Psychotherapy for adults in New York and California
Sessions are held online, with occasional in-person sessions available in New York City and San Francisco. Coaching for expats living outside the US.
Maybe there is a clear reason you’re thinking about therapy: a loss, a move, a relationship that has changed, a hard stretch at work. Or maybe there is no single event, just a long period of feeling tired and dissatisfied.
The people I work with are often thoughtful and capable. You may have always been the person who pays attention to others, smooths over conflicts, and worries about disappointing people.
That awareness has probably helped you in your relationships, your family life, and your work. But under strain, patterns like second-guessing decisions, replaying conversations in your head, or feeling anxious when someone seems unhappy with you become hard to switch off and start to wear you down.
There is a subtler cost, too. Your attunement to others, the instinct that keeps you connected, can leave you out of touch with yourself: what you feel, what you need, and what matters to you.
Therapy is not about becoming less caring, or deciding that other people no longer matter. It might mean noticing guilt without letting it make every decision, or turning some of the attention you give everyone else back toward what works for you.
We begin by looking closely at these patterns, including how they developed, what they have helped you manage, and what they may now be costing you.
The work often involves getting clearer about what you want, easing the overthinking that keeps you stuck, and understanding the difference between care and responsibility.
As you make sense of them, you can begin to feel more present, more confident, and less guarded. In daily life, that can mean expressing yourself more directly, and relationships that feel more balanced.
Kelsey Crowe
More than a sounding board
I am a psychotherapist and the co-author of the bestselling book There Is No Good Card for This, about empathy and how to show up for people in difficult times. My work has been featured by NPR, The Wall Street Journal, and Forbes.
I work with adults who are self-aware and often used to carrying a great deal: emotionally, relationally, or professionally.
My style is warm, engaged, and direct. I listen closely, but I am not a blank screen. Together, we can find words for what is hard to name, and think about what change could look like.
My clinical work is informed by both depth-oriented and practical approaches. Psychodynamic therapy, attachment-based therapy, and parts work help us understand the less conscious fears, wishes, family patterns, and relational experiences that may shape present-day struggles.
I also draw from Acceptance and Commitment Therapy to support change in the present: noticing what is happening in the moment, making room for difficult feelings, and making choices that are more connected to your values.
Education
PhD in Social Welfare, University of California, Berkeley
Master of Social Work, Silberman School of Social Work at Hunter College / CUNY
BA, Earlham College
Additional clinical training
British Psychotherapy Foundation, psychodynamic psychotherapy training
Acceptance and Commitment Therapy (ACT), course with Russ Harris, author of The Happiness Trap
Attachment-based therapy: Emotionally Focused Therapy (EFT) course with Sue Johnson through the International Centre for Excellence in EFT (ICEEFT)
Parts work: Internal Family Systems (IFS) live course with Richard Schwartz, who developed the model
How I work
I try to avoid therapy that feels overly formulaic or didactic. Tools can be helpful, but I do not believe people change simply by being given a worksheet or told what to do.
Good therapy often involves both depth and practicality: understanding why a pattern developed, noticing how it shows up now, and experimenting with new ways of responding.
Much of this is about how earlier experiences shaped the ways you learned to manage closeness, conflict, ambition, guilt, anger, loss, and need.
The aim is not insight for its own sake. The work is about understanding what has shaped you, noticing what is happening now, and building a life that feels meaningful and sustainable, not just manageable.
Writing and empathy
I am the co-author of There Is No Good Card for This, a book about empathy and what people need from one another during grief, illness, loss, and other moments when ordinary language often fails. While my therapy practice is not limited to grief, I do work with people navigating loss, major transitions, illness, family strain, and the emotional weight of caring for others.
My background spans clinical practice, teaching, writing, and a former career in leadership in public policy. I bring that range of experience to my work with people navigating high-pressure careers, creative ambitions, complex relationships, and transition.
I have taught at institutions including UC Berkeley, California State University, and the University of Ghana, Legon. I have also lived and worked in the United States, Europe, South America, and West Africa, including Peace Corps service in Ghana. I now spend part of each year in Paris, and much of my coaching work is with people building a life across more than one country.
Personally, I have experience with illness and loss, and with caring for a family member living with mental illness.
The book
There Is No Good Card for This
What to Say and Do When Life Is Scary, Awful, and Unfair to People You Love
A book about empathy and what people need from one another during grief, illness, loss, and other moments when ordinary language fails. Co-authored with, and illustrated by, Emily McDowell.
“This book is a gift. It’s the wonderful crash course in Humanity 101 that none of us got to take in school. Without judgment, and with humor and compassion, it shows you how to show up as the best possible version of yourself when it matters most.”
Elizabeth Gilbert, author of Eat, Pray, Love
Named to best-of lists, 2017–2022
BuzzfeedNational Library BoardSan Francisco ChronicleChicago TribuneThe Christian CenturyOverDrive Librarians
Featured on
NPRThe Wall Street JournalForbesMSNBCCNNNew York MagazineSlateSelfSalonViceGreater Good
Endorsed by
Sheryl Sandberg, New York Times bestselling author of Lean In
Adam Grant, Wharton professor and New York Times bestselling author of Think Again
Glennon Doyle, New York Times bestselling author of Untamed
BJ Miller, MD, palliative care physician and author of A Beginner’s Guide to the End
“One of seven books to read to change your life.”
Buzzfeed
“A mandatory manual for humans that plan to interact with other humans.”
Book Riot
“This is the most important book I’ve read in the last couple of years! It’s an unbelievably compassionate, well-researched, and beautifully illustrated guide through the challenges of being there for one another in difficult times.”
Amazon reviewer
University Common Reads selection
Universities use the book as a common read, introducing first-year students to empathy and to supporting one another.
“One of my biggest takeaways from our University Strategies course would be the lessons shared in our common read, There Is No Good Card for This.”
Student reader
“Personally, the book was like therapy, easing you into uncharted territory gently.”
Empathy, communication, and showing up in difficult times.
Kelsey Crowe is the co-author of There Is No Good Card for This and has spoken to audiences across healthcare, business, education, and the nonprofit world about empathy, communication, burnout, and how to support people through difficult moments.
Her talks are warm, practical, and engaging, offering audiences language and tools they can use right away — without turning empathy into another impossible standard to meet.
“This work is incredibly honest and powerful. It gives us a way to talk with each other that allows us to be more fully ourselves.”
Karen May, Vice President of People, Google
“For a more caring work culture, I cannot recommend Empathy Bootcamp enough. We are so grateful, and wish we had taken on Kelsey’s message and learnings so long ago.”
Megan Thiel, Director of HR, StoryCorps
“Our experience with the Empathy Bootcamp was phenomenal. I received countless comments about its depth and practicality.”
Amy Hunter, Director of Equal Opportunity and Compliance, Smith College
“Taking this course was like wearing prescription glasses for the first time.”
Jen Taylor, California Department of Education
Where I’ve spoken
Selected clients
Kelsey has spoken for organizations across business, higher education, healthcare, public education, and the nonprofit world.
Companies
GoogleJ.CrewCare.comTriNetSwiss Re
Universities
Stanford UniversityColumbia UniversityUniversity of Pennsylvania (Wharton School)Smith College
Hospitals & medical centers
Stanford University, Department of MedicineCleveland ClinicUCSFCalifornia Pacific Medical Center
Nonprofits
Leukemia & Lymphoma SocietyStoryCorpsReImagineGood GriefCommonwealth Club of California
Education
California Department of EducationStanislaus County Office of EducationMerced County Office of EducationLab School Paris
Talks and workshops
What I speak about.
Kelsey speaks and leads workshops on empathy in difficult times, empathy burnout, and connecting across difference, for corporate, medical, educational, and nonprofit audiences — including universities using There Is No Good Card for This as a Common Read selection.
Her signature workshop, Empathy Bootcamp, is an immersive three-hour session that brings these themes together in one room. Full talk descriptions, formats, and audiences are in the speaker sheet, and every session can be tailored to your audience and goals.
Continuing education (CE) credits are available in medical, psychology, education, and social work settings.
A few things people often want to know before reaching out. If your question isn’t here, you’re welcome to get in touch.
Do I even need therapy?
People often come to therapy during a difficult transition or rupture: a breakup, grief, illness, job loss, family conflict, burnout, or a major life decision.
Others come with something harder to name: a nagging sense that they are anxious, resentful, disconnected from themselves, or living in a way that no longer feels sustainable.
Both are good reasons to begin. Therapy can help you understand not only what is happening now, but the deeper patterns it may be bringing into view.
How long are sessions, and how often do we meet?
Sessions are 55–60 minutes. I work with people weekly, and sometimes twice weekly — that consistency is a big part of what makes therapy effective, so new work begins at a weekly cadence.
What are your fees?
Weekly sessions are $300, twice-weekly $275 each, and $320 for established clients on an every-other-week schedule. For expats and clients living outside the US, ongoing coaching varies, and we settle it during the consultation. Full details, including reduced fees, insurance and HSA use, are on the Fees page.
Do you offer reduced fees or a sliding scale?
Yes, a small number of spots, reserved for people facing a recent loss or drop in income and for those in lower-paying nonprofit work. Availability varies. See the Fees page for how to ask.
Do you take insurance?
I’m an out-of-network provider, so I don’t bill insurance directly. Many clients still use their benefits: if your plan includes out-of-network coverage (most PPO plans do), it may reimburse a portion of each session — often somewhere in the range of 50–80% — once you’ve met your out-of-network deductible. The exact amount depends on your plan, and some plans (such as many HMOs) don’t include out-of-network benefits at all.
To make this straightforward, I provide a monthly superbill — an itemized receipt you submit to your insurer for reimbursement. The Fees page walks through the whole process, including using an HSA or FSA.
To find out what your plan covers, you can ask your insurer: – Do I have out-of-network benefits for outpatient mental health? – What’s my out-of-network deductible, and how much have I met this year? – Once it’s met, what percentage of each session is reimbursed? – Is there a maximum reimbursable (“allowed”) amount per session? – Is there a limit on the number of sessions per year? – How do I submit a claim, and is there a deadline? If the answers are confusing, I’m happy to help you make sense of them.
I live outside the US. Can we work together?
Yes. For expats and clients living outside the US, I offer coaching as regular ongoing sessions. We start with a call to talk about what you are looking for and to settle pricing.
Coaching is a separate service from therapy. It isn’t psychotherapy, isn’t intended to treat mental health conditions, and isn’t billed through insurance — and for the same reason it is not eligible for HSA or FSA funds.
My psychotherapy practice is limited to clients located in New York and California, where I am licensed.
What if I need to cancel or miss a session?
You can miss up to six sessions in any twelve-month period without a fee, and you never have to explain why. The full policy is on the fees page.
Do you offer online or in-person sessions?
My practice is primarily online, and sessions are held by video. When schedules and location allow, I also offer in-person sessions in New York City and San Francisco. The first consultation is a phone call.
What approaches do you use?
My work draws on psychodynamic and attachment-based therapy and parts work to understand the roots of present-day struggles, alongside Acceptance and Commitment Therapy to support change in the present.
How do we get started?
We begin with a brief 20-minute consultation by phone to see whether this feels like a good fit. There’s no obligation to continue — it’s a chance to share what’s bringing you in, ask questions, and get a feel for how we might work together. The consultation is free. Have a look at the Fees page first, then write to me and we’ll find a time.
Why aren’t there any reviews?
Fair question, and it isn’t for lack of clients I’m grateful to. Professional ethics across the therapy field — in social work, psychology, and counseling alike — discourage soliciting reviews or testimonials from clients, and flatly prohibit it with anyone currently in treatment. The reason is the power imbalance: a client could feel they ought to leave a glowing review, or that the relationship somehow depends on it, and that kind of pressure has no place in work that runs on trust.
I know that can feel a little cryptic when we’re used to checking reviews for everything under the sun, especially for something that asks for as much trust as therapy does — and where the field lands on this as norms shift, who knows. For now, the better way to get a feel for me is to read how I describe my approach here and to book a short consultation, so you can decide for yourself.
Is what we talk about confidential?
Yes. Therapy is confidential, with limited exceptions required by law (such as risk of serious harm to yourself or others). I’ll go over exactly what that means at the start of our work.
Ordinary email isn’t a secure or private channel, so please keep it general — a few sentences about what you’re looking for is plenty. Anything personal is better talked through on the call.
For speaking engagements and workshops, the same address works — just mention your organization and audience.
Or send a message here
Thank you — your note is on its way to Kelsey. She’ll be in touch soon.
Hmm, that didn’t send. Please email me directly using the button above instead.
Whatever you write comes straight to me, and only to me. No need to go into anything sensitive or clinical here — a few sentences about what you’re looking for is plenty, and we’ll talk through the rest privately.
You have the right to receive a Good Faith Estimate explaining how much your care will cost.
Under the federal No Surprises Act, health care providers must give people who are uninsured, or who are not using insurance, an estimate of the expected cost of services.
You have the right to a Good Faith Estimate for the total expected cost of any non-emergency services.
You can ask any provider for a Good Faith Estimate before you schedule a service.
You will receive a Good Faith Estimate in writing at least one business day before your first session.
If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute it.
Keep a copy of your Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate, visit cms.gov/nosurprises or call 1-800-985-3059.
Fees & insurance
What therapy costs
Here’s what therapy with me costs, along with what I know about using insurance and pre-tax accounts to bring that cost down.
Session fees
Twice weekly — 55–60 minutes
$275 / session
Weekly — 55–60 minutes
$300 / session
Every other week — established clients only
$320 / session
Ongoing coaching — expats and clients living outside the US
Set during consultation
New therapy work begins at a weekly cadence. That consistency is a large part of what makes therapy effective, so the every-other-week rate is available only to established clients who move to that schedule later.
Reduced fees
I keep a small number of reduced-fee spots. I use a version of the Green Bottle Method, a sliding scale framework designed by Alexis J. Cunningfolk. Look at the three bottles and see which one sounds like your situation.
A full bottle. You meet your basic needs comfortably. Any debt you carry doesn’t get in the way. You have regular access to health care, some savings, and enough left over each month for the things you enjoy. You can take a holiday or time off without it setting you back.
A partly full bottle. You meet your basic needs, though it isn’t always effortless and you sometimes worry about it. You’re employed and have health care. There may be modest savings and a little left over each month. You buy some things new and find others secondhand. Time away is possible, if not every year.
A nearly empty bottle. Meeting basic needs is a frequent strain, and sometimes you can’t. Debt gets in the way. Housing or transport may be unstable. You may be unemployed, underemployed, or eligible for public assistance. There’s little or nothing left over, and time off isn’t realistic.
Income is only part of it. Access to family money, existing savings, and a reasonable expectation of future security all belong in the calculation, even when you aren’t drawing on them now.
If the second or third bottle describes you, just say so when we talk and we’ll find a rate that works. Availability varies, so these spots are sometimes full.
The consultation call
We begin with a brief 20-minute consultation by phone to see whether this feels like a good fit. There’s no obligation to continue — it’s a chance to share what’s bringing you in, ask questions, and get a feel for how we might work together.
The consultation is free. It’s a phone call; ongoing sessions are held by video.
How to begin
When you’re ready, write and we’ll find a time for the consultation.
You can miss up to six sessions in any twelve-month period, whether you cancel or not, and you never have to explain why. Rescheduling within two weeks doesn’t count toward the six. Beyond that, missed sessions are charged at the full fee. Notice is appreciated but never required.
Paying with an HSA or FSA
If you have a Health Savings Account or Flexible Spending Account, you can generally use it for therapy. The IRS treats psychotherapy provided by a licensed clinician as a qualified medical expense when it’s for the treatment of a diagnosed condition, and a Licensed Clinical Social Worker qualifies. In practice that means you can pay with your HSA or FSA card, or pay me directly and reimburse yourself from the account. The superbill I provide is the documentation your plan administrator will want.
Two things worth knowing:
Coaching is not eligible. Coaching isn’t psychotherapy and isn’t intended to treat a mental health condition, which is exactly the line the IRS draws. Please don’t use HSA or FSA funds for coaching sessions.
You can’t claim the same expense twice. Sessions paid for with pre-tax HSA or FSA dollars can’t also be taken as a medical deduction on your return.
Plans differ in what they ask for, and some request a letter of medical necessity. Your plan administrator is the authority on your own account — but I’ll provide whatever documentation you need from my end.
Insurance
I’m an out-of-network provider, which means I don’t bill insurance directly. Even so, many clients who have out-of-network benefits can recover part of the cost of their sessions by submitting a superbill to their insurer — often somewhere in the range of 50–80% once the out-of-network deductible is met, though the exact amount depends entirely on your plan. Some plans, including many HMOs, have no out-of-network benefits at all.
The rest of this page walks through how that works. The paperwork can look intimidating at first, but it usually becomes a short, repeatable routine once you’ve done it the first time. If anything is unclear, please ask me — I’m glad to help.
What a superbill is
A superbill is simply an itemized receipt containing everything your insurance company needs to consider an out-of-network claim. You pay me directly for each session; I give you a superbill; you send it to your insurer; and if you have out-of-network coverage, they reimburse you for part of the cost.
A complete superbill includes:
Your name and date of birth
My name and credentials, practice address, and National Provider Identifier (NPI)
My practice tax identification number
The dates we met, the service (CPT) code for each session, the session length, and the fee you paid
The place of service — for example, in person or telehealth
A diagnosis code (ICD-10), if your plan requires one to process the claim
Before you start, call your plan
A few minutes on the phone with the member-services number on the back of your insurance card will tell you most of what you need to know. It helps to ask:
Do I have out-of-network benefits for outpatient mental health or psychotherapy?
What is my out-of-network deductible, and how much of it have I met this plan year?
Once the deductible is met, what percentage of the allowed amount do you reimburse?
Is there any limit on the number or frequency of sessions?
Do I need preauthorization or a referral?
Which session (CPT) codes are covered — for example 90791, 90834, 90837, or 90847?
Are telehealth sessions covered, and do they require a modifier such as 95?
Is there a deadline for submitting a claim after the date of service?
How do you prefer claims to be submitted — online portal, app, mail, or fax?
How long does processing usually take, and how is reimbursement sent?
Write down the date you called, the name of the representative, and any reference number they give you. It makes following up much easier later.
How to submit
Get your superbill from me.
Add proof of payment if asked. Most plans only need the superbill itself, though some also want a receipt or card statement.
Send it through your plan’s preferred channel. An online claim portal is usually fastest; if you mail it, use your insurer’s claim form and attach the superbill. Keep a copy of everything.
Track the claim. Note the date you submitted, and check back if nothing has moved within the window they quoted.
Read your Explanation of Benefits (EOB). This statement shows the allowed amount, what was applied to your deductible, and what will be reimbursed.
Appeal if you need to. If a claim is denied or paid less than expected, call and ask exactly what is needed to reprocess it.
How reimbursement is calculated
Your insurer sets an allowed amount for each type of session. Once you have met your out-of-network deductible, they reimburse a set percentage of that allowed amount — not necessarily of my fee. If my fee is higher than the allowed amount, the difference is not reimbursed.
For example:
Session fee: $300
Plan’s allowed amount: $160
Reimbursement rate after deductible: 70%
You would receive: about $112
Why claims are sometimes delayed or denied
Most hold-ups are small and fixable:
A missing NPI or tax ID — I can reissue a corrected superbill.
A member ID or date of birth that doesn’t match your plan’s records — correct it and resubmit.
A session code that isn’t covered, or a missing modifier — ask which code or modifier they accept, and I’ll adjust it.
Out-of-network benefits that aren’t active yet, or a deductible not yet met — refile once coverage applies.
A required diagnosis — some plans will not process a claim without an ICD-10 diagnosis on the superbill.
A note on privacy
If your plan requires a diagnosis in order to reimburse you, that diagnosis becomes part of the record your insurer keeps. For some people that is no concern at all; for others it matters. You are welcome to talk it through with me before deciding to submit, and we can think together about what feels right for you.
Feeling overwhelmed?
It can look like a lot on paper, but it tends to settle into a simple monthly habit. If you get stuck at any point, reach out — I’m happy to walk through it with you.
This page is general information to help you make use of any out-of-network benefits you may have. It is not a guarantee of coverage or reimbursement — what you receive depends entirely on your own plan. I am not able to bill your insurer directly, but I will always provide the documentation you need.
