THERAPY FOR ADOLESCENT GIRLS IN SAN FRANCISCO
For adolescents who need to be heard.
You used to know how to help her. Now you're not so sure.
The strategies that worked when she was younger, such as setting clear rules, having direct conversations, or the comfort of your presence, often stop landing in adolescence. It's not that you've changed. She's changed, and the world she's growing up in has changed, and the parenting playbook you were operating from doesn't quite map to what she's navigating now.
She's forming her own identity, managing peer relationships you don't fully see, and dealing with pressures that exceed what most adults faced at her age. Social media has reshaped how adolescent girls relate to themselves and each other. Academic expectations have intensified. The pandemic cost her years of social development. Earlier puberty is colliding with later emotional maturity. And the cultural conversation about mental health has shifted in ways that are mostly good but also genuinely confusing. Leaving the questions: when is something "normal teenager stuff" and when does it warrant something more?
Most parents who reach out to me have been working hard at this. They've had the conversations. They've sought advice. They've consulted with friends, family, pediatricians, school counselors, and the internet. They've tried different approaches and second-guessed each one. By the time they call me, they've already done a lot, and they're not failing. They're recognizing that their daughter may benefit from an adult outside the family system who is specifically trained to work with adolescents in this particular cultural moment.
You’re tired of:
Watching her carry something she won’t tell you about
Hearing the way she talks about herself and not knowing how to challenge it
Seeing her hold it together at school and fall apart at home
Wondering whether what you're seeing warrants outside help
how i can help
Therapy creates a space where your daughter can name what's happening and figure out what to do with it.
What Your Daughter Gets from Therapy
She gets a relationship with an adult who is paying close attention to what she's saying and what she isn't. That attention is what makes everything else possible. It’s the noticing of patterns, the gentle naming of difficult experiences, the asking of questions other adults haven't thought to ask. Adolescents thrive when at least one adult outside the family system is consistently attuned to them. That's the foundation of my work.
What the Sessions Are Actually Like
Sessions are 50-minute, typically weekly, but individualized based on your daughter’s current mental health needs. We talk about what's happening in her life, such as friends, family, school, identity, social media, mood, and the questions she's wrestling with. Sometimes we work on specific skills (managing anxiety, navigating a difficult relationship, processing something hard). Sometimes we just think together about what she's experiencing, in an effort to name what is happening to open up the path to healing. What we work on emerges from where she is at, not from a predetermined treatment protocol that ignores her immediate needs.
What Changes Over Time
The change in adolescent therapy is rarely dramatic. It's gradual, and it usually shows up first in small ways. She might come home from a conflict with a friend slightly less reactive. She might use language about her feelings that she didn't have words for a few months ago. She might come to you with something hard before it becomes a crisis. The trajectory of good adolescent therapy is toward greater self-understanding and more flexible coping over time.
What Parents Can Expect
The therapeutic relationship depends on your daughter's trust that what she shares is private, with the standard exceptions for safety. So I won't be reporting back on the content of sessions. What I will do is keep you informed about how therapy is going in general terms, tell you when something needs your attention, and be available to you when concerns arise. The collaborative work between us happens in our parent communications and, when useful, in your own parent consultation sessions.
Therapy with me is…
A relationship built on attunement and consistent attention
Substantive clinical work that takes time to develop
A space where your daughter sets the pace and direction
Genuine collaboration with you as her parent
Direct, warm, research-grounded clinical care
Therapy with me is not…
A predetermined treatment protocol applied to your daughter
A quick-fix solution that resolves problems in a few weeks
A space where I tell her what's wrong and how to fix it
A confidential black box that excludes you entirely
Generic feel-good therapy or coaching
what becomes possible…
Understanding what's actually happening for her.
Right now you may be reading her behavior, watching her mood, trying to interpret what she's not saying. Therapy creates a place where she can learn to name what's underneath the surface, and where you can have a clearer picture of what she's actually navigating.
Skills she keeps after she graduates from therapy.
A lot of what we work on is transferable: noticing a thought and questioning it instead of believing it automatically, sitting with something uncomfortable without needing it to stop immediately, recognizing the physical signature of her own anxiety early enough to do something about it. These aren't insights she has in my office and forgets by Thursday. They're things she'll use in college, in her first job, in relationships you won't be anywhere near.
Home stops being the only place she can fall apart.
If you're getting the worst of her right now, it's usually because you're the safest place she has; she holds it together for six hours at school, and it comes off the moment she walks in the door. When she has somewhere else to put that, the pressure at home tends to drop. Not because she's suppressing anything, but because it finally has another route.
I want you to know:
What you’re navigating matters, and so does she.
What you're seeing with her is real. What you've been carrying as a parent is real. The work of figuring this out doesn't have to continue alone, and that's what the first conversation is for.
Wondering how to bring this up to her? There’s a page written for her, not about her.
What is the difference between teen therapy and parent consultation?
THERAPY IS FOR HER.
Your daughter is the client. The work is hers, exploring what she's carrying, how she talks to herself, and what she wants to be different. You're involved through periodic check-ins and as a partner in her care, but the hour is hers.
PARENT CONSULTATION IS FOR YOU.
You're the client. The work is about your role, the conversations you're not sure how to have, the decisions you're making in four seconds, what's developmentally normal and what isn't. Your daughter doesn't need to be in therapy for this to be useful.
Some families do both. Some start with one and add the other later. If you're not sure which fits, that's what the consultation is for.
faqs
Common questions about therapy
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This is one of the most common concerns I hear from parents, and it's a fair one. Adolescents often resist therapy initially, sometimes because they don't want one more adult in their business, sometimes because they don't yet trust that it will help, sometimes because they're worried about being labeled as "the problem."
What I've found is that most adolescents who reluctantly come to therapy decide within a few sessions whether to engage. My job in those early sessions is to give your daughter a clear sense of what therapy is, what it isn't, and what she has actual choice about within the work. When she has agency in the process — what we talk about, how fast we go, what stays private — most adolescents find they actually want to keep coming.
If your daughter is strongly opposed to therapy, parent consultation may be a better starting point. You can engage in your own work with me, and your daughter can decide later whether she wants her own therapy.
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This is one of the most important things to understand about adolescent therapy. Confidentiality is real, and your daughter needs to know that what she shares is private, but it doesn't mean you'll be in the dark.
What I share with you generally:
Overall progress and clinical themes (without specific content from sessions)
Significant changes in mood, behavior, or risk
Information that affects safety
Treatment recommendations and how the work is going
What I don't share without your daughter's awareness:
Specific things she shares in sessions
Day-to-day details of her experience
Romantic or social information (unless safety is involved)
Many parents also choose parent consultation alongside their daughter's therapy, which gives you your own dedicated space to think through what you're navigating as a parent and how to best support your daughter.
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Therapy is for your daughter. The work focuses on what she's navigating emotionally, relationally, developmentally, and the clinical relationship is between us. You're involved through periodic check-ins and as a partner in her overall care, but the therapeutic work itself is hers.
Parent consultation is for you. The work focuses on supporting you in your role as her parent, such as thinking through specific situations, understanding what she may be navigating developmentally, building skills and frameworks for the parenting work that's specifically hard with adolescents. You're the client; the work is for you.
Some families engage in both. Some only need one. Some start with parent consultation and add their daughter's therapy later. The 15-minute consultation is the place to figure out what's most useful for your specific situation.
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$365 per 50-minute session.
That fee covers more than the session itself. Adolescent work involves a substantial amount of coordination: check-ins with you, conversations with her school counselor when that's useful, contact with her pediatrician, psychiatrist, or testing psychologist, and the occasional call between sessions when something urgent comes up. Routine collateral contact is included. Extended coordination beyond 60 minutes per month is billed at the same rate. I don't bill separately for the ordinary version of that work, because for teenagers it is part of the work.
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I'm an out-of-network provider, which means I don't bill insurance directly. Many families are still reimbursed for a significant portion of the fee.
If your plan is a PPO with out-of-network mental health benefits, the usual structure is that you pay me at the time of session, I provide a superbill, and your insurer reimburses you directly at a set percentage once your out-of-network deductible is met. Reimbursement commonly falls between 50% and 70%, which in practice can bring your cost per session to roughly $110–180 after the deductible.
I can't tell you what your specific plan will do, but the next question will help you find out in about ten minutes.
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Call the member services number on the back of your insurance card and ask:
Do I have out-of-network outpatient mental health benefits?
What is my out-of-network deductible, and how much of it have I met this year?
Once the deductible is met, what percentage do you reimburse for CPT code 90834?
Is there a limit on the number of sessions per year?
Do I need pre-authorization before starting?
Write down the answers and the reference number for the call. If it's easier, bring what you learn to our consultation and we'll go through it together.
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I hold a small number of reduced-fee spots and they're occasionally available through my partnership with Open Path Collective.
To apply for sliding fee scale services, please visit: www.openpathcollective.com.
Ready to get started?