Therapy FAQ

This therapy is for high-responsibility adults who are carrying a lot internally and externally, and want care that takes their real life seriously, not just symptoms. Common themes include anxiety and panic, trauma and chronic stress, workplace or relationship strain, identity-related stress, and feeling like you are functioning outwardly while struggling inside.

A good fit usually feels like clarity and steadiness, not pressure. In the consultation, we'll look at what you are dealing with, what you have already tried, and what you want to be different. If we are not the best match, we will tell you directly and help you think about the next best step.

We get specific about what is happening now and what you want to change. We will ask about your history only as it becomes relevant. We also talk about pacing, safety, and what support looks like between sessions, so the plan fits your life.

It depends on your goals and what you are navigating. Many people work with us for several months to a year. Some come for shorter-term support around a specific problem, and some stay longer when they are doing deeper trauma work or moving through major life transitions.

Most clients start weekly or every other week. We decide together based on your needs, your capacity, and what will be sustainable.

It means we treat your stress and your symptoms as intelligent responses to real experiences, not as problems to be managed away. Trauma-informed care at PAAPOY recognizes that many of the patterns you developed — hypervigilance, overwork, emotional containment, perfectionism — were strategies that kept you safe. Therapy is not about eliminating those patterns. It is about understanding them well enough to choose when they serve you and when they do not.

Yes. Many of our clients have done meaningful therapeutic work and reached a point where insight alone is no longer producing change. This is common with trauma, attachment wounds, and chronic stress patterns that are held in the body as much as in the mind. Modalities like EMDR and, when appropriate, ketamine-assisted psychotherapy can access material that talk therapy alone sometimes cannot reach. Hitting a ceiling does not mean therapy failed. It may mean you need a different kind of access.

Yes, and we take burnout seriously as a clinical issue, not just a lifestyle problem. Many of our clients are working professionals whose burnout is rooted in structural pressures — workplace harm, systemic barriers, caregiving demands — not personal failings. We address burnout through the same trauma-informed lens we bring to all our work, because chronic overextension often has the same nervous system signature as trauma.

EMDR (Eye Movement Desensitization and Reprocessing) is an evidence-based therapy that helps the brain reprocess distressing memories so they feel less raw and less triggering. We use structured, guided steps to help your nervous system "digest" what got stuck.

EMDR can be a strong fit if you have specific memories, sensations, images, or situations that keep resurfacing, or if you feel stuck in patterns that do not shift through insight alone. It can also help when you are tired of talking through the same story without relief. We’ll confirm fit and readiness together.

Not necessarily. We do not require detailed storytelling for EMDR to work. We go at a pace that feels safe, and we focus on what is needed for processing, not on re-living your experience.

We start by building stability and identifying what you want to target. During processing, we use bilateral stimulation (such as eye movements or tapping) while you notice what comes up. We track shifts in your body, thoughts, and emotions, then close the session with grounding so you leave feeling oriented.

If you tend to dissociate, shut down, or feel easily flooded, we can still do EMDR, but we may start with more preparation and pacing. Safety and stabilization come first. If EMDR is not the right first step, we will tell you and adjust the plan.

KAP combines psychotherapy with a ketamine-supported session when clinically appropriate and when you have a prescribing medical provider. Ketamine can temporarily shift how the brain and nervous system process emotion and memory. Your therapist is present during the session to provide real-time support, and integration sessions help you make sense of what came up and translate it into real-life change.

KAP can help adults dealing with trauma, PTSD, treatment-resistant depression, chronic pain, and anxiety. Some clients come to KAP after years of therapy that built insight but not lasting relief. Others are navigating conditions where conventional treatments have not provided enough improvement. Readiness looks different for everyone. A free consultation helps determine whether KAP is the right fit for where you are right now.

Ketamine infusion clinics typically administer ketamine in a medical setting without a therapist present. Clients are often left to process the experience on their own. With KAP, a trained psychotherapist is with you before, during, and after the session, providing real-time therapeutic support. The therapeutic relationship is the foundation, not just the medicine. This is what makes KAP psychotherapy, not just treatment.

KAP is a structured clinical process with medical oversight, therapeutic support, and clear treatment goals. The dosing is prescribed and monitored by a licensed provider. Your therapist is present during the experience to help you work with what arises. Recreational use has none of these safeguards. The therapeutic container is what makes KAP effective, not the substance alone.

KAP follows a three-phase structure. Preparation sessions build trust, clarify intentions, and develop grounding skills. During the KAP session, you take the medicine as prescribed by your provider, typically a tablet or nasal application, with your therapist present via telehealth or in person. A support person may also be with you in your space. Integration sessions afterward help you process what emerged and connect it to your life.

No. We provide psychotherapy, preparation and integration support. Ketamine is prescribed and medically managed by a licensed medical provider. We can coordinate care with your prescriber if you want.

Preparation focuses on safety planning, intentions, and reducing avoidable risks. Integration focuses on meaning-making and follow-through: what you noticed, what shifted, and how to apply insights to your daily life, relationships, and decisions.

You will need a prescriber before beginning KAP sessions, but you do not need one before reaching out to us. You can work with any licensed ketamine prescriber. If you are having difficulty finding one, we can suggest options to help you get started. This is something we can discuss during a consultation.

Not necessarily. Some KAP clients have extensive therapy backgrounds. Others are newer to the process. What matters is readiness, not a specific history. During a consultation we assess where you are and whether KAP, EMDR, or another approach is the best starting point.

When prescribed by a licensed medical provider and supported by a trained therapist, KAP has a strong safety profile. Your prescriber manages all medication, dosing protocols, and medical oversight. PAAPOY provides the psychotherapy component, including preparation, therapeutic presence during sessions, and integration afterward.

Yes. Research supports ketamine's effectiveness for certain chronic pain conditions, and the psychotherapy component of KAP helps clients develop new relationships with pain, build coping strategies, and process the emotional weight that often accompanies chronic pain. A consultation can help determine whether KAP is appropriate for your situation.

This varies by person and what you are working on. KAP is not a one-time treatment. It is part of ongoing therapy that includes preparation and integration. Some clients benefit from a focused series of sessions. Others incorporate KAP periodically as part of longer-term work. We build a plan together based on your goals and response.

Preparation and integration sessions are available via telehealth throughout New York State. During KAP sessions, your therapist can be present via secure telehealth while you are in your own space with your prescribed medicine and a support person if needed. Specific logistics depend on your prescriber's protocol.

Therapy sessions including preparation and integration may be covered by insurance depending on your plan. PAAPOY is in-network with Aetna, Cigna/Evernorth, and Empire Blue Cross Blue Shield. The ketamine medication itself is managed and billed separately through your prescriber. A consultation is a good place to discuss your specific coverage.

Your prescriber handles the medical side: dosing, administration, and monitoring. When clinically appropriate, your therapist is present to hold the therapeutic space. This is not talk therapy during the experience. It is grounded, quiet support. Your therapist helps you feel safe, stays attuned to what is emerging, and is there when you are ready to begin processing. The structure of same-day support varies depending on your prescriber's model and your clinical needs.

Ketamine has shown meaningful results for people whose depression has not responded to traditional medications or therapy. It works through a different mechanism than standard antidepressants, supporting the growth of new neural connections and creating a window of increased neuroplasticity. At PAAPOY, we pair this with structured psychotherapy so the changes have something to land on. Preparation, same-day therapeutic support, and integration are what make the difference between a temporary shift and a lasting one. Your prescribing provider determines whether ketamine is medically appropriate for your situation.

Some clients come to KAP because chronic pain has become intertwined with depression, anxiety, or trauma. Ketamine has been studied for its effects on certain pain conditions, and many clients find that addressing the psychological dimensions of pain alongside medical treatment opens new ground. We do not treat chronic pain directly. Your prescriber manages the medical protocol. Our role is to support the therapeutic processing that happens around and after ketamine sessions, which for some clients includes working with how pain has shaped their nervous system, their identity, and their daily life.

Many of our clients are professionals, caregivers, or people who have managed significant challenges without ever appearing to struggle. High-functioning does not mean low-suffering. If you have done years of therapy that built insight but not relief, or if you have been managing symptoms through discipline and strategy rather than actual recovery, KAP may offer a different kind of access. The preparation and integration is designed for people who think carefully about their own process and want to understand what is happening, not just feel different temporarily.

We are a psychotherapy practice that integrates ketamine-assisted treatment when it is clinically appropriate. That means every client has a therapeutic relationship before, during, and after ketamine sessions. The three-phase structure — preparation, same-day therapeutic support, and integration — ensures that the ketamine experience is held within a therapeutic relationship, not delivered as a standalone procedure. Your prescriber handles the medicine. We handle the meaning.

We accept insurance through our network partnership (Octave) for eligible clients and plans. We also offer private pay. If you are not sure what applies to you, start by checking your coverage.

Use this link to check coverage and estimated costs: Check your insurance
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Yes, when clinically appropriate and when your plan allows it. A superbill is a detailed receipt you can submit to your insurance for possible reimbursement. Reimbursement is not guaranteed and depends on your plan.

We offer both private pay and insurance-based options. Fees vary by service type and session length. The simplest way to confirm your cost is to use the insurance checker link above or ask during a consultation.

We keep a limited number of reduced-fee spots when available. If cost is a barrier, please let us know, and we will let you know what is currently possible.

We ask for at least 24 hours notice to cancel or reschedule. Late cancellations may be charged the full session fee. This policy protects time reserved specifically for you.

If you miss a session without notice, we typically charge the full session fee. If something unexpected happens, let us know as soon as you can, and we will respond with care and clarity.

Most sessions are held online via secure video for clients located in New York State. Limited in-person availability in NYC may be offered depending on scheduling and fit.

A private, quiet space, a stable internet connection, and a device with a camera and microphone. Headphones can help with privacy. If privacy is complicated, we can troubleshoot options together.

Scheduling is handled through Calendly. You can book, reschedule, or cancel using the link in your confirmation email. If you get stuck, email us and we will help.

We use a secure, HIPAA-compliant video platform. You will receive a private link before each session.

Limited evening times may be available. Weekend sessions are not typically offered. If you have a schedule constraint, mention it during the consult so we can confirm what is realistic.

Therapy services are available only to clients located in New York State at the time of the session. If you are outside NY, we can offer general guidance on next steps and help you identify appropriate resources.

You’re welcome to email between sessions for scheduling, logistics, or a brief clarification related to our work. Please use a clear subject line so your message is easier to triage. We typically respond within 1–2 business days. Email is not monitored in real time, so if you need urgent support, call 988 or 911.

We typically respond within 1–2 business days. Messages sent evenings, weekends, or holidays are answered the next business day.

Brief check-ins may be available when clinically appropriate and scheduling allows, but are not guaranteed. If you anticipate needing additional support, we can discuss options such as adjusting session frequency.

If you are in immediate danger or need urgent support, call 988 (Suicide & Crisis Lifeline) or 911, or go to the nearest emergency room. You can also contact a trusted support representative. We can address what happened and plan support in your next session.

Yes. What you share in therapy is confidential, with limited legal exceptions such as imminent risk of harm, suspected abuse or neglect, or a valid court order. We can review confidentiality in the first session so expectations feel clear.