Who will I be working with?+
You’ll be matched with an associate therapist who has completed their graduate training and is working toward full licensure under close clinical supervision. At Attune, your therapist receives structured, detailed feedback from a licensed supervisor after every session. This means your care has more clinical oversight than you’d typically receive at a traditional practice, even from a fully licensed therapist working independently.
What does a session look like?+
Sessions are 50 minutes and take place over secure video. You and your therapist will work together to set goals and monitor your progress throughout treatment, so there’s continuity and direction to the work from week to week.
How much does therapy cost?+
We use a sliding scale fee structure based on your income and financial situation. Your fee will be discussed during the intake process. We are a private pay practice and can provide superbills for out-of-network insurance reimbursement.
Is my information kept private?+
Yes — and we go further than the legal minimum. When you use insurance for therapy, a formal psychiatric diagnosis gets attached to your file and flows to your insurer, where it can get flagged in underwriting databases (including the Medical Information Bureau) that life and disability insurers query when you apply for coverage. A diagnosis of anxiety or depression can result in a mental/nervous exclusion rider on a disability policy, and that record persists for years. For people in high-stakes careers, this isn’t theoretical: pilots face FAA medical certification consequences for documented mental health diagnoses, defense contractors navigate SF-86 security clearance disclosures that include mental health consultations, and attorneys and physicians deal with licensing board reviews that have historically asked about mental health treatment. Attune does not bill insurance, so no formal diagnosis is attached to your file and nothing flows to underwriting databases. We do not share your information with third parties — not advertisers, not employers, not anyone. Your data is used for exactly one thing: your care. HIPAA sets the floor. We built higher.
Are my sessions confidential?+
Yes. Attune operates as a HIPAA-compliant covered entity. Your sessions are conducted via secure, HIPAA-compliant telehealth and your information is handled with full privacy protections. We do not use your data to train any AI models.
What approaches do your therapists use?+
Our therapists are trained in evidence-based approaches including Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Acceptance and Commitment Therapy (ACT), and trauma-focused therapies. Treatment is personalized to your needs and goals.
What if Attune isn’t the right fit for me?+
That’s completely okay, and it’s part of what the intake conversation is for. If we’re not the right match for your needs, we’ll do our best to connect you with a provider or resource that’s a better fit.
Is an associate therapist as qualified as a licensed therapist?+
For the presentations we work with — anxiety, burnout, depression, occupational stress — the research says the credential alone isn’t what you should be evaluating. Across studies representing more than 17,000 patients, therapist licensure status and years of experience explained virtually none of the variance in patient outcomes (Wampold & Brown, 2005; Chow & Miller, 2015). Where the research does identify a risk is implementation drift — when clinicians without adequate supervision shift away from structured, evidence-based approaches without realizing it (Waller, 2009, Behaviour Research and Therapy). That’s precisely what our supervision model is designed to prevent: weekly direct session review, structured feedback, and session-by-session outcome tracking eliminate the drift that happens when clinicians work without oversight — whether they’re licensed or not.
What’s the evidence behind Attune’s supervision model?+
Medicine figured this out decades ago — surgical checklists, nursing protocols, outcome audits exist because systems catch what individuals miss. Therapy has been slower to follow. In a landmark study tracking 170 therapists over up to 18 years, clinical effectiveness did not improve with experience, and in some cases quietly declined (Goldberg et al., 2016, Journal of Consulting and Clinical Psychology). What did predict outcomes: the individual clinician, the quality of the relationship, and whether someone was monitoring whether the therapy was actually working. Therapists working without outcome monitoring have been shown to miss 97.5% of patients whose condition was quietly getting worse (Hannan et al., 2005, Psychotherapy Research). At Attune, every case is reviewed weekly by a licensed clinical director using direct session observation, and we track outcomes every session using validated tools like the PHQ-9 and GAD-7. In a 2025 study of 18,721 patients across 755 clinicians at a platform implementing this kind of structured outcome monitoring, the result was a 23.6% relative improvement in combined anxiety and depression outcomes (Frontiers in Health Services, 2025).
What’s a Clarity Consult?+
A structured 15-minute conversation, not a therapy session, where we get a clear picture of what you’re seeking in therapy, what you’ve tried, establish your session rate, and whether Attune is the right fit. We’ll get you scheduled for your first session during that time, but if we’re not the right fit for you, no hard feelings!
Why cash-pay instead of insurance?+
The math: if you’re on a high-deductible health plan, you’re likely paying out of pocket for therapy anyway until your deductible is met — typically $1,600 to $2,500, with in-network sessions running $150–$250 each. Our sliding scale rate ($60–$150) is often lower than what you’d pay pre-deductible, and that gap is real from session one. The clinical autonomy: we’re not constrained by what an insurance adjuster considers “medically necessary.” Your care is designed around what you actually need, not a session limit set by someone who’s never met you.
Can I use my HSA or FSA?+
Yes. Therapy is an eligible expense under both HSA and FSA plans, and you can pay for Attune sessions directly from your account. Note: California does not conform to the federal HSA tax exemption, so CA residents receive less tax advantage from HSA spending — another reason the straight cash-pay math often works in your favor.
What happens if I’m not making progress?+
We know before you have to tell us. Outcomes are tracked every session, so we see the data moving — or not moving — in real time. If your scores aren’t trending in the right direction, your clinical team reviews the case, your therapist adjusts the approach, and if needed, we discuss whether a different clinician or modality would serve you better. You don’t have to advocate for yourself — that’s our job.
What is high-functioning anxiety?+
High-functioning anxiety isn’t a formal clinical diagnosis, but it’s a common and real pattern: anxiety that coexists with strong outward performance. It can look like persistent worry, overpreparing, physical tension, or difficulty relaxing, all while still meeting deadlines and looking fine from the outside. It’s often missed precisely because it doesn’t interfere with performance the way people expect anxiety to. See our
dedicated page or take the
2-minute check-in quiz to see how it might be showing up for you.