trained professional . What to Look For Sudden difficulties communicating or responding Person seems disoriented Frozen, wide-eyed stare, clenched or fluttering eyes Inability to make eye contact Dysregulated, uncontrollable flood of emotions, such as crying, screaming, shaking (panic) Calling out for help, repeatedly saying “no” or trying to run away Curling into a fetal position or trying to hide Seemingly unaware of or disconnected from the present Making movements or gestures as if responding to something that is not really there What to Do 1. DO NOT TOUCH someone (even a loved one) in an active flashback. This may be extremely triggering for them and the physical touch may inadvertently be experienced as part of the traumatic memory/flashback. As they are starting to come out of it and are becoming more oriented, it’s ok to ask permission to touch them (for example, placing a hand on their shoulder, a safe embrace, or using touch to guide the person to a better location). If they say “no” or appear to shudder or recoil, respect this as an indication the person does not want to be touched at that time. 2. Do not ask them to talk about the flashback details. It’s ok to ask if they are having a bad memory or if they feel like something bad is happening to them right now. It’s important to keep in mind that if a person is having a flashback, they are overwhelmed and flooded. This is not the time to try to get them to talk about anything related to the trauma. They need help coming back to the present moment, regulating their nervous system, and feeling safe again. 3. Orient to present time and surroundings. Identify yourself and announce where you are and say something present-oriented, such as your name and relation to the person, even if they know you well. Let them know where you are and remind them they are safe in the present moment. For example: “Laura, this is Sarah, your sister. You are here with me in your house in Florida. Today is [say the day and date]. It’s just me and you and nothing bad is happening to you right now. You’re safe here with me.” 4. Use a warm, but firm voice to give instructions. Ask them to listen to the sound of your voice. Ask them to indicate they can hear you and know who you are. It’s very helpful to get a person in a flashback to open their eyes and begin looking around the room. This is key in helping them gradually be able to realize they are in the present (where it’s safe), as opposed to in the past when the traumatic experience actually occurred. Repeat this in a calm, but firm voice until they are able to do so. Ask the person to look around the room and name as many colors as they can, name the objects they see, find something close by that makes them feel safe and comforted (e.g., a beloved pet, a favorite blanket, an article of clothing or a piece of jewelry) and ask them to hold on to it and describe it to you in as much detail as possible. Instruct the person to put both feet on the floor to literally “ground” them in the present moment. I like to ask people to wiggle their toes, gently press their heels into the floor, and to notice what it feels like to be supported by the ground beneath them. 5. Repeat grounding or safety phrases as much as needed. Again, continue to use a warm, but firm voice consistently. The person may be relying on the presence of a supportive voice to “guide” them out of the flashback experience. You can continue to say things like: It’s ok, you are here with me now. It’s all over, you have already survived this. He/she/they can’t hurt you anymore. You are safe, you aren’t in danger anymore. You are no longer in __________ (e.g., parent’s house, city or country of traumatic event, etc.) You are an adult now, which means you are safer, you have more resources, you have more choices. 6. If necessary, continue with more structured breathing or grounding exercises. If the person is hyperventilating or appears to be panicking, you can ask them to take some slow, deep breaths with you. It can help to mirror this for them and do it along with them. Ask them to notice what their breath feels like as they breathe in and then to notice what it feels like to breathe out. See if they can take a deep breath in for the count of 4 and then breathe out for a count of 4. Repeat until breathing has stabilized. For further grounding strategies, continue to ask the person to look around the room as much as possible. You can transition to using all 5 senses (sight, sound, smell, taste, and touch) if something “stronger” is needed. Ask the person to name 5 things they see, 4 things they touch, 3 things they hear, 2 things they smell, and 1 thing they taste. Feel free to offer assistance by giving access to scented candles or lotions, mints or chewing gum, or anything else that would likely be soothing. Key Points to Keep in Mind Be warm, firm, and consistent Be calm and patient and don’t give up Do not push and try not to get scared or frustrated yourself Repeat as much as necessary and don’t worry about sounding like a “broken record” Once the person is fully out of the experience, you can ask the person for feedback about what was helpful and what wasn’t. Make a plan for next time and please follow up with professional help if needed. If flashbacks are happening often or feel unmanageable, trauma-focused treatment can address the memories that drive them. Our EMDR therapy page describes one of the approaches our clinicians use to help the nervous system reprocess what it has been carrying. Questions people ask What should I not do when someone is having a flashback? Do not touch them without permission and do not press them to talk about the trauma. Both can intensify the flashback. Focus instead on helping them feel safe and oriented to the present moment. How do I ground someone during a flashback? Use a calm, firm voice, say who you are and where they are, and invite them to open their eyes, look around, name colors or objects, and place their feet on the floor. Repeat reassurance until they return to the present. Request your match → Or call (215) 399-4128 ===================================================================== URL: https://turningleaftherapyservices.com/5-steps-to-find-the-courage-to-get-the-help-you-need-after-abuse-or-trauma/ ===================================================================== Home / Blog / Finding Courage to Start Therapy FROM THE BLOG 5 Steps to Find the Courage to Get the Help You Need After Abuse or Trauma Written by Kaycee Beglau, PsyD Reviewed and updated July 2026. ON THIS PAGE 1. Do Your Research 2. Ask for an Initial Consultation 3. Listen to Yourself 4. Ask Questions 5. Go Slow and Take Control Questions people ask Beginning therapy for the first time or with a new therapist can be a scary, terrifying situation. This can be true for anyone, but especially for people who have experienced any kind of abuse or trauma. There may be a part of you that acknowledges you need help, but another part (or parts) of you that are afraid to seek help or believe that it is pointless. Having the ability to trust another person with these deepest, darkest aspects of yourself or your history may seem impossible. Still, it may be terrifying to even think about talking about the trauma or abuse, and you may believe this is what will be required of you in order to be in therapy. Additionally, many people with trauma or abuse histories have, unfortunately, had bad or traumatizing experiences with therapists or other mental health professionals. Of course, if this has happened to you, it understandably makes it even more difficult and scary to make the decision to try therapy again. These are just a few of the things that can make it difficult and scary to seek help from a therapist. Still, therapy has the potential to offer a healing relationship, increased stability, and hope for the future. Although it may feel like a risk, seeking help from a healthcare professional is a healthy risk. Here are 5 steps you can take to make finding a new therapist a little less scary. 1. Do Your Research Chances are, if you are reading this post, you are really good at finding information on the internet. Many people find their therapists online, and are used to reading therapist profiles , websites, blog posts, etc. While this is a great place to start, it doesn’t have to stop there. Feel free to look up the school and program where the therapist graduated from and any trainings attended. If a therapist reports using a specific therapeutic approach or technique that you are not familiar with, take the time to look into it. Make sure it looks like the therapist’s background, training, and approach are consistent with your thoughts and the direction you want to go in therapy. Although this does not ensure a good fit, it can help give you some peace of mind, knowing as much as possible about the potential new therapist. For people with a history of severe or prolonged childhood abuse, dissociative symptoms, and/or self-injurious or suicidal thoughts/feelings, I highly recommend finding someone who specializes in these problems . 2. Ask for an Initial Consultation Many people do not realize you can “therapist shop” or meet with multiple therapists to interview them before actually starting therapy. This can help take some of the pressure off and give you some space to get a sense of what might be the most helpful for you and to reflect on your feelings without feeling “trapped” or “obligated” to return. Therapy works best when there is a good fit between the therapist and the client. There is no point in trying to force a good fit, when there is likely a better fit out there. Many therapists are glad to offer a brief initial consultation when they know someone would like to interview them before beginning therapy. It is perfectly ok to ask for this option when making the initial contact with a potential new therapist. 3. Listen to Yourself We often have a little voice inside or a feeling telling us information about what we may need. If you are like me, it is sometimes difficult to trust that voice or that feeling. It is much easier to minimize that, brush it off, or even criticize it. But actually, there is a lot of wisdom in what these experiences tell us and it’s important to not only listen to that, but to also trust it. If there is a part of you saying you don’t want to see a particular kind of therapist or participate in a particular kind of therapy, honor that part of you and try to find a therapist that does not contradict what that important part of you is saying. Also, try not to “should” yourself, (i.e., I should see a male therapist because that will help me get over my past), or follow someone else’s advice at your own expense. Listening deep down and following your own instincts or intuition will help you feel more in control of this process. 4. Ask Questions You absolutely have the right to interview or question your therapist. It is important you have the opportunity to understand the therapist’s education, level of training, and background. You can ask how many years of experience he or she has in treating a particular problem or using a particular approach. Questions regarding the therapist’s philosophy or approach to therapy, boundaries, and ways he or she would handle particular problems are completely appropriate. If you struggle with things like self-injury or suicidality, definitely ask up front for the policies and procedures for making crisis calls during times of emergencies. If something is bothering you, making you afraid, or if you have specific needs, ask, ask, ask. 5. Go Slow and Take Control Therapy is for you, and it is beyond important that you feel as safe and comfortable as possible. I strongly believe that your history belongs to you and you should be in complete control over how and when you share this information, if you choose. As a trauma therapist , I do not believe I need to know the details of anyone’s trauma history at the onset of therapy in order to help them. Although I believe having this information is helpful and being able to tell one’s story is an important part of the therapeutic process, I think it is more important for the person to be in complete control of what information is shared and when. It’s ok to take your time, and you can decide when it feels safe to start talking about your trauma or abuse history. You do not have to feel pressured by a therapist to talk about it before you are ready and it’s ok to say you do not want to talk about it. Therapy can focus on managing and coping with trauma symptoms, promoting safety and stabilization, improving quality of life, and building a solid therapeutic relationship without the demand to talk about trauma or abuse details. When you are ready to take that first step, our getting started page walks you through exactly what happens next. Questions people ask Do I have to talk about my trauma right away in therapy? No. You control what you share and when. Good trauma therapy can begin with safety, stabilization, and building trust, without requiring the details of what happened before you are ready. How do I find the right trauma therapist? Research their training and approach, ask for an initial consultation, ask direct questions about how they work, and pay attention to fit. For severe or childhood trauma, look for someone who specializes in it. Request your match → Or call (215) 399-4128 ===================================================================== URL: https://turningleaftherapyservices.com/trauma-a-word-with-different-meanings/ ===================================================================== Home / Blog / What Trauma Really Means FROM THE BLOG Trauma: A Word with Different Meanings Written by Kaycee Beglau, PsyD Reviewed and updated July 2026. ON THIS PAGE Examples of Big-T Traumas Examples of Little-t Traumas Questions people ask Understanding and Defining Different Types of Trauma These days it seems there is a misconception, or even a “watering down” of what the word trauma actually means. In everyday conversations, the word “traumatic” can be used in the same way as words like “stressful” or “upsetting.” For example, we have all seen the dramatized, reality tv-show star say something to the effect of, “Finding out my wrinkle cream has been discontinued has been really traumatic for me.” But, if you have lived through a traumatic experience, you know on a deep level that trauma and stress are not the same thing. On the other hand, when most people think about trauma, they often think about those who have survived a natural disaster, been physically or sexually assaulted, or been exposed to war or combat. Understandably, these kinds of experiences can be extremely traumatic for a lot of people who go through them. However, a person does not have to have undergone an experience as obviously profound as these for it to cause a traumatic reaction or response. Some trauma experts like to distinguish between “big-T” traumas and “little-t” traumas. Big-T traumas are what most people typically think of, as I just described. They create a terrifying sense of being completely overwhelmed, are often sudden, and leave the person’s life or sense of well-being feeling physically threatened. Examples of “Big-T” Traumas Natural disasters Serious car or other accidents Physical or sexual assault Rape or sexual abuse War or combat exposure Violent crime Life-threatening illness or injury Witnessing violence or death The sudden, unexpected loss of a loved one Little-t traumas, on the other hand, may not be life threatening or as horrifying or terrifying as the typical list of qualifying traumatic events. Nevertheless, many kinds of events or experiences can be traumatic even if there was no threat of physical injury or death. These types of traumas include experiences that threatened the person’s sense of psychological integrity or well-being. Examples of “Little-t” Traumas Emotional abuse or chronic criticism Childhood emotional neglect Bullying or social rejection Divorce or the end of a significant relationship Betrayal or infidelity by a trusted person Being chronically dismissed, overlooked, or invalidated Financial hardship or job loss Non-life-threatening injuries or medical procedures Growing up with constant conflict at home Humiliation or public shaming Of course, neither of these lists are exhaustive and represent only a small fraction of life events or experiences that a person can experience as being potentially traumatic. Big-T traumas, by nature, are very severe. Yet, it also makes sense to me that these less obvious forms of trauma (i.e., little-t traumas) can have a profoundly traumatizing effect on people and can create many of the same post-traumatic responses as the Big-T traumas. This becomes more and more true with experiences that are chronic, repetitive, or having survived multiple types of traumas, as this tends to have a “cumulative” traumatizing effect. Even if what you have experienced has not been mentioned in this blog, it does not mean you have not suffered a trauma or that what you have experienced did not result in post-traumatic reactions. What these different types of trauma have in common is the lasting impact they can have on people, which includes experiences such as being emotionally, physically, and mentally overwhelmed and feeling shocked, horrified, helpless, damaged, or fractured in some deeply profound way. The important thing is not to focus on what type(s) of trauma(s) you have survived and to try to quantify it in some way, but to recognize the ways you have been affected and what all of this means to you. There is hope for recovery, and it begins with recognizing and coming to terms with what has occurred and the many ways it has impacted your sense of self, your experience of the world, your perspectives, your ability to connect with others, and to engage in a quality of life that feels personally meaningful. Our trauma-informed approach is built for exactly this work. Questions people ask What is the difference between big-T and little-t trauma? Big-T traumas are events most people recognize as traumatic, like assault, accidents, or disasters. Little-t traumas are experiences like emotional neglect, bullying, or betrayal that may seem smaller but can leave lasting effects, especially when repeated. Does something have to be a major event to count as trauma? No. Cumulative little-t experiences can produce the same responses as a single major event. What matters is how the experience affected you, not how it ranks against what others have been through. Request your match → Or call (215) 399-4128 ===================================================================== URL: https://turningleaftherapyservices.com/its-all-my-fault-why-do-i-blame-myself-for-my-trauma/ ===================================================================== Home / Blog / Why Do I Blame Myself? FROM THE BLOG “It’s All My Fault”: Why Do I Blame Myself for My Trauma? Written by Kaycee Beglau, PsyD Reviewed and updated July 2026. Traumatic experiences profoundly affect us in deeply personal ways, in part, because they make us feel out of control in this world, feel unsafe with others, and even unsafe with ourselves. We start to feel unsafe with ourselves, for example, when we question our own judgments, lose trust in ourselves, or carry a sense of inner badness, defectiveness, or self-disgust. We may find ourselves asking questions like, “Why did this happen to me?” or “What did I do to deserve this?” Sometimes, this inner sense of being to blame or of having some kind of inner “badness” is so significant, it makes us question or lose faith in our spiritual belief system. For example, we may say “I’m so awful, not even God could love me.” Inevitably, those who have experienced trauma find themselves trying to sit with and make sense of a tangled knot of intense emotions. These can include feeling anxious, frightened, alone, angry, sad, depressed, guilty, and ashamed. When these emotions are accompanied by thoughts of self-blame or self-hatred, it’s like pouring gasoline on a blazing fire. For example, when we are already feeling sad and alone, to think thoughts like, “It’s all my fault” or “I should have done something different” only makes us feel more depressed and isolated from others. So, in this way, a vicious cycle of negative, intense emotions and social isolation is perpetuated. Why is blaming oneself for traumatic experiences so common even though it can make us feel so much worse? To outsiders, it may seem obvious it is not our fault or even absurd that these kinds of thoughts could be believable to us. But, the truth is, there are many understandable reasons why we can tend to blame ourselves. These reasons often center around themes of either 1) Needing to have a sense of control or 2) Needing to have a sense of meaning. Following is a list of some examples of underlying (or unconscious) reasons why we can hold on to self-blame after traumatic experiences: It feels better to believe we either did have control (e.g., I caused this because I am bad) or that we could have had control (e.g., if I didn’t make him angry with me, he wouldn’t have hurt me). Essentially, if we feel like we have control then it can feel like we can prevent future traumas from happening and we will ultimately be safer. If we were raised in families where, as children, we were blamed when bad things happened, this may feel like a natural “role” we readily take upon ourselves. It can feel easier to blame ourselves than to ponder philosophical or spiritual questions about why bad things happen to good people. We can preserve our spiritual beliefs or our framework for how we make meaning out of life that way. It can feel safer to be angry at ourselves than others that we love or even at God or the world. With this being said, it makes perfect sense to me why some end up carrying around this sense of self-blame despite how much worse it can make things feel. On the other hand, it has been my experience that those who carry these feelings around the most are also the ones who carry a tremendous amount of shame and who are the most likely to be suffering from other serious symptoms of Post-Traumatic Stress Disorder (PTSD) . This may be because the shame is so powerfully painful, it can keep us from talking about or coping with the traumatic experiences in ways that could ultimately be healing and freeing. The shame keeps us wanting to avoid the trauma-based thoughts, feelings, and memories and from sharing these with potentially helpful others because it can be so frightening and painful. However, the avoidance only ends up keeping us trapped inside ourselves, without being able to get the support needed to face, process, and ultimately resolve the feelings of shame or guilt and to heal from the traumatic experiences themselves. If you find yourself relating to these experiences of self-blame, I encourage you to find someone you can trust (even just a little bit at first), whether that is a friend, a relative, a spiritual or religious leader, or a licensed therapist and start to take the healthy risk of sharing your story with someone. It’s going to feel very scary and painful at first, but over time, having someone hear your story and accept it without judgement can help you start to resolve these feelings of shame, self-blame, and self-hatred and to move forward in your life. Questions people ask Why do I blame myself for my trauma? Self-blame often provides a sense of control or meaning. Believing you caused it can feel safer than accepting that something harmful happened outside your control, especially if you were blamed as a child. How does therapy help with trauma-related shame? Sharing your story with a safe, nonjudgmental person gradually loosens shame's grip. Therapy helps you separate what happened from what you concluded about yourself, and process the feelings underneath. Request your match → Or call (215) 399-4128 ===================================================================== URL: https://turningleaftherapyservices.com/the-lost-childhood-role-reversal-and-the-parentified-child/ ===================================================================== Home / Blog / The Parentified Child FROM THE BLOG The Lost Childhood: Role Reversal and the Parentified Child Written by Kaycee Beglau, PsyD Reviewed and updated July 2026. “Children are not meant to provide the emotional or psychological needs of parents.” Sheila Darling In a “good enough” home environment, children have mostly consistent, predictable, and nurturing responsiveness from an attuned parent or caregiver. There is an internal experience of being taken care of that comes from healthy boundaries between the parent and the child. The child understands and knows on a deep level the adult is there and “has got this” while also not feeling overly controlled and smothered. There is a balance between dependence and independence, structure and freedom, love and discipline. In family environments that aren’t so ideal, as in cases where a parent experiences ongoing emotional difficulties, this balance is not achieved on a consistent basis. The child intuits, or “picks up,” that something is not emotionally (or sometimes physically) safe and takes on a sense of responsibility for taking care of the parent in a variety of ways, typically by providing emotional or physical caregiving to the disturbed parent. Life in this kind of dysfunctional family environment pulls the child into a role reversal with the disturbed parent. The result for the child is often a pervasive sense of worry or anxiety about the feelings and needs of the adult, feelings of depression or sadness, low self-esteem, withdrawal from developmentally appropriate activities and engagement with peers, and an exaggerated sense of being mature or “wise beyond your years” that equates with a lost childhood. Taking on these feelings and the overwhelming sense of responsibility for a parent is often referred to as being a “parentified child.” The costs to these children are tremendous. First, the child often learns that his or her needs are not wanted, acceptable, nor likely to be met. These needs are either ignored, neglected, or perhaps even worse, the child is actively punished, criticized, shamed, or rejected when expressing his or her own desires or wishes. As a result, the child learns how to “cut off,” bury, or deny his or her needs in order to take care of the parent’s and to prevent further disappointment or harm. This pattern sits at the heart of what we treat as childhood emotional neglect . Secondly, as an adult, there is often a deeply profound sense of shame that comes from having a personal need emerge. Throughout childhood, there was a complete orientation towards taking care of the parent, often at the exclusion of being aware of one’s own sense of self and healthy entitlement to personal needs and interpersonal boundaries. After growing up always being oriented toward “the other,” adults from this type of family environment often have a hard time developing certain abilities, such as feeling entitled to saying “no” to others, expressing anger, getting close and developing deeper levels of intimacy , and feeling whole and worthwhile as an individual. If you recognize yourself in these descriptions, it is possible you grew up with a parent or caregiver that relied too heavily on you to meet his or her emotional and/or physical needs. Individual psychotherapy with a relational or attachment-focused approach can provide a certain kind of space and therapeutic relationship where you can be free to explore the effects of your unique childhood experiences on your development and ability to connect in healthy ways with others. Although this will inevitably require a certain amount of courage and willingness on your part, parentified children are undoubtedly strong and resilient by nature and healing and growth are certainly possible if given the right opportunity. Questions people ask What is a parentified child? A parentified child takes on emotional or practical caregiving for a parent, reversing the normal roles. They often become wise beyond their years while their own needs go unmet. How does parentification affect adults? Adults who were parentified often struggle to set boundaries, say no, express anger, or feel entitled to their own needs. Relational, attachment-focused therapy helps reclaim those parts of the self. Request your match → Or call (215) 399-4128 ===================================================================== URL: https://turningleaftherapyservices.com/the-differences-and-useful-benefits-of-seeing-a-pre-licensed-professional/ ===================================================================== Home / Blog / Seeing a Pre-Licensed Therapist FROM THE BLOG The Differences and Useful Benefits of Seeing a Pre-Licensed Professional Written by Kaycee Beglau, PsyD Reviewed and updated July 2026. ON THIS PAGE What’s a Pre-Licensed Therapist? Why See a Pre-Licensed Therapist? Are There Downsides to Seeing a Pre-Licensed Therapist? Conclusion Questions people ask Psychotherapy can be a wonderful way to better understand yourself and improve your life. Psychotherapy can help you process past traumas, get through difficult emotions, and learn new coping skills. It can also be a helpful part of recovery from substance abuse, help you improve your relationships with others, or even to be a better parent to your children. But not everyone can afford to see a licensed therapist. If you’re looking for some guidance without breaking the bank, pre-licensed therapists are one option to consider. What’s a Pre-Licensed Therapist? A pre-licensed therapist is someone who has graduated from a master’s degree program but has not yet passed the licensing exam or accumulated enough post-graduate supervised hours to meet the licensure requirements. While every state has different requirements for licensure, in the state of Pennsylvania, master’s level therapists are required to earn 3,000 hours of supervised clinical experience over a minimum of 2 years. During these 2 years, they are required to spend at least 2 hours each week in supervision with an experienced, licensed clinician who is there to guide them and help them continue developing and applying their skills. Pre-licensed therapists will have gained some experience in their graduate training program, through their practicums and internships. They have most of the skills and knowledge of a licensed therapist, but simply haven’t “been around the block” as much as a licensed professional. While there are pros and cons to this, they are still highly knowledgeable and committed to helping clients heal and grow into their best selves! Why See a Pre-Licensed Therapist? There are many reasons why you may want to see a pre-licensed therapist. Some of the most common include: More affordable Sometimes lower cost than with high-deductible insurance plans No waitlist Greater schedule flexibility On the cutting edge of research and training Bring a high energy level, passion, and commitment Can relate to younger clients better Have “beginner’s mind” with a tendency towards openness and curiosity Receiving rigorous supervision, which means you will have the benefit of having “2 sets of eyes” on your care Are There Downsides to Seeing a Pre-Licensed Therapist? There are a few downsides to seeing a pre-licensed therapist. First, as noted above, they may not be able to provide the same level of care as someone who is licensed. This is because their training and experience are limited. Even though they have gone through the necessary education to earn their master’s degree in counseling and have an understanding of the field (and probably even more than some fully licensed clinicians), not having that extra qualification could mean that they don’t have access to certain treatments or techniques that may be helpful for you. Additionally, if your health insurance doesn’t cover out-of-network mental health care costs, or if it only covers therapy delivered by licensed professionals, you may not be able to submit claims for out-of-network reimbursement. Conclusion As you can see, there are many benefits to seeing a pre-licensed therapist. They’re more affordable and their training is similar to that of licensed therapists. Although they may not have all the skills of a licensed therapist yet, they’ll still be able to help you work through your problems with a supportive environment that can give you valuable insight into how therapy works in general. So, if you’re looking for someone who offers reasonable rates on therapy sessions or just want someone with less experience but still has an understanding of what it means to be in therapy then pre-licensed therapists are definitely worth considering! At Turning Leaf Therapy, we take our training program very seriously, and hand select the most qualified applicants from a very large pool. We invest heavily in their training and supervision to ensure you get the best care possible! Ready to begin? See how getting started works. Questions people ask Is a pre-licensed therapist qualified? Yes. A pre-licensed therapist has completed a master's degree and is accruing supervised hours toward full licensure, working under a licensed supervisor. In practice, two clinicians are attending to your care. Why would I see a pre-licensed therapist? They are typically more affordable, often have greater availability and less of a waitlist, and bring energy, current training, and close supervision. For many concerns they are an excellent fit. Request your match → Or call (215) 399-4128 ===================================================================== URL: https://turningleaftherapyservices.com/psychoeducational-sexual-assault-survivor-group-therapy/ ===================================================================== Home / Blog / Trauma Responses After Assault FROM THE BLOG Trauma Responses After Sexual Assault, Explained Written by Samara Perez, LPC Reviewed and updated July 2026. ON THIS PAGE What Trauma Responses Can Look Like Why Your Body Responds This Way What Healing Can Look Like Cost Should Not Be a Barrier Questions people ask Survivors are strong individuals who have overcome some difficulty or traumatic experience. Surviving a sexual assault is a traumatic experience as it violates the body and mind. Boundaries have been crossed and it feels like all control over the situation has been lost. This is when the mind decides to go into fight, flight, or freeze mode. Your mind does this to protect you from the mental and physical pains of being violated and to help you survive the experience. While this process can be a protective factor in the moment, sometimes these mechanisms can be detrimental if they persist for too long. When this happens, it can be considered a trauma response. Trauma responses are often described as feeling sad a lot of the time and mentally replaying the experience over and over again. There are unfortunately more symptoms that people don’t know exist. These include dissociation, having trouble sleeping, developing illnesses and autoimmune diseases, having gastrointestinal issues, self-destructive behaviors, becoming more of a people-pleaser and more. What Trauma Responses Can Look Like Hypervigilance. Scanning every room for danger, startling easily, and finding it hard to relax even in places you know are safe. After an assault, the mind recalibrates toward threat, and it can stay there long after the danger has passed. Dissociation. Feeling foggy, far away, or disconnected from your body, as if you are watching your life from the outside. Dissociation is the mind’s way of creating distance from something overwhelming. Sleep changes. Trouble falling asleep, staying asleep, or nightmares that return you to the experience. Sleep asks the body to let its guard down, which is exactly what a braced nervous system resists. Physical symptoms. Headaches, muscle tension, gastrointestinal distress, and stress-related illness. The body carries what the mind has not yet been able to process. Avoidance. Steering around people, places, dates, or sensations that echo what happened, sometimes without realizing that is what you are doing. Self-blame and shame. Replaying what you did or did not do, as if the assault were your fault. It was not. People-pleasing. Keeping everyone around you comfortable as a way of staying safe, sometimes called the fawn response. When saying no once felt dangerous, agreeableness can become a survival strategy. Why Your Body Responds This Way After a traumatic experience like sexual assault, our minds are heightened to recognize danger in every corner. Sometimes our minds work too well and categorize something as dangerous when it isn’t. None of this is a choice, and none of it is weakness. Fight, flight, freeze, and fawn are automatic survival responses that your nervous system selected for you in a moment when survival was the only goal. A nervous system that stays braced after the danger has passed is an adaptation that once protected you, not evidence that something is wrong with you. What Healing Can Look Like Trauma-informed therapy begins with safety, not with retelling. You will never be pressured to share the details of what happened before you are ready, and you remain in control of what is shared and when. The early work is about stabilizing, understanding what your body is doing and why, and building a therapeutic relationship that feels steady enough to hold the rest. From there, you and your therapist can decide together how to approach the deeper work of processing, at your pace. Our PTSD and complex PTSD page describes how our clinicians approach that work. With psychoeducation, we can understand more about why our minds and bodies behave like this and we can learn how to grow from our experiences. Schedule an appointment to learn how to better understand and care for your body’s responses, cope with future uncomfortable situations, and heal what was once broken. Cost Should Not Be a Barrier Pennsylvania’s Victims Compensation Assistance Program (VCAP) can cover the cost of therapy for victims of crime, including survivors of sexual assault. Turning Leaf works with VCAP, and where it is approved, sessions may be fully covered. IF YOU NEED SUPPORT RIGHT NOW 988 Suicide and Crisis Lifeline: call or text 988 Philadelphia Crisis Line: (215) 685-6440 WOAR Philadelphia Center Against Sexual Violence, 24-hour hotline: (215) 985-3333 If you are in immediate danger, call 911. Questions people ask Why do I feel numb or on edge after an assault? Hypervigilance, numbness, and dissociation are automatic survival responses, not weakness. After an assault the nervous system braces for danger, and with support it can learn to settle again. Can therapy help after sexual assault? Yes. Trauma-informed therapy begins with safety and moves at your pace, never requiring you to recount details before you are ready. Pennsylvania's VCAP may cover the cost for survivors of crime. Request your match → Or call (215) 399-4128 ===================================================================== URL: https://turningleaftherapyservices.com/how-to-help-your-child-with-transitions/ ===================================================================== Home / Blog / Helping Your Child With Transitions FROM THE BLOG How to Help Your Child with Transitions Guest author: Katie Fries, LCSW, RPT · Clinically reviewed by Kaycee Beglau, PsyD Reviewed and updated July 2026. ON THIS PAGE 1. Hold Assumptions at the Door 2. Provide Opportunities to Practice 3. Take Care of Yourself! Questions people ask 1. Hold Assumptions at the Door It can be very easy (and understandable!) to assume that the struggles you faced in middle school are the same ones your child will experience: mean girls, peer pressure, opening lockers, you name it. And while some of those fears seem to stand the test of time (have they changed those dang padlock lockers?!), others will change based on both new forms of communication (like social media) as well as your child’s individual strengths and challenges. If we assume that children are concerned about peer pressure and talk with them all about how to “say no to drugs” when what they are actually concerned about is where they will sit at the lunch table, they may end up feeling unsupported and be less likely to disclose about the things that are actually stressing them out. A couple of helpful questions to ask are: “What are you most excited about?” and “What are you most nervous about?”. Asking those questions not only normalizes the feelings of excitement and nervousness, but it also gives them the opportunity to express what they need from you. That support may be similar or different from what was originally imagined. 2. Provide Opportunities to Practice Often the fears a child holds can be minimized by knowing what to expect. The fear of being late to class because they weren’t able to open their locker can be greatly decreased by becoming an expert at opening a padlock at home. The fear of getting lost in the hallways can be solved by walking from class to class before the first day of school. The fear of knowing how to say no to a party while saving face can be decreased by creating a plan or code word to use if they need you to assert that they’re not allowed to go out. While many schools offer the option of a tour for incoming students, if your child seems particularly anxious about starting somewhere new, it might be worth asking for a private tour of the space to assuage those fears. Again, it is important to attend to your child’s individual needs, as practicing or rehearsing something unnecessarily can unintentionally send the message that you doubt their ability to manage new situations. 3. Take Care of Yourself! Having a child transition to a new phase of life can bring up feelings of joy, grief, and uncertainty. Fears can easily arise such as: “Will my child be okay?” “Have I prepared them well enough?” and “What can I do to make sure my child doesn’t have to go through what I did?”. To avoid the trap of projecting anxiety onto your child, it’s a good idea to be curious about and validate any challenges during transitions that come up for you. This way you can accompany your child on their own journey in a way that’s healthy for them. Some of the challenges they will face will mirror your own, and some will be different. Knowing you believe in their capacity to manage stress and navigate this new time in life is the most effective way to help them have that same confidence in themselves! If your child or teen could use extra support around a big change, our child therapy and teen therapy pages describe how we work with young people at every stage. Questions people ask How can I help my child through a big transition? Ask what they are excited and nervous about rather than assuming, give them chances to practice the new situation, and manage your own anxiety so you do not pass it on. Your confidence in them builds their confidence in themselves. My child seems anxious about starting a new school. What helps? Concrete preparation reduces fear: tour the building, practice the locker or the route between classes, and make a plan for tricky moments. Tailor the preparation to their specific worries. Request your match → Or call (215) 399-4128 ===================================================================== URL: https://turningleaftherapyservices.com/gaslighting-the-artistry-of-a-narcissist/ ===================================================================== Home / Blog / Gaslighting FROM THE BLOG Gaslighting: The Artistry of a Narcissist Guest author: Alisa Stamps, MSS, LCSW · Clinically reviewed by Kaycee Beglau, PsyD Reviewed and updated July 2026. Have you ever been in a situation where you just can’t seem to remember exactly how the events played out? Maybe you went out to eat with your partner and you remember having the fish, but your partner insists you had the chicken? And your partner does everything they can to convince you that you are not remembering things, what YOU ate, correctly? Sounds pretty harmless, right? Well, not when you involve a narcissist… The Oxford Dictionary defines gaslighting as a “form of psychological manipulation where a person seeks to sow seeds of doubt in a targeted individual” (Oxford Languages). This is done to make that individual question their own perception, memory, and sanity in order to destabilize the target and delegitimize the target’s beliefs, using such methods as denial, contradiction, lying, and misdirection. The term originates from the 1938 play entitled Gaslight, in which a “husband attempts to convince his wife that she is insane by manipulating small elements of their home environment, including slowly dimming the gaslights in their house while pretending nothing has changed, thus making his wife doubt her own perceptions” (Angel Street). How does a narcissist utilize this skill to their target’s detriment? Through gaslighting, a narcissist is making sure that when you look in the mirror, you see them: their thoughts, their perceptions, their beliefs. The trick is to make their targets think they are not capable of functioning without the narcissist, and thus the target will rely on the narcissist to give the “correct” version of reality. If we are “taught” that we can’t trust ourselves then we will inevitably be drawn to the person that has ensured their version of truth is the only option. Another tactic of gaslighting is known as “splitting” and one that the narcissist may use frequently. Splitting is when you are pitted against others by the narcissist, the purpose of which is to isolate you from the important people in your life. This can even happen in a clinical setting. In my previous job working as a therapist in an inpatient drug and alcohol facility, I would often have a patient that would tell me one thing and then go to another therapist to tell them something completely different or only a small version of the truth. In these instances, I would usually have to tell staff members to direct this patient back to me in order to put an end to the splitting. When the narcissist is challenged in this way and the splitting is disrupted, this tactic can usually be stopped or at least lessened. This type of behavioral monitoring is definitely not fun, but can be, if they are open and willing to take it in, a beneficial learning experience for the narcissist. But now back to the target. What can we do to help ourselves when gaslighting is present? Most importantly, make sure that you seek out your own support system: a therapist, a trusted friend or family member, etc. Second, hold on to what you know to be the truth. Try and stay grounded in your authentic self, and understand what it is that the narcissist is trying to do to you. Lastly, don’t be afraid to stop and pause before reacting. One of the best pieces of advice I heard early on in my career is that just because you were invited to the crisis does not mean that you have to go. Not reacting is a reaction and probably not one that the narcissist is used to dealing with. Gaslighting is a tactic to inflict shame on the target, and if we don’t bite, the narcissist can’t be successful. I thought it might be interesting to research TV or movie characters who have been crafted to use a gaslighting technique. One that was surprising to me, though I can totally see it now, was Ross Geller from Friends. Ross lies to Rachel about still being married after their ceremony in Vegas and convinces her that they are no longer married when in fact they are; he puts ideas in her head that just because he is the father of their baby she should be with him; and of course who could forget about the whole “We were on a break!” thing? Gaslighting at its finest. Until next time my friends (no pun intended), be like a tree and remain grounded. If gaslighting has shaped how far you trust your own perceptions, individual relationship therapy and trauma-informed therapy can help you rebuild that trust, and attachment work can address why these dynamics came to feel familiar in the first place. “Angel Street” . Internet Broadway Database. RELATED READING Boundaries: A Narcissist's Scorched Earth → Questions people ask What is gaslighting? Gaslighting is manipulation that makes you doubt your own memory, perception, or sanity, through denial, contradiction, and lying. It is used to destabilize a target so they rely on the manipulator's version of reality. How do I protect myself from gaslighting? Seek outside support, hold on to what you know is true, and pause before reacting. Simply naming the tactic reduces its power over you. Request your match → Or call (215) 399-4128 ===================================================================== URL: https://turningleaftherapyservices.com/boundaries-a-narcissists-scorched-earth/ ===================================================================== Home / Blog / Boundaries With a Narcissist FROM THE BLOG Boundaries: A Narcissist’s Scorched Earth Guest author: Alisa Stamps, MSS, LCSW · Clinically reviewed by Kaycee Beglau, PsyD Reviewed and updated July 2026. Boundaries. I feel like I talk about them with clients all day long. I say things like, “How would it feel to try and establish or even consider establishing better boundaries?”, or “Sounds like you put up a good boundary there for yourself”. They are so abstract and yet they aren’t. There are actual physical boundaries in this world, the Great Wall of China and the once existing Berlin Wall. But what about personal boundaries? How do we build these? And most of all, how do we get the courage to build them and not see them as selfish, but rather self-helping? How many of you would say that you have a problem with boundaries? Let me dial it back…how many of you would say that you have a “problem with saying no”? I have posed this question to many clients over the years, and the answer is nearly unanimous. In a relationship with a narcissist, the target is conditioned to learn how to not say “no”. Saying no may mean incurring wrath, so the target learns quickly that to preserve their safety it’s best to always agree or never challenge the narcissist. This agreement can then possibly spill over into other relationships in our lives. Romantic relationships or even work/boss relationships can be affected. We may work well past our eight-hour days or continue to take on project after project because we can’t say no. Conditioned targets can also be real people-pleasers. That might be part of why we can’t say no, we fear disappointing or losing our place as the “golden child” or “star employee”. The narcissist has made us believe that if we ever say no, we are less than or not good enough in their eyes. Someone recently shared with me the idea that boundaries can include both a door and a window. This idea was a game changer for me. I feel that when we are used to interacting with narcissists, because of their behaviors of idealization and devaluation, we are so used to things being black and white that the thought of considering some grey areas is foreign to us. JH Simon’s book, “How to Kill a Narcissist” states otherwise. It suggests that we can: “utilize the ability to say enough. We can remain in a situation but change the terms of engagement. We can go shopping with somebody but use some of that time to seek out our own stuff that we want. We can speak with a person then politely end the conversation when it gets too much. If the people in our lives love us, they will be flexible and open to negotiating each situation so that everyone is comfortable. We have the right to change the situation to suit our internal state better. When we do it in service of our true self, we never have to feel guilty”. (p. 157-158). See? Doors and windows. This takes practice. This is hard. Especially when we have not done much boundary setting before. But boundaries are scorched earth to a narcissist: they cannot continue their assault if their blood-source has been cut off, if the target is refusing to play the game. Start small with boundaries that don’t involve the narcissist yet by maybe not staying that extra hour at work, or not over-scheduling yourself during the weekend and see what that feels like. Pretty soon you will fall in love with “saying no” and hopefully also yourself along the way. If saying no still feels dangerous, our relationship therapy and trauma-informed therapy pages describe how we help people rebuild boundaries from the inside. Simon, J. H. (2016). How to kill a narcissist: debunking the myth of narcissism and recovering from narcissistic abuse . United States: JH Simon. RELATED READING Gaslighting: The Artistry of a Narcissist → Questions people ask Why is it so hard to say no to a narcissist? Targets are often conditioned that saying no brings anger or withdrawal, so agreeing becomes a survival strategy. Over time that habit can spread into other relationships as well. How do I start setting boundaries? Start small, with limits that do not involve the difficult person, like not staying late at work or not overscheduling your weekend. Notice how it feels, and build from there. Request your match → Or call (215) 399-4128 ===================================================================== URL: https://turningleaftherapyservices.com/eating-disorder-therapy-philadelphia/ ===================================================================== Home / Specialties / Eating Disorders & Body Image old city, philadelphia Eating disorder and body image therapy in Philadelphia Eating disorder therapy at Turning Leaf in Old City Philadelphia is a relational, trauma-informed approach for teens and adults navigating anorexia, bulimia, binge eating, ARFID, disordered eating, and body image distress. Sessions are 53 minutes; we treat what the eating disorder has been holding, not just the behavior. In-network with Aetna, BCBS, United, and Optum; self-pay $130 to $200. Binge eating disorder alone affects an estimated 2.8 percent of U.S. adults in their lifetime (NIMH) , more than anorexia and bulimia combined, and it remains the least recognized of the three. It looks like it is about food. The counting, the rules, the rituals, the mirror. But food is the language, not the story. You do not need to look a certain way, or feel sick enough, to deserve care. WHAT WE TREAT HERE Anorexia, bulimia, binge eating, ARFID, and body image distress INSURANCE In-network with Aetna, Blue Cross plans, United Healthcare, Optum, PA VCAP Typical copay $15 to $50. See all plans SELF-PAY $130 to $200 per session Superbills provided for out-of-network reimbursement. Rates SESSIONS 53 minutes, usually weekly FORMAT In person in Old City Philadelphia, or telehealth Across Pennsylvania, and New Jersey with select clinicians. Telehealth AGES Teens (13 to 17) and adults APPROACH Relational depth plus structure CBT-E and DBT skills, weight-inclusive NEW CLIENTS We are accepting new clients After your intake form, a coordinator reviews it and verifies your benefits; most people have a first session within about a week. Start your intake → ON THIS PAGE Never only about food What the symptom protects Eating disorders we treat Body image How we treat it Who we see The right level of care In Old City Philadelphia Getting started Using your insurance Common questions An Eating Disorder Is Never Only About Food For some people the day is organized around eating or not eating: which foods are safe, what was already consumed, what must be earned or undone. For others it is the cycle of restraint and loss of control, the secrecy afterward, the promise that tomorrow will be different. For others still there is no diagnosable disorder at all, just a running commentary about their body that never shuts off, a mental tax paid at every meal, every photo, every doctor’s appointment, every swim. An estimated 9 percent of Americans, roughly 28.8 million people, will experience an eating disorder in their lifetime (Deloitte Access Economics and Harvard STRIPED, 2020), and eating disorders carry one of the highest mortality rates of any psychiatric condition. Yet most people who struggle never receive specialized care, often because the disorder itself insists they are not sick enough to deserve it. You do not need to look a certain way to have an eating disorder. Most people with eating disorders never do. If your relationship with food or your body is taking up more of your life than it should, that is reason enough to start. Food is the language, not the story. What the Symptom Is Protecting At Turning Leaf Therapy, we practice from a relational psychodynamic foundation, and that changes how we understand eating disorders. Symptom-focused treatment asks what: what you are eating, what you are avoiding, which behaviors need to stop. Those questions matter, and we use structured, evidence-based tools to address them. But we also ask why. Why restriction, why now, what it solved when it began, what it is still doing for you. An eating disorder almost always started as an adaptation. Control, when everything else was chaotic. Numbness, when feeling was unbearable. Achievement, in a family that graded bodies. Smallness, when taking up space felt dangerous. Where behavior-focused treatment changes the behavior, depth work understands what the behavior is protecting and provides the conditions for it to become unnecessary. The research supports this frame. Trauma histories are dramatically overrepresented among people with eating disorders, and in a city where nearly 70 percent of adults report at least one adverse childhood experience (Philadelphia Urban ACE Study), a trauma-informed lens is not an add-on for this work. It is the context for most of it. Eating Disorders We Treat Anorexia Nervosa Restriction of intake, intense fear of weight gain, and a self-worth fused to body size. Anorexia is often invisible to the person living with it; the disorder insists they are fine, or that they have not earned help yet. We also treat atypical anorexia, in which every psychological feature of anorexia is present in a body that is not underweight. It is just as serious, and just as deserving of treatment. Bulimia Nervosa Cycles of binge eating followed by compensatory behaviors, held together by shame and secrecy. Bulimia often hides inside outwardly high-functioning lives for years. The cycle is not a character flaw. It is a physiological and emotional loop, and it is treatable. Binge Eating Disorder The most common eating disorder in the United States, more prevalent than anorexia and bulimia combined, and the most misunderstood. Recurrent episodes of eating with a sense of loss of control, followed by distress, guilt, or self-punishment. Binge eating disorder is not a willpower problem. It is very often the predictable rebound of chronic restriction and dieting, tangled with emotion regulation and shame. Treating it means treating the whole cycle, not lecturing the binge. ARFID Avoidant/restrictive food intake disorder involves significant limits on eating that are not driven by body image: sensory sensitivity, fear of choking or vomiting, or little natural drive to eat. ARFID affects adults as well as children and is routinely mislabeled as picky eating long past the point where it is interfering with health, energy, and social life. OSFED and Disordered Eating Most people who reach out to us do not fit a textbook diagnosis. Chronic dieting that never ends. Food rules that keep multiplying. Clean eating that turned rigid. Exercise that functions as punishment or permission. Fear foods, body checking, mental math at every meal. Subclinical does not mean insignificant. Disordered eating deserves treatment before it becomes a disorder, not after. The cycle is not a character flaw. It is a loop, and it is treatable. Body Image Is Its Own Clinical Concern Body image distress does not require an eating disorder to deserve care, and it rarely resolves on its own with time, weight change, or compliments. We work with clients whose lives have quietly contracted around their bodies: avoiding photos, mirrors, intimacy, pools, reunions, and doctors. Clients caught in comparison loops that social media is engineered to feed. Clients navigating body change through postpartum recovery, illness, aging, menopause, or medical treatment. Clients for whom body image and gender identity are intertwined, where an affirming frame matters as much as a clinical one. And clients whose appearance preoccupation has crossed into obsessive territory, where we assess for body dysmorphic disorder and either treat it or connect you with the right specialized care. Body dissatisfaction is one of the strongest known predictors of future eating disorder onset. Treating it early is not cosmetic. It is prevention. How We Treat It: Depth Plus Structure Most eating disorder treatment is manualized: a protocol, a workbook, a fixed number of sessions. Those tools have real evidence behind them, and we use them. At Turning Leaf, they are held inside a therapeutic relationship, not substituted for one. Your pattern with food and your body formed in relationship: to caregivers, to family food culture, to coaches and doctors and partners, to a culture that treats body size as a moral report card. It heals in relationship too. No meal log can do what a consistent, attuned, trustworthy relationship can do. Within that relational foundation, our clinicians draw on: CBT and CBT-E (enhanced cognitive behavioral therapy for eating disorders), the leading evidence-based structure for interrupting the restriction and binge cycle and rebuilding regular, flexible eating. DBT skills for urges, emotion regulation, and distress tolerance, especially where bingeing or compensatory behaviors function as emotional escape. IFS (Internal Family Systems) , particularly powerful for this work: the part of you that restricts or binges is not the enemy, it is a protector doing an outdated job. EMDR to reprocess the trauma that so often sits underneath the eating disorder. ACT and self-compassion approaches for body image flexibility, values-based living, and unhooking from the inner critic. Gradual, collaboratively paced exposure work for fear foods and body image avoidance, never forced. Two commitments shape all of it. First, we are weight-inclusive: we treat your relationship with food and your body, not your body size. There are no weigh-ins in our therapy offices, no diets, and no moral language about food. Second, we work as a team. For active eating disorders, best-practice care involves coordination with your physician and, when appropriate, a registered dietitian. We collaborate with your existing providers or help you build that team. Clinicians on our team work in eating disorders and body image every week, meet the team . FEATURED CLINICIAN Annie Hawks, LAPC Annie works with eating disorders, body image, and identity through a warm, relational, trauma-informed lens, and is currently welcoming new clients. Work with Annie → Read her profile No meal log can do what a consistent, attuned relationship can do. Who We See Adolescents (13 to 17) and adults. Women, men, and people of every gender. Roughly one in three people with an eating disorder is male, and men are dramatically underdiagnosed, in part because male presentations often center muscularity, supplement and training rigidity, and binge eating rather than the thinness-focused picture most screening was built around. We bring particular depth to: LGBTQIA+ clients , who experience elevated rates of eating and body image concerns and for whom identity and body are often intertwined. Athletes, lifters, dancers, and performers, where sport culture, weight classes, and aesthetic demands can turn discipline into disorder. Pregnancy and postpartum, when body change, appetite change, and identity change collide. Higher-weight clients whose symptoms have been dismissed, or worse, prescribed. In one body, restriction is diagnosed. In another, it is congratulated. We know the difference. You do not need to feel sick enough to begin. Is Outpatient Therapy the Right Level of Care? Honest answer: not always. Weekly outpatient therapy is the right fit when you are medically stable, safe, and able to work on change between sessions. Signs that a higher level of care (intensive outpatient, partial hospitalization, or residential treatment) may be the better starting point include medical concerns flagged by a physician, rapid physical changes, safety concerns, or behaviors that will not interrupt despite consistent outpatient work. If that is where you are, we will tell you directly, help you find the right program in the Philadelphia region, and coordinate the handoff. Many clients return to us for step-down care after a higher level of treatment, and that is often where the deepest work happens. If you need support today, the National Alliance for Eating Disorders offers a clinician-staffed helpline at (866) 662-1235 and treatment referrals. In crisis, call or text 988 . Eating Disorder Therapy in Old City Philadelphia Turning Leaf Therapy is a group practice of 26 clinicians at 123 Chestnut Street, Suite 304, in Old City Philadelphia, steps from the 2nd Street Market-Frankford Line station. We see clients in person from Old City, Society Hill, Northern Liberties, Fishtown, Queen Village, Washington Square West, and across Center City, and by secure telehealth throughout Pennsylvania and New Jersey. Most specialized eating disorder therapy in Philadelphia is out-of-network, waitlisted, or both. We are in-network with Aetna, BCBS, United, and Optum, and our intake coordinator personally matches you with a clinician within 1 to 2 business days. Getting Started 01 Complete our short intake A short adaptive form. It asks only what applies to you. 02 We match you, personally Our intake coordinator reviews your response and matches you with the clinician who fits your concern, insurance, and schedule. 03 Meet your therapist Your first session is a clinical consultation, scheduled directly with the right fit. Start your intake → Or call (215) 399-4128 Using Your Insurance for Eating Disorder Therapy Therapy for eating disorders and body image is covered as a standard outpatient behavioral health benefit under every plan we participate in. Turning Leaf is in-network with Aetna , Highmark Blue Cross , Capital Blue Cross , Anthem , Empire , the Federal Employee Program , Horizon BCBS of New Jersey , United Healthcare , Optum , and Pennsylvania VCAP . Outpatient eating disorder therapy is covered behavioral health under the plans above. In-network clients usually pay $15 to $50 per session after deductible, verified before the first session. Coordination with a dietitian or physician is billed separately by those providers under their own contracts. Independence Blue Cross, Cigna, Medicare, and Medicaid are outside our network. Sessions are $130 to $200 with superbills provided for out-of-network reimbursement. Where a higher level of care is the right recommendation, we will help you find a program and check its network status too. The insurance page explains the path in plain terms. Common Questions How do I know if I have an eating disorder or just disordered eating? + The clinical line is drawn by frequency and diagnostic criteria, but the treatment line is simpler: distress and interference. If thoughts about food, eating, or your body take up significant mental space, shape your schedule, or keep you from things you value, that warrants support regardless of diagnosis. Disordered eating is also the strongest risk factor for developing a full eating disorder, so early treatment is prevention. Do you treat binge eating disorder in Philadelphia? + Yes. Binge eating disorder is the most common eating disorder in the United States and a core focus within this specialty. We treat the full cycle, including the chronic restriction and dieting that typically drive binge episodes, using CBT-E structure and DBT skills inside a weight-inclusive, depth-oriented frame. In person in Old City Philadelphia or by telehealth across Pennsylvania and New Jersey. Can I get therapy for body image without an eating disorder? + Yes. Body image is its own clinical concern. Many clients eat relatively normally but live with constant body monitoring, comparison, avoidance, or appearance anxiety that limits their life. Therapy targets the self-worth structure underneath, not just the thoughts. Because body dissatisfaction is one of the strongest predictors of future eating disorder onset, this work is also preventive. Do you take insurance for eating disorder therapy in Philadelphia? + Yes. Turning Leaf Therapy is in-network with Aetna, the Blue Cross plans other than Independence Blue Cross, United Healthcare, and Optum, which is rare among specialized Philadelphia practices, most of which are out-of-network only. Our intake team verifies your benefits before your first session. Do you offer virtual eating disorder therapy in Pennsylvania or New Jersey? + Yes. We provide secure, HIPAA-compliant telehealth to residents of Pennsylvania and New Jersey, with no app download required. Many clients combine in-person sessions at our Old City Philadelphia office with virtual sessions. For active eating disorders, we may recommend periodic in-person care and medical coordination as part of a safe treatment plan. Will my therapist put me on a meal plan or weigh me? + No. Our therapists do not prescribe meal plans or diets, and there are no weigh-ins in our offices. We practice from a weight-inclusive frame: we treat your relationship with food and your body, not your body size. When nutritional rehabilitation is part of care, we coordinate with a registered dietitian and your physician. Do men get eating disorders? + Yes. Roughly one in three people with an eating disorder is male, and men are significantly underdiagnosed. Male presentations often center muscularity, rigid training and supplement rules, and binge eating rather than the thinness-focused picture most screening was built around. Our clinicians treat men regularly, including athletes and lifters. Do you work with teenagers with eating disorders? + Yes. We see adolescents ages 13 to 17 for eating and body image concerns, with parent and caregiver involvement and coordination with your teen’s pediatrician. See our teen therapy page. When family-based treatment or a higher level of care is the right recommendation, we will make it and help you get there. What type of therapy works best for eating disorders? + The strongest evidence supports CBT-E for adults and family-based approaches for adolescents, with DBT skills valuable where emotion regulation drives behaviors. At Turning Leaf, those tools are held inside a relational psychodynamic foundation. Structure interrupts the behavior. The relationship changes what made it necessary. When is weekly therapy not enough for an eating disorder? + When there are medical complications, rapid physical changes, safety concerns, or behaviors that will not interrupt despite consistent outpatient work. In those cases, intensive outpatient, partial hospitalization, or residential treatment is the appropriate starting point. We assess this honestly at intake and throughout care, refer to trusted programs in the Philadelphia region, and welcome clients back for step-down therapy afterward. How long does eating disorder therapy take? + It varies, and recovery is rarely linear. Some people work with us for a focused period, while others stay for longer, deeper work, sometimes stepping up to a higher level of care and back down again. Progress tends to come in waves, and therapy can feel harder before it feels better, which is often the work deepening, not failing. We revisit your goals with you throughout. Struggling with food or your body? You do not need a diagnosis to begin. Reach out and our intake coordinator will pair you with a clinician who fits your concern, insurance, and schedule, within 1 to 2 business days. Start your intake → (215) 399-4128 ===================================================================== URL: https://turningleaftherapyservices.com/blog/is-emdr-right-for-you/ ===================================================================== Home / Blog / Is EMDR Right for You? FROM THE BLOG Is EMDR right for you? An honest guide from a Philadelphia trauma practice Written by Kaycee Beglau, PsyD Reviewed and updated July 2026. ON THIS PAGE What EMDR actually is Why everyone is suddenly asking about it What the research actually says What EMDR does well, and where it is not enough by itself Every EMDR therapist is full. Now what? Getting started in Philadelphia Frequently asked questions The short answer: EMDR is a legitimate, evidence-based therapy for trauma, and it is one of several. Decades of research find that trauma-focused therapies produce broadly comparable results, and that the strongest predictor of your outcome is not which method you choose: it is the fit and trust between you and your therapist. So the real question usually is not “should I get EMDR?” It is “what does my healing actually require?” If you have been hearing about EMDR everywhere and wondering whether it is the answer, or you have called around and found every EMDR therapist full, this guide is the honest version, from a practice that offers EMDR and does not think it is magic. What EMDR actually is EMDR, Eye Movement Desensitization and Reprocessing, is a structured, eight-phase therapy developed in the late 1980s. In its best-known phases, you briefly hold a distressing memory in mind while following side-to-side movements or taps (“bilateral stimulation”), which appears to help the brain reprocess the memory so it loses its raw, present-tense charge. It is recognized as an effective PTSD treatment by major clinical guidelines, including those of the American Psychological Association and the Department of Veterans Affairs. Here is the part social media skips: eye movements are phases 3 through 6 of 8. The first phases of EMDR are history-taking, building trust with your therapist, and developing stability and coping resources. Even inside EMDR, the foundation is the relationship. Keep that, it matters later. You can read how we structure this on our EMDR therapy page . Why everyone is suddenly asking about it EMDR is having a moment. Celebrities credit it, and short-form video loves it: a therapy with visible hand movements and dramatic before-and-after stories is made for TikTok and Instagram in a way that quiet, week-after-week therapy will never be. To be clear: curiosity is good. If a video made you consider trauma therapy for the first time, that video did something valuable. But treatment decisions deserve better information than a 60-second clip, which is why we would rather you read something real, even if it is longer. What the research actually says Three findings, stated plainly: 1. EMDR works for PTSD. Multiple clinical guidelines recommend it, and meta-analyses consistently find meaningful symptom reduction, including a 2025 review in the British Journal of Psychology on its clinical and cost-effectiveness. 2. It is not uniquely superior. Head-to-head, EMDR and other trauma-focused therapies perform comparably overall, and researchers still debate how much the eye movements themselves add beyond the exposure and reprocessing common to trauma treatments. Anyone telling you EMDR is the way to heal trauma has left the evidence behind. 3. The relationship is the strongest lever you control. Across hundreds of studies and every modality, the alliance between client and therapist is one of the most consistent predictors of outcome. A skilled trauma therapist who genuinely fits you, using another approach, will typically take you further than a poor fit armed with the trendy protocol. What EMDR does well, and where it is not enough by itself Where EMDR shines: discrete, vivid traumatic memories, an assault, an accident, a birth, a loss, that stay intrusive and present-tense; times when talking through details feels impossible; targeted work inside a broader therapy. Where EMDR alone often falls short: trauma that was not an event but an environment. If what shaped you was years of relational injury, emotional neglect, chronic criticism, instability, feeling unseen, there may be no single memory to reprocess. What needs healing is a pattern: how you attach, protect yourself, and treat yourself. Clinical guidance for complex trauma emphasizes phased, relationship-based care for exactly this reason. Patterns learned in relationships tend to heal in relationships, which is the deeper, week-by-week work our practice is built around, with relational, depth-oriented therapy as the frame and tools like EMDR integrated when they serve the plan. That is not EMDR versus depth work. Done well, it is sequence and fit: trauma-informed care first, protocols in service of the person, never the other way around. Every EMDR therapist is full. Now what? Demand for EMDR has outpaced trained clinicians nearly everywhere, and we will be straight with you: our EMDR-trained clinicians are not taking new clients right now. We would rather tell you in one sentence than let you find out three forms deep. But before you put your healing on hold for a technique, remember what EMDR itself teaches: reprocessing does not begin on day one. The first phases are history, trust, and stabilization. Starting now with a skilled trauma therapist builds the very foundation EMDR itself would start with: safety, regulation, self-understanding, a relationship that can hold hard things. And that foundation is not a consolation prize: for many people, especially where trauma was relational and long-running, the deeper work turns out to be the treatment, not the warm-up. At Turning Leaf, trauma-informed care is not a specialty corner, it is the core training of all 26 clinicians, across PTSD and complex PTSD , anxiety, grief, and attachment work. Tell our intake team what you are carrying and what drew you to EMDR; they will match you within 1 to 2 business days with a clinician whose approach fits it. One thing we are honest about: we match once, carefully, and you build with your therapist. We do not move clients between therapists to chase a technique, which is exactly why we take the matching itself so seriously. In-network: Aetna, United Healthcare / Optum, Highmark BCBS, Capital Blue Cross, Anthem, Empire and FEP BCBS, and Horizon BCBS NJ; typical copay $15 to $50 after deductible. Not in-network with Independence Blue Cross or Cigna, superbills provided. Full cost details in our Philadelphia therapy cost guide . Getting started in Philadelphia 1 Reach out using the button below or call 215-399-4128 . Forms sent tonight are answered first thing the next business day. Mention EMDR if it is on your mind; that context helps us match you. 2 A real person listens to what happened, what you are hoping for, and your insurance, verified before your first session. 3 You are matched within 1 to 2 business days by specialty and fit, at our Old City office (123 Chestnut Street, Suite 304) or via telehealth anywhere in Pennsylvania and New Jersey. NOW ACCEPTING NEW CLIENTS Start with the foundation EMDR itself begins with. A short, adaptive form: it asks only what applies to you, including your insurance and what brings you in. About five minutes. Our intake team reviews it personally and matches you with a trauma-trained clinician. Get matched → Call 215-399-4128 Curious who you might work with? Meet the team , 26 clinicians filterable by specialty. Frequently asked questions Is EMDR better than talk therapy? No. Research finds trauma-focused therapies perform comparably overall, and the therapist-client fit predicts outcomes more strongly than the modality. EMDR is an excellent tool for some people and some kinds of trauma; it is not a tier above everything else. Can I start with a trauma therapist now and switch to EMDR later? We are honest about this one: no, we match once, carefully, and you build with that therapist rather than switching tracks later. If EMDR specifically is essential to you, tell our intake team up front so we can be straight about what we can offer. What we have seen again and again: the foundation work is the same either way, and for many people, especially with complex or relational trauma, the deeper work turns out to be the treatment, not the waiting room. Is it safe to try EMDR on myself using TikTok or YouTube videos? We would gently but firmly say no. Reprocessing traumatic material can stir up intense distress, which is why trained clinicians control the pacing and build stabilization first. If self-guided videos have left you activated, that is a signal to bring this work to a professional, not a sign you failed. Does insurance cover trauma therapy and EMDR? At Turning Leaf, trauma therapy, including EMDR when part of your treatment plan, bills like any psychotherapy session: in-network copays typically run $15 to $50 after deductible with the plans we accept. How do I know if I need EMDR specifically? You do not have to decide alone, that is what assessment is for. A trauma-trained therapist will look at what happened, how it lives in you now, and what you want, then recommend an approach. The treatment plan should come from your story, not from what is trending. Turning Leaf Therapy at a glance: Depth-oriented, trauma-informed therapy in Old City, Philadelphia (123 Chestnut Street, Suite 304) and via secure telehealth across Pennsylvania and New Jersey. All 26 clinicians practice trauma-informed care; EMDR offered by select clinicians (availability varies). In-network with Aetna, United Healthcare / Optum, Highmark BCBS, Capital Blue Cross, Anthem / Empire / FEP BCBS, and Horizon BCBS NJ; typical copays $15 to $50 after deductible. Matched with a therapist within 1 to 2 business days. 215-399-4128. This article is educational and is not a substitute for professional care or diagnosis. Trauma content can be activating. If you are in crisis or thinking about harming yourself, call or text 988 (Suicide and Crisis Lifeline), text HOME to 741741 (Crisis Text Line), call the Philadelphia Crisis Line at 215-685-6440, or go to your nearest emergency room. Request your match → Or call (215) 399-4128 ===================================================================== URL: https://turningleaftherapyservices.com/blog/using-insurance-for-therapy-pa-nj/ ===================================================================== Home / Blog / Using Insurance for Therapy FROM THE BLOG Using insurance for therapy in PA and NJ: deductibles, copays and superbills, explained simply Written by Kaycee Beglau, PsyD Reviewed and updated August 2026. ON THIS PAGE The four words that decide what you pay The math, walked through twice Why your card says a name you have never heard Is my plan actually required to cover therapy? Out-of-network, explained without the runaround Exactly what to say when you call your insurer Paying with pre-tax dollars (HSA and FSA) The diagnosis question, and your privacy Getting started Frequently asked questions The short answer: yes. If you have health insurance in Pennsylvania or New Jersey, it almost certainly covers therapy. Federal parity law requires health plans that offer mental health benefits to cover them comparably to medical care. What you will actually pay comes down to four numbers on your plan, and at Turning Leaf, where we are in-network with Aetna, United Healthcare and Optum, Highmark BCBS, Capital Blue Cross, Anthem, Empire and FEP BCBS, and Horizon BCBS NJ, most clients land at a $15 to $50 copay per session after deductible. This guide explains those four numbers in plain English, walks the math with real examples, and gives you word-for-word scripts for calling your insurer. And if you would rather not do any of it: tell our intake team your plan, and we verify your benefits for free before your first session. The four words that decide what you pay Premium is what you or your employer pay monthly just to have the plan. Already spent; ignore it for therapy math. Deductible is what you pay out of pocket each plan year before insurance starts sharing costs. Until it is met, you pay your plan’s negotiated rate per session, which is usually less than a practice’s self-pay price. Copay is a flat fee per session once your deductible is met. This is where most of our in-network clients live: $15 to $50. Coinsurance is the alternative some plans use, a percentage of the session rate rather than a flat fee, often around 20 percent. One important wrinkle: some plans skip the deductible for outpatient mental health entirely and charge you just the copay from session one. This single detail changes your first-month costs more than anything else, and it is question two in the phone script below. The math, walked through twice Sarah, on a copay plan You may remember Sarah from our Philadelphia therapy cost guide : Aetna, a $1,500 deductible, a $30 mental health copay. Early in the plan year she pays Aetna’s negotiated session rate until she has spent $1,500 across all her health care. After that, therapy is $30 a session, every session. Marcus, on a coinsurance plan Marcus has a plan with a $1,000 deductible and 20 percent coinsurance. After meeting his deductible, if his plan’s allowed rate for a session is $120, Marcus pays $24 and his plan pays the rest. Same logic, a percentage instead of a flat fee. Both examples are illustrative. The only numbers that matter are yours, which is exactly what a benefits check tells you before you commit to anything. Whether you are starting anxiety therapy or deeper trauma work , the billing works the same way. Why your card says a name you have never heard Many plans carve out mental health benefits to a partner company. The classic example: your medical card says UnitedHealthcare, but your therapy benefits run through Optum. Nothing is wrong. It is the same coverage under a different administrator, and it is why the behavioral health number on the back of your card is the one that matters for therapy questions. We are in-network on the Optum side, which is what counts for UHC members. There is more on network confusion in our guide to finding a therapist who takes your insurance . Is my plan actually required to cover therapy? In almost all cases, yes. The federal Mental Health Parity and Addiction Equity Act requires plans that offer mental health benefits to cover them comparably to medical care, with no harsher session limits, copays, or approval hurdles than you would face for physical health. Pennsylvania and New Jersey plans also generally cover telehealth therapy on par with in-person care, which is how our clients see us from anywhere in either state. What parity does not do is set your copay or erase your deductible. It guarantees fairness, not a price. The price is those four numbers above. Turning Leaf is in-network with Aetna, United Healthcare and Optum, Highmark BCBS, Capital Blue Cross, Anthem, Empire and FEP BCBS, and Horizon BCBS NJ. Typical copay $15 to $50 after deductible. We are not in-network with Independence Blue Cross, Cigna, Medicare, or Medicaid; superbill reimbursement is explained below. Full session rates are on our rates page . Out-of-network, explained without the runaround If your plan is not on our list, here is the honest version of how out-of-network reimbursement works: You pay the session rate, $130 to $200 depending on the clinician’s license level. We give you a superbill, an itemized receipt with the diagnosis, service, and CPT codes insurers require. You submit it to your plan. If your plan has out-of-network mental health benefits, and many PPOs do, it reimburses a percentage of its allowed amount after you have met your out-of-network deductible. Two honest caveats. The allowed amount may be lower than the session price, so 70 percent back means 70 percent of their number, not ours. And Medicare and Medicaid generally cannot be reimbursed through superbills; their out-of-network rules are much stricter than commercial plans. If that is your coverage, ask our intake team about your options rather than counting on reimbursement. The insurance page lays out every plan we take. Exactly what to say when you call your insurer Call the behavioral health number on the back of your card and read these off. The rep may transfer you, which is normal. Script A, if we are in-network with your plan “Do I have outpatient mental health benefits for office and telehealth visits?” “Does my deductible apply to outpatient mental health, or do I just pay the copay?” “What is my copay or coinsurance per session?” “How much of my deductible is already met this year?” “Do I need a referral or prior authorization for outpatient therapy?” Usually no, but two minutes now beats a surprise later. Script B, if we are out-of-network “Do I have out-of-network outpatient mental health benefits?” “What is my out-of-network deductible, and how much is met?” “What percentage of the allowed amount do you reimburse for CPT code 90837, a therapy session?” “How do I submit a superbill, and how long does reimbursement take?” Write the answers down with the date and the rep’s name. Or skip the call entirely: tell us your plan and our intake team runs the check for you before your first session. Paying with pre-tax dollars (HSA and FSA) Psychotherapy is generally an HSA and FSA eligible expense, covering copays, self-pay sessions, and out-of-network balances alike. For many people that is an effective 20 to 30 percent discount, using money you have already set aside. Check with your plan administrator; no special paperwork is usually needed. The diagnosis question, and your privacy Insurance pays for treatment of a condition, so in-network billing requires a diagnosis code from your therapist. That code appears in your insurance records and on your Explanation of Benefits, the summary your insurer mails or posts after each claim. Superbills carry the same codes. Your therapist will discuss any diagnosis with you openly; nothing goes on paper that has not been talked about in the room. One situation deserves plain speech. If you are on someone else’s policy, a parent’s or a spouse’s, the policyholder can typically see Explanations of Benefits, which show that visits occurred, though not what was said. Your session content is confidential either way. If billing privacy is a real concern for your situation, tell our intake team. Options exist, including self-pay, and we would rather solve it with you upfront. Getting started 1 Reach out using the button below or call 215-399-4128 . Forms sent tonight are answered first thing the next business day. 2 A real person verifies your benefits , including deductible status, copay, and telehealth coverage, and tells you your expected cost per session. 3 You are matched with one of our clinicians at our Old City office, 123 Chestnut Street, Suite 304, or via telehealth anywhere in Pennsylvania and New Jersey. After your intake form, a coordinator reviews it and verifies your benefits; most people have a first session within about a week. Start your intake → Or call (215) 399-4128 Frequently asked questions Does insurance cover online therapy in Pennsylvania and New Jersey? Generally yes, on par with in-person sessions, with the same copays and benefits, for the in-network plans we accept across both states. Is a diagnosis required for insurance to pay for therapy? For in-network billing, yes. A diagnosis code accompanies each claim. Your therapist discusses it with you transparently, and it never includes session content. Self-pay is the alternative if you would rather keep insurance out entirely. My deductible is huge. What are my options? Ask question two from Script A first, because many plans charge only the copay for mental health and leave the deductible untouched. If yours does not, negotiated in-network rates are lower than sticker price, HSA and FSA dollars help, and associate-level clinicians start at $130. Our cost guide walks through all five levers. Does Medicare or Medicaid cover therapy? Both cover outpatient mental health care with participating providers. Turning Leaf is not in-network with either, and their rules generally do not allow superbill reimbursement, so if you carry Medicare or Medicaid, tell our intake team and we will be straight about whether we are a workable fit before you invest time. I am on my parents’ insurance. Will they know I am in therapy? The policyholder can typically see Explanations of Benefits showing that visits occurred, never what you talked about. If that is a barrier, raise it with our intake team; between plan-privacy options and self-pay rates, there is usually a path. Turning Leaf Therapy at a glance: depth-oriented, trauma-informed therapy in Old City, Philadelphia, at 123 Chestnut Street, Suite 304, and via secure telehealth across Pennsylvania and New Jersey. In-network with Aetna, United Healthcare and Optum, Highmark BCBS, Capital Blue Cross, Anthem, Empire and FEP BCBS, and Horizon BCBS NJ, with typical copays of $15 to $50 after deductible. Not in-network with Independence Blue Cross or Cigna; superbills provided. Free benefits verification before your first session. Call 215-399-4128 . This article is educational and is not a substitute for professional care or individualized insurance advice; always confirm benefits with your plan. If you are in crisis or thinking about harming yourself, call or text 988, the Suicide and Crisis Lifeline, text HOME to 741741 for the Crisis Text Line, or go to your nearest emergency room. ===================================================================== URL: https://turningleaftherapyservices.com/blog/first-therapy-session-what-to-expect/ ===================================================================== Home / Blog / Your First Therapy Session FROM THE BLOG What to expect at your first therapy session (and how intake works at a Philadelphia practice) Written by Kaycee Beglau, PsyD Reviewed and updated August 2026. ON THIS PAGE Nervous? That is not a sign something is wrong How intake actually works here The first 53 minutes What you will not be asked to do Office or telehealth? How will I know it is a fit? Getting started Frequently asked questions The short answer: a first therapy session is a structured getting-to-know-you conversation, 53 minutes covering what brings you in, some of your history, and what you are hoping for, with time for your own questions. There is no couch you have to lie on, no requirement to tell your hardest story on day one, and no commitment beyond seeing how it feels. Feeling nervous beforehand is close to universal, and your therapist knows that and plans for it. Here is exactly how it works at our relational, depth-oriented practice , from the moment you reach out to the moment your first session ends, including the parts nobody explains. Nervous? That is not a sign something is wrong Almost everyone is nervous before a first session, including people who have done therapy before, and including therapists starting their own therapy. Nerves do not mean you are not ready. They usually mean it matters. One thing worth knowing in advance: the urge to cancel tends to spike the day of the appointment. It is so common it is almost part of the process. The same protective instinct that kept you managing everything alone gets loud right before you try something different. If that urge shows up, you do not have to argue with it. Just go anyway. The hardest session is the one you are dreading; it is almost never the one you actually have. Before your first session: how intake actually works here At Turning Leaf, the path from thinking about it to sitting with your therapist looks like this. You reach out. The intake form or 215-399-4128 . A sentence about what is going on is plenty; you do not need a polished story or the right clinical words. A coordinator reviews it personally. Our intake team follows up to learn a bit about what you are looking for and to take your insurance information. We verify your benefits before your first session, so you know your expected cost per session up front. For most in-network clients that is a $15 to $50 copay. The full money picture lives in our therapy cost guide and our insurance guide . You are matched with a clinician who has availability. This is the step we are most deliberate about. With twenty-six clinicians across specialties, we match you by what you are coming in with and by style, not by whoever has the next opening. Most people have a first session within about a week. You schedule directly with your therapist and complete the intake paperwork online before you arrive: consents, policies, a bit of history. Doing it beforehand means your first session is spent talking rather than filling out forms. What to have ready: your insurance card, and nothing else. Notes are welcome if they help you feel prepared, but they are optional. The first 53 minutes, roughly minute by minute Every therapist has their own rhythm, but a first session at a depth-oriented practice usually flows something like this. Minutes 0 to 5: settling in. Introductions, how confidentiality works, any logistics. Your therapist expects you to be nervous and will carry the conversation until you find your footing. Minutes 5 to 15: so what brings you in? Say it however it comes out: polished, messy, out of order, through tears. There is no wrong version. "I do not know exactly, things just feel off" is a completely legitimate answer that therapists hear weekly. Minutes 15 to 35: your context. Questions about your life, including work, relationships, family, health, and what has helped or has not before. This is not an interrogation; it is your therapist building a map. You can pass on anything. "I would rather not get into that yet" is an allowed sentence, and saying it is itself useful information for both of you. Minutes 35 to 45: what you are hoping for. What would feel different in three months? You do not need goals in bullet points. "I want to stop feeling like this" counts. Minutes 45 to 53: your questions, and next steps. Ask anything: their approach, what sessions will look like, how they will know it is working. Then you will set a regular time. Most people start weekly. What you will not be asked to do Lie on a couch while someone takes silent notes. It is a conversation, in chairs or on video. The stereotype is fifty years out of date. Retell your trauma in detail on day one. As a trauma-informed practice , we work at the pace trust allows. Safety first, story when you are ready. That is not a courtesy; it is how good trauma care works. Have it all figured out. Confusion about what is wrong or what you need is a normal starting point, not a disqualification. Commit forever. You are committing to a first session, then a rhythm that gets reviewed openly as you go. Prove you are sick enough. If it is weighing on you, it qualifies. Old City office or telehealth for your first session? Both work. Research consistently finds online therapy as effective as in-person care for most concerns, so choose on comfort and logistics rather than effectiveness. In person: our Old City office at 123 Chestnut Street, Suite 304, is two blocks from the 2nd Street station on the Market-Frankford Line. Some people find that leaving their environment, physically going somewhere for themselves, helps mark the hour as protected. Telehealth: secure, HIPAA-compliant video from anywhere in Pennsylvania, and New Jersey with select clinicians, with no app download. For session one, find a room with a door, use headphones if privacy is thin, and sign on a few minutes early so technology is not the first thing on your mind. Many clients who start on video for convenience simply stay, and it is fully real therapy. More on how it works is on our telehealth page . How will I know my therapist is a fit? Fair question. Fit is the single strongest thing you bring to therapy’s success, so here is how we think about it honestly. We do the fit work up front. Our matching is not next available. Intake matches you by concern, specialty, and style across twenty-six clinicians precisely because you will be building something with this one person. We match once, carefully, and you build with your therapist. Give it two or three sessions before judging. First sessions are logistics-heavy and nerve-heavy for everyone. Fit shows itself once the room gets familiar. Do you feel listened to rather than processed? Can you say a hard thing and have it land safely? Do you leave feeling even slightly more understood than when you walked in? If doubt shows up, say it in the room. This is the counterintuitive part: telling your therapist "I am not sure this is working" is not rude and is not quitting. It is some of the most productive material therapy has. In relationship-based work, working through a wobble is the work, and it is often exactly where things deepen. Your therapist can take it. Bring it to them first. In-network: Aetna, United Healthcare and Optum, Highmark BCBS, Capital Blue Cross, Anthem, Empire and FEP BCBS, and Horizon BCBS NJ, with typical copays of $15 to $50 after deductible. Not in-network with Independence Blue Cross or Cigna; superbills provided. We verify your benefits before your first session. See all plans . Getting started Reach out. The intake form or 215-399-4128 . A coordinator reviews it and verifies your insurance, so you know your cost before you commit. You are matched with a clinician who has availability, and most people have a first session within about a week, in Old City or by telehealth. More detail on our getting started page and in the FAQ . Start your intake → Meet the clinicians Frequently asked questions What should I say in my first therapy session? Whatever is true. "Things feel off and I am not sure why" is as valid as a detailed history. Your therapist’s questions will do the structuring; your job is honesty at whatever depth feels possible on day one. Can I bring notes? Yes, and many people do. A few phrases about what you want to mention, or a timeline if your story feels tangled. Nobody will find it strange. What if I cry, or go completely blank? Both happen constantly, and neither derails anything. Tears are information, not embarrassment, and blankness usually eases once the first questions land. Therapists are trained for exactly these moments, and there is nothing you can do wrong in a first session. Do I have to talk about my trauma right away? No. You control the pace and the depth. A trauma-informed therapist builds safety before story; if anything, rushing into detail on day one is the opposite of good care. How long until therapy starts helping? It varies. Many people feel relief within the first few sessions simply from being heard, while meaningful change in longstanding patterns usually unfolds over months. Most people start weekly to build momentum, and your therapist will talk openly with you about progress as you go. Turning Leaf Therapy at a glance: depth-oriented, trauma-informed therapy in Old City, Philadelphia, at 123 Chestnut Street, Suite 304, and via secure telehealth across Pennsylvania and New Jersey. In-network with Aetna, United Healthcare and Optum, Highmark BCBS, Capital Blue Cross, Anthem, Empire and FEP BCBS, and Horizon BCBS NJ, with typical copays of $15 to $50 after deductible. Free benefits verification before your first session. Call 215-399-4128 . This article is educational and is not a substitute for professional care or diagnosis. If you are in crisis or thinking about harming yourself, call or text 988, the Suicide and Crisis Lifeline, text HOME to 741741 for the Crisis Text Line, or go to your nearest emergency room. ===================================================================== URL: https://turningleaftherapyservices.com/team/taylor-dunn/ ===================================================================== Home / Our Team / Taylor Dunn Psychology Resident Dr. Taylor Dunn The therapeutic relationship is of the utmost importance to me and the work that we will do together. Request your match → She/Her IV Specialties Anxiety Childhood Emotional Neglect Childhood Trauma Depression Life Transitions Relationships Trauma & PTSD Women’s Issues My Approach Psychodynamic Trauma-Informed Integrative Location In-Person / Virtual (PA residents) Rate $150 per session Licensure Psychology Resident, supervised by a licensed psychologist Insurance In-network with Aetna and PA VCAP. Superbills provided after every session on request. O ur past experiences have a profound impact on the present, particularly on our emotional and relational patterns. Through our work in therapy, I hope to spend time exploring your past experiences while also attending to your needs in the here and now. My therapeutic approach will help you gain insight into how and why your patterns developed and help you move toward desired and meaningful change in your life. Throughout the course of therapy, I strive to meet you where you are at and go at a pace that makes sense for you. I consider myself to be a psychodynamic and trauma-informed practitioner. I have worked with individuals across the lifespan with varying presenting concerns including depression, anxiety, and attachment and relationship difficulties. However, I have particular expertise in trauma and complex trauma. I also recognize the importance of culture and intersectionality and aim to provide culturally-informed care to everyone I work with. The therapeutic relationship is of the utmost importance to me and the work that we will do together. My hope is to create a therapeutic space that feels empathic, warm, safe, and comfortable. I look forward to connecting! request an appointment Request Taylor. Our intake coordinators review every request personally. Mention Annie in the intake and we will check openings and fit, or suggest the closest match. Request Taylor → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/team/karla-martin-gonzalez/ ===================================================================== Home / Our Team / Karla Martin González LAPC Karla Martin González Therapy can be a space of creation where something new is given room to emerge with every word spoken. Request your match → She/Her IV Specialties Anxiety Childhood Trauma Depression Grief & Loss Identity Exploration Intergenerational Trauma Life Transitions Relationships My Approach Psychoanalytic Psychodynamic Trauma-Informed Person-Centered Existential Languages English & Spanish Location In-Person / Virtual (PA residents) Rate $130 per session Licensure LAPC, licensed in Pennsylvania Insurance In-network with Aetna and PA VCAP. Superbills provided after every session on request. D o you find yourself repeating the same scene? Would you like to relate to yourself in a new way? Therapy can be a space of creation where something new is given room to emerge with every word spoken. Rather than treating recurring struggles as flaws to correct, I regard them as symptoms, coded messages worth deciphering. My analytic work is an invitation to uncover the parts of yourself still waiting to be understood. My clinical practice offers a space free of judgment, where you can speak openly and begin to articulate your own singular desire. Together, we will journey through your repetitive symptomatic patterns, not to erase them, but to change your relationship to them, so a more livable expression of you can give birth. Psychoanalysis leads to lasting shifts: an authentic life, and your unique way of moving through the world. Whether you are seeking relief from distress, a new understanding of yourself, or simply a new direction, I will meet you where you are, and together we will listen to what insists in your dreams, your slips, your relationships, and your speech. I am trained in psychoanalysis and sociology. As an immigrant, I have moved across languages, borders, and belongings. That movement has shaped how I listen: attentive not only to what is spoken, but to what a life carries with it, and to the patterns that keep returning, dressed in new circumstances but familiar in their shape. I offer a multicultural, LGBTQ+-affirming, trauma-informed practice to individuals from all backgrounds and can work in English and/or Spanish. request an appointment Request Karla. Our intake coordinators review every request personally. Mention Annie in the intake and we will check openings and fit, or suggest the closest match. Request Karla → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. ===================================================================== URL: https://turningleaftherapyservices.com/team/brian-matlaga/ ===================================================================== Home / Our Team / Brian Matlaga Psychology Resident Dr. Brian Matlaga The desire to understand and feel understood is one of our most basic human needs. Request your match → He/Him IV Specialties Attachment Childhood Emotional Neglect Childhood Trauma Identity Exploration Intergenerational Trauma Relationships Self-Harm & Suicidal Ideation Trauma & PTSD My Approach Psychodynamic Family Systems Attachment-Focused Location In-Person / Virtual (PA residents) Rate $170 per session Licensure Psychology Resident, supervised by a licensed psychologist Insurance In-network with Aetna and PA VCAP. Superbills provided after every session on request. T he desire to understand and feel understood is one of our most basic human needs. This desire is the foundation upon which I practice my approach to psychotherapy. I primarily take a psychodynamic approach, which means that I believe we as humans find ourselves repeating certain patterns that in some way contribute to our suffering. I believe, in the most general sense, that psychotherapy can be most helpful when it allows us to understand these parts of ourselves that repeat these patterns. I also believe the therapeutic relationship must provide the trust to allow this type of exploration. I completed my doctorate training in clinical psychology at Chestnut Hill College where I studied both psychodynamic and systems approaches to individual and family therapy. I completed my doctoral internship, as well as my advanced clinical practicum, at Tuttleman Counseling Services, which is the college counseling office at Temple University. In addition to college counseling experience, I have also worked in private practice for approximately three years seeing individuals and families. During my training for my master’s degree in clinical mental health counseling, I acquired practical experience in substance use treatment centers and have worked with various levels of care as it pertains to people with addiction. Independently of my academic trainings, I am currently in the advanced stages of training to become certified in Mentalization Based therapy, which is a treatment originally designed for individuals with Borderline Personality Disorder and Antisocial Personality Disorder, but it has proven clinical applications for people with Narcissistic Personality Disorder, Trauma-Related Disorders, Depression, Eating Disorders, and more. I have also completed a Trauma certification program. Specific diagnoses that I believe my approach works best for are personality disorders, trauma-related disorders, and some mood-related disorders. Regardless of diagnosis, I find that I work well with people who are struggling with a sense of identity or continuity in their sense of self, people who have distressing or non-traditional families of origin, people who are experiencing significant distress in their personality or romantic relationships, people engaging in self-harm or self-destructive behavior, and grief and loss. In my work with family therapy, I find I work best with adult families especially ones that are working through cutoffs with other family members. Please reach out if you want to make the next step and get into contact with me about the possibility of beginning psychotherapy. I do ask that people interested in working together are able to meet weekly for the most part, as I believe this is the most effective way for psychotherapy to work. request an appointment Request Brian. Our intake coordinators review every request personally. Mention Annie in the intake and we will check openings and fit, or suggest the closest match. Request Brian → Or call (215) 399-4128 HIPAA-secure. Reviewed personally by our intake coordinator team. Response in 1 to 2 business days. # Last Updated 2026-09