CBT in Manhattan — With a Psychiatrist Who Also Prescribes

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Most people doing CBT in New York see a therapist for the therapy and, if medication is involved, a separate prescriber for fifteen minutes every few months. Those two clinicians rarely talk. The therapist doesn't know why the dose changed; the prescriber doesn't know what happened in session.

I do both. That is the practical difference here, and for anyone whose treatment involves medication alongside therapy, it is the difference that matters most.

What CBT actually is

CBT is a structured psychotherapy built on a specific claim: that thoughts, feelings, and behaviors interact, and that changing the behavioral and cognitive patterns changes the feeling. It was developed by Aaron Beck at Penn in the 1960s and has since accumulated more randomized controlled trial evidence than any other psychotherapy.

What it looks like in practice:

• Structured sessions. Each has an agenda set collaboratively at the start.
• Between-session work. Not busywork — the behavioral experiments and practice are where most of the change happens. This is the part people underestimate.
• Measurement. Symptom scales at intervals, so we both know whether it's working rather than guessing.
• Time-limited. A typical course is 12–20 sessions. CBT is designed to end.

That last point is worth sitting with. CBT is explicitly a skills-transfer model. The goal is that you no longer need me.

Where the evidence is strongest

CBT is not equally good at everything, and it is worth being specific:

If someone tells you CBT is the answer for everything, they are selling rather than practicing.

When CBT is the wrong choice

Straight answer, because this matters more than a list of what it treats:

• Long-standing relational and characterological patterns. CBT is a poor fit where the problem is a lifetime pattern of relationships rather than a discrete symptom cluster. Psychodynamic work is often better suited, and I provide that too.
• Active severe depression with impaired concentration. CBT is cognitively demanding. Sometimes medication has to come first to make therapy possible.
• Emotion dysregulation and chronic suicidality. DBT was built for this specifically, and it is a better fit.
• When you don't want homework. CBT without between-session practice is largely conversation. If that's not something you'll do, a different modality will serve you better and I'll say so.

What working together looks like

Sessions 1–2 — Evaluation. Full psychiatric assessment, not a symptom checklist. Diagnostic clarification, comorbidity screening, treatment history, and an honest conversation about whether CBT is the right modality for what you're bringing.

Sessions 3–4 — Formulation. We build a shared model of what maintains the problem. This is the part most treatment skips, and it's why so much therapy drifts.

Sessions 5–16 — Active work. Cognitive restructuring, behavioral experiments, exposure where relevant, activity scheduling for depression. Measurement at intervals.

Final sessions — Relapse prevention. Consolidating what worked into something you can run yourself.

If medication is part of the picture, it's managed in the same appointment by the same person. See medication management.

Credentials

I trained in CBT at Weill Cornell Medicine during my child and adolescent psychiatry fellowship, under Avital Falk, PhD — director of Weill Cornell's pediatric OCD, anxiety, and tic disorders program — and Angela Chiu, PhD, a national trainer in MATCH-ADTC, the modular CBT protocol for youth. I contributed to developing MATCH workbook materials for young patients.

Board certified in Adult Psychiatry and Child & Adolescent Psychiatry. Assistant Professor of Clinical Psychiatry at Columbia University Irving Medical Center, where my research examines the comparative safety and effectiveness of psychotherapy and medication interventions — which is to say I study the questions this page is about.

Related

DBT · EMDR · ERP for OCD · Medication management · Anxiety · Depression · Medication vs. therapy vs. both

Frequently Asked Questions

How long does CBT take?

A typical course runs 12 to 20 sessions, usually weekly. Panic disorder and insomnia often respond faster; chronic depression and long-standing anxiety typically take longer. CBT is explicitly time-limited by design — the aim is skills you keep, not indefinite treatment.

What's the difference between CBT and regular talk therapy?

CBT is structured and directive. Sessions have agendas, there is work between sessions, and progress is measured with symptom scales. Supportive and psychodynamic therapies are less structured and focus more on insight and relational patterns. Both are legitimate; they suit different problems.

Can a psychiatrist do CBT, or do I need a separate therapist?

Most psychiatrists no longer provide psychotherapy — the field largely split into prescribing and therapy roles over the past thirty years. Some of us still do both. When medication is part of treatment, having one clinician handle both removes the coordination gap that fragments split care.

Does CBT work as well as medication for depression?

For mild to moderate depression, CBT and antidepressants perform comparably in head-to-head trials, and CBT shows lower relapse rates after treatment ends. For severe depression, combination treatment outperforms either alone. The right answer depends on severity, prior treatment history, and preference.

Do you offer CBT by telehealth?

Yes. CBT translates well to video — the structure and between-session work are unchanged. I'm licensed in New York, Virginia, and Montana, and registered as an out-of-state telehealth provider in Florida.

How much does CBT cost in NYC?

See what out-of-network psychiatric care costs in Manhattan for fees, how out-of-network reimbursement actually works, and why the percentage your insurer quotes is not the percentage you receive.