Starting Psychotherapy With Dr. Lewis's Team: What to Expect

Starting psychotherapy with Dr. Lewis's team usually begins the same way as any other care at the practice: a free discovery call by phone or text, where you can ask about care options, scheduling and insurance. Individual clinical care then starts with the Patient Interest Form, which helps the team understand whether the practice is the right fit for you.

The practice's therapists work on the same team as its psychiatrists, psychiatric nurse practitioners and health and wellness coach. This guide explains who the therapists are, what kinds of therapy the practice lists, what the first few sessions of therapy generally look like, and how therapy and medication care can be coordinated. It does not cover availability or fees, which change; ask the team directly.

Who provides therapy on the team

The practice lists seven psychotherapists: Dr. Beth Wecksell, PsyD (bilingual Spanish-English); Dr. Linda Perez-Puelles, PsyD; Peggy Kaplin Zaloga, LCSW; Mandy Rice, LMSW; Mary Florence Sullivan, LMSW; Alura Bennett, LMHC; and Maria Szabo, MHC-LP. The letters after each name are a doctoral degree (PsyD) or a New York license or permit type, and they tell you something about training and supervision.

None of these credentials is a measure of how good a particular therapist will be for you. A supervised clinician can be an excellent fit, and a doctoral-level psychologist can be the wrong one. What the license tells you is the training path and whether a senior clinician oversees the work. It is reasonable to ask on the discovery call who would supervise a pre-licensed therapist.

The team page and the facts the practice publishes describe one therapist's language (Spanish-English) but not each therapist's clinical focus. If you are looking for someone with specific experience, such as trauma, eating concerns or work with teenagers, ask the team which clinician they would suggest and why. For Spanish-language care, see the guide to Spanish-English bilingual therapy in Brooklyn.

What kinds of therapy the practice lists

The practice lists psychotherapy, including cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT), as part of its ongoing care, alongside psychiatric evaluation and medication management, coaching, lab testing, and nutrition and lifestyle psychiatry.

Cognitive behavioral therapy

The National Institute of Mental Health describes CBT as an approach that helps a person become aware of automatic ways of thinking that are inaccurate or harmful, then question those thoughts, understand how they affect emotions and behavior, and change self-defeating behavior patterns. CBT is typically structured, often with a session agenda, practice between sessions and specific goals, though the format varies by therapist. The practice has a page on CBT in Brooklyn, and if you are weighing CBT against a more exploratory approach, the comparison of CBT and psychodynamic therapy covers the differences.

Dialectical behavior therapy

DBT is an empirically supported treatment for people with suicidal behavior, and it teaches skills for intense emotions and the behaviors people use to cope with them. Standard DBT has several components: individual therapy, skills training, telephone coaching and a therapist consultation team. In a 2015 trial of 99 women with borderline personality disorder at high risk of suicide, all three versions of DBT tested led to similar improvements in suicide attempts, but the versions that included skills training reduced nonsuicidal self-injury and depression more than DBT without skills training. That matters when you compare programs: "DBT-informed" individual therapy and a full DBT program are not the same thing. Ask which one is being offered. The practice's DBT page describes its approach, and the guide to borderline personality disorder treatment explains where full-model DBT fits.

What the first few sessions generally look like

The details vary by therapist, but most outpatient therapy follows a similar arc. Knowing it in advance makes the first weeks less confusing.

1. Intake and history. The first session or two are mostly questions: what brings you in now, what you have tried, your health, sleep, substance use, relationships, work and safety. It can feel more like an interview than therapy.
2. Shared formulation. The therapist should offer a working explanation of what is keeping the problem going and what approach they suggest. You should be able to repeat it back in your own words.
3. Goals and a way to measure them. Good goals are specific: fewer panic attacks, getting back to the gym twice a week, sleeping past 5 a.m. Some therapists use brief questionnaires at intervals to track change.
4. Frequency and length. Ask how often you will meet, roughly how long the therapist expects treatment to last, and when you will review progress together.
5. Confidentiality. Ask what stays private and what the limits are, including how information is shared with your prescriber if you have one on the team.

NIMH suggests asking a prospective therapist about their credentials and experience, what approach they will use, whether they have experience with your age group and condition, what the goals of therapy are and how progress will be assessed, whether medication is an option, and whether there are limits to confidentiality. Those questions work just as well inside one practice as when you are comparing several.

For a realistic sense of timelines, the guide on how long therapy takes gives typical ranges by condition.

Fit matters, and it is measurable

The working relationship between you and your therapist, often called the therapeutic alliance, is one of the most studied predictors of how therapy goes. A 2018 meta-analysis of 295 studies covering more than 30,000 patients found a robust positive association between the strength of the alliance and outcome in adult psychotherapy. The association was modest in size (a correlation of about 0.28), and because it is a correlation, it does not by itself prove that a better relationship causes a better result.

The practical lesson is modest but useful. After three or four sessions, ask yourself whether you agree on the goals, whether the tasks make sense to you, and whether you feel the therapist understands you. If the answer is no, say so in session. A good therapist will want to know. Asking about a change of approach, or about seeing a different clinician on the team, is a normal request, not a failure.

How therapy and psychiatry coordinate on one team

Because the practice has psychiatrists, psychiatric nurse practitioners, psychotherapists and a health and wellness coach on one team, you can see a therapist and a prescriber without stitching together two separate offices. NIMH notes that psychotherapy can be used as an alternative to medication or alongside it, and that even when medication relieves symptoms, psychotherapy can help address specific issues.

Coordination is only as good as the agreements behind it. Before you start with both, it helps to ask:

• Will my therapist and prescriber talk to each other, and how often?
• What will they share, and what will stay between me and my therapist?
• Who do I contact first if my mood or sleep changes suddenly, or I have a medication side effect?
• If my therapist thinks a medication review would help, how does that get arranged?

Many people start with therapy alone and add a medication evaluation later, or the reverse. The evidence on when each makes sense is covered in medication, therapy or both. If you already have a therapist outside the practice and want only medication care here, see keeping your therapist while seeing an integrative psychiatrist.

When outpatient therapy is not the right first step

Weekly outpatient therapy is the right level of care for many people, but not for everyone. If you are having thoughts of harming yourself, cannot keep yourself safe between sessions, are not eating or sleeping for days at a time, or are hearing or seeing things others do not, you need a faster and more intensive level of care first. The guide to levels of mental health care explains intensive outpatient, partial hospital and inpatient options.

If you are thinking about suicide or are in crisis, call or text 988 (the 988 Suicide & Crisis Lifeline) or go to the nearest emergency room.

It also may not be the right first step if your main goal is habit change without a mental health condition, such as building an exercise routine or improving sleep habits. In that case coaching may fit better. The comparison of coaching, therapy and psychiatry walks through how to tell.

Practical points before you start

Insurance and cost

Dr. Lewis and all of the practice's practitioners are out of network with all insurance plans, including Medicare and Medicaid, and payment is due at the time of service. The practice provides a superbill you can submit to your insurer for possible out-of-network reimbursement, and superbills are available in the patient portal after each session. Current fees are on the insurance and payment page, and the practice offers a Good Faith Estimate of expected costs before you start care. If you need care that is in network with your plan, ask the team on the discovery call about options.

Before you start, call your insurer and ask the practice's four questions: whether you have out-of-network mental health benefits, whether there is an out-of-network deductible, what the reimbursement rate is, and what the approved visit cost is. The answers tell you what therapy will actually cost you over a few months.

In person or telehealth

Dr. Lewis sees patients in person in Brooklyn and by telehealth for patients who are physically located in a state where she holds an active medical license, and the team confirms eligibility for your state before your first visit. Therapist licenses are state-specific too, so ask whether therapy by video is possible where you will be, and if you travel or split time between states, mention it early.

A short preparation list

• Two or three sentences on what you want to be different, in concrete terms.
• Past therapy: what type, how long, what helped and what did not.
• Current medications and supplements, with doses.
• Any diagnoses you have been given, and by whom.
• Your schedule constraints, so you can discuss scheduling on the discovery call.

How the practice handles starting therapy

At this practice, therapy sits inside an integrative model: the team's ongoing care includes psychotherapy alongside medication management, coaching, lab testing and lifestyle psychiatry. The practical route is the same as for other care: a free discovery call by phone at (212) 621-7770 or text at (929) 600-7724, then the Patient Interest Form. The psychotherapy page describes the practice's approach, and the full list of starting points is in the Choosing Psychiatric Care guide. If you want to prepare questions first, see questions to ask on a discovery call.

Frequently asked questions

Can I choose which therapist I see?

You can tell the team what matters to you, such as language, gender or experience with a particular concern, and ask who they would suggest. Ask on the discovery call how the practice matches patients with therapists.

Do I need to see a psychiatrist before starting therapy?

Not necessarily. Many people start with therapy alone. If symptoms are severe, or you are already on medication, a prescriber can be added on the same team.

What is the difference between an LMSW and an LCSW?

Both are licensed social workers. In New York an LMSW may provide clinical social work, including psychotherapy, only under the supervision of an LCSW, licensed psychologist or psychiatrist. An LCSW holds New York's clinical social work license and is one of the clinicians who can supervise an LMSW.

Is therapy at the practice covered by insurance?

All of the practice's practitioners are out of network with all plans. The practice provides superbills for possible out-of-network reimbursement. Current fees are on the insurance and payment page.

Does the practice offer couples or family therapy?

Ask the team on the discovery call. This guide only covers what the practice lists for individual ongoing care, which includes psychotherapy such as CBT and DBT.

What if I do not click with my therapist?

Raise it in session first; a good therapist will want to know. If it still does not fit, ask the team about switching to another clinician.

Can I do therapy by video?

Telehealth depends on the state you are physically located in. Dr. Lewis sees patients by telehealth when they are located in a state where she holds an active medical license, and the team confirms eligibility for your state before your first visit. Ask on the discovery call whether therapy by video is possible for you.

Sources

1. Psychotherapies. National Institute of Mental Health, 2024. nimh.nih.gov
2. The alliance in adult psychotherapy: A meta-analytic synthesis. Psychotherapy (Flückiger C, Del Re AC, Wampold BE, Horvath AO), 2018. pubmed.ncbi.nlm.nih.gov
3. Dialectical Behavior Therapy for High Suicide Risk in Individuals With Borderline Personality Disorder: A Randomized Clinical Trial and Component Analysis. JAMA Psychiatry (Linehan MM et al.), 2015. pubmed.ncbi.nlm.nih.gov
4. Licensed Master Social Worker: License Requirements. New York State Education Department, Office of the Professions, 2026. op.nysed.gov
5. Mental Health Counselors: License Requirements. New York State Education Department, Office of the Professions, 2026. op.nysed.gov

Educational information, not medical, tax or legal advice. Decisions about diagnosis, medication and treatment belong with a clinician who knows your history.