Questions, answered honestly.
Everything we're most often asked — about getting started, fees, the online format, our team, and how the work actually goes. If yours isn't here, email us and we'll answer it directly.
Getting started.
How do I get started with therapy at Align?
Most clients begin with a free 15-minute consultation. You'll talk with the therapist you're matched with — or one you've chosen from our team page — about what's bringing you in, what you're hoping for, and whether it feels like a good fit.
From there, you can book your first session, take time to think, or ask to be matched with someone else. No pressure.
What happens during the free consultation?
It's a low-pressure first conversation, about 15 minutes long. The therapist will ask what's bringing you in. Then, they'll offer a recommended approach based on their experience. You can ask anything you want — about their training, their experience, what therapy with them tends to look like.
The point of the consultation is to figure out fit, not to start the work.
How do I choose between therapists?
Browse our team page, read what each therapist works with, and request whoever feels right. Or say match me with the best fit and we'll do it for you based on what you share in the consultation.
If you start with one therapist and realize someone else might be a better fit, we'll help you switch any time you like.
What should I expect in my first session?
The first session is mostly about getting to know each other and laying the groundwork. Your therapist will ask about what's bringing you in, a brief history with the issue, what you've tried before, and what you're hoping to feel different. Something that makes us different is that we usually offer some easy coping skills to help you while we work on the bigger issues.
There's no pressure to "go deep" — that comes later, when the relationship has more weight under it.
How soon can I start?
Most clients have a consultation within 2–3 business days of reaching out, and a first session within a week. If you're in a hurry, just let us know — we'll do what we can to fit you in sooner.
Fees & insurance.
How much do sessions cost?
Individual therapy sessions are $200. Couples and family sessions are $250. We're out-of-network with all insurance plans — but most plans reimburse 50–80% of out-of-network sessions, which often brings the effective cost meaningfully lower.
Do you accept insurance?
We're out-of-network with all insurance plans. That means we don't bill insurance directly, but we provide a superbill after each session that you can submit to your insurance for out-of-network reimbursement. Most plans reimburse a substantial portion.
What is a superbill and how does it work?
A superbill is an itemized receipt for therapy services. You submit it to your insurance, and they reimburse you directly for whatever portion of the session your out-of-network benefits cover.
Many clients find this brings their out-of-pocket cost down to close to in-network rates.
Do you offer sliding scale?
We have a limited number of sliding-scale spots for clients with financial need. Just ask in the consultation — we'll figure out what works.
The online format.
How does online therapy actually work?
You log in to a HIPAA-compliant video session from wherever you are — your home, your car, your office — at your scheduled time. Your therapist joins. You have a real session, just like an in-person one, but without the commute.
Most clients find they're more honest online because they're already in their own space.
What platform do you use for sessions?
We use SimplePractice, a HIPAA-compliant telehealth platform built specifically for therapy practices. You'll get a secure link before each session. No software to install — just click and join.
What do I need to participate?
A device with a camera and microphone (laptop, phone, or tablet), a stable internet connection, and a private space where you can speak freely. Headphones help. Nothing else is required.
Where can I have my sessions from?
Anywhere in California where you have privacy and a reliable internet connection. Bedroom, office, parked car, hotel room while traveling within the state.
Outside California, we can't legally hold sessions — California-licensed therapists are licensed to practice within the state.
Is online therapy as effective as in-person?
Research consistently finds online therapy as effective as in-person for most common concerns — anxiety, depression, OCD, relationship work, life transitions. The effectiveness comes from the relationship and the work, not the room.
Our team.
Are all your therapists California-licensed?
Yes. Every clinician at Align is licensed or registered with the California Board of Behavioral Sciences (BBS). Our LMFTs hold full licensure; our AMFTs and ASWs are registered associates working under licensed supervision.
What's the difference between LMFT, AMFT, and other titles?
LMFT = Licensed Marriage and Family Therapist (fully licensed). AMFT = Associate Marriage and Family Therapist (registered, working under licensed supervision). LCSW = Licensed Clinical Social Worker.
All of these are qualified to provide therapy. Associates often have lower rates and bring substantial training under expert supervision.
Can I switch therapists if it's not the right fit?
Yes, any time. Try talking with your current therapist about what isn't working first — most things are workable inside the relationship. If you still want to switch, just let us know. No notice required.
The therapy process.
How long does therapy typically take?
Most clients begin to notice meaningful change in 8–12 sessions. Lasting change — the kind where you don't go back to the old pattern — typically takes 6–12 months of consistent work.
We don't believe in artificially short or artificially long timelines.
How often will I have sessions?
Weekly to start. After the first three or four months, some clients move to every other week as they consolidate the work. We'll figure out the right cadence together.
How long is each session?
Individual sessions are 50 minutes. Couples and family sessions are 75–90 minutes. These lengths give enough time to do real work without exhausting the room.
How will I know if therapy is working?
Most clients notice change in three places first: the way they sleep, the way they react to their usual triggers, and the conversations they have (or don't have) with themselves.
The big shifts often come quietly. You'll notice you did something different before you notice you've changed.
Can I pause therapy and come back later?
Yes. Many clients pause when life gets stable and return when something shifts. Your therapist will hold your spot when possible, or help you re-match if scheduling has changed.
What we work with.
What do you specialize in?
Anxiety and overthinking. Relationship anxiety. Family boundaries. People-pleasing. OCD and intrusive thoughts. Disordered eating. Identity and cultural questions. Depression. Burnout and work stress. Life transitions and feeling lost. Loneliness and connection. Couples and premarital work.
We focus on the patterns that adults in their 20s and 30s commonly arrive with — and the patterns underneath them.
Do you work with couples and families?
Yes. Several of our therapists are trained in couples work — including Gottman Method, Emotionally Focused Therapy (EFT), and attachment-based approaches. We work with dating couples, partners, married couples, premarital pairs, and family units.
Can you treat OCD?
Yes — with ERP (Exposure and Response Prevention), the gold-standard evidence-based protocol for OCD. Danielle leads our OCD work and has expert-level training in it.
What if my concern isn't listed on your site?
Reach out anyway. Our specialty areas are the most common reasons clients come in, not the full scope of what we work with. Mention it in the consultation. Or browse the full Topics Index — over 90 named patterns we work with — and see if your version of it is named there. We'll either work with it or refer you to someone whose specialty is closer.
Privacy, safety & the practical bits.
Is online therapy confidential?
Yes. Therapy in California is governed by strict confidentiality laws (HIPAA and California Civil Code), with narrow legal exceptions: imminent danger to self or others, mandated reporting of abuse, and court orders.
Is your platform HIPAA-compliant?
Yes. SimplePractice, our video platform, is fully HIPAA-compliant. Your sessions are encrypted, your records are private, and your notes never leave the secure system without your written authorization.
Will my family or insurance see what we discuss?
No. Your sessions are private. If you submit a superbill for insurance reimbursement, your insurance receives only a diagnosis code and billing information — not session content. Your family doesn't receive anything unless you choose to share.
What if I'm in crisis between sessions?
For an immediate crisis, call or text 988 (Suicide & Crisis Lifeline) or go to your nearest emergency room. For something urgent but not immediately life-threatening, message your therapist — most respond within a few hours during business days.
Therapy isn't a crisis service, but we'll always help you get connected to the right level of care.
Do you prescribe medication?
No — therapists don't prescribe. That's the role of a psychiatrist or psychiatric nurse practitioner. We work alongside prescribers when medication is part of a client's care, and we can refer you to telepsychiatrists we trust.