Therapy for Physicians & Doctors

If you're asking this, you're in good company. Nearly 40% of physicians say they've been reluctant to seek mental health care because of licensure concerns, according to a study in Mayo Clinic Proceedings. Most of the doctors we work with have stared down a credentialing form at some point and done the mental math on what a mental health question might cost them. So no, you're not being paranoid. But your wellbeing matters too, and there are real, structural ways to protect both.

Helm Psychology is a private-pay practice. When you pay privately, no diagnosis is submitted to any insurance company and nothing about your treatment enters an insurance database. Your therapy is protected by the same confidentiality laws that govern all psychotherapy, and it stays between you and us.

If you decide to seek out-of-network reimbursement, we want you to know exactly what that involves: a superbill includes a diagnosis code, and your insurer will see it. Some physicians decide the reimbursement is worth it. Others keep therapy entirely outside the insurance system for exactly the reasons that brought them to a private-pay practice in the first place. Either way, nothing gets submitted without you understanding the tradeoff first.

Two things we'll always be straight with you about. First, confidentiality in therapy has narrow legal limits that apply to everyone (physician or not) such as imminent safety concerns, and we're glad to walk through the specifics in your consultation. And second, while we can't give legal advice about how your particular state board words its questions, it's worth knowing that many boards and credentialing bodies have shifted toward asking only about current impairment, not any history of ever having sought care.

We've worked with enough physicians to know that this fear doesn’t have to stop you from getting help. We built this practice around people whose careers depend on discretion, and we take your license as seriously as you do.

This is one of the most common complaints we hear from physicians about past attempts at therapy, where they felt like they spent more time explaining the realities of practicing medicine to their therapist than actually getting therapy. When your therapist doesn’t understand your world—and especially medicine—therapy risks becoming just another place where you’re managing other people. 

You won’t have to worry about any of that with Helm Psychology. Dr. Annia Raja got her PhD at UT Southwestern Medical Center (where she worked alongside physicians throughout her clinical training), her husband is a physician in a demanding specialty, and she’s built her therapy practice around serving doctors for years. Dr. Chaim Rochester has carried a physician-heavy caseload for much of his therapy career, along with years of therapy and coaching work with executives and others in high-stakes roles. So no, you won't have to do any overexplaining here.

None of this means we'll assume we know everything about your experience. Medicine isn't a monolith. A rural ER doc, an academic surgeon, and a private-practice dermatologist live very different lives, and part of our job is learning yours. But you'll be starting from a shared vocabulary, not a blank page. This way, you get to spend therapy on the real meat of what's brought you in.

Most of those approaches focus on managing symptoms: better habits, better boundaries, better coping. There's nothing wrong with that, and many of our physician clients have already tried some version of it. The problem is that these strategies usually hit a ceiling. The exhaustion comes back, and the same patterns eventually reassert themselves. Why? Because these approaches tend to skim the surface, and the deeper stuff underneath never gets the time and attention they need.

Our work is psychodynamic and depth-oriented. So that means that instead of handing you another set of surface-level coping tools, we look at why the overwork, perfectionism, guilt, and over-responsibility keep happening in the first place. Over time, we dive deep into where those patterns come from and what they've been protecting. You can read more about how we work on our psychodynamic therapy page.

Most of the doctors who come to us are incredibly high-functioning. And that's kind of the point. They're seeing patients, running practices, meeting the standard—but privately, something (or a lot of things) feels off. Flat, resentful, unfulfilled, exhausted in a way that no vacation can touch, or feeling far away from the life they imagined would be on the other side of all those hard years put into the grind of medical training. 

Functioning and feeling well are not the same thing, and medicine trains you to treat the first as proof of the second. As long as you're performing well enough, there must not be a problem. But high-functioning people like you are capable of carrying a lot for a very long time before it shows anywhere visible, and by the time it does show, it usually has a longer history than the moment it surfaced.

You don't need a crisis to justify therapy. Something asking for your attention and care is reason enough.

Honest answer: therapy cannot fix the staffing ratios, the documentation burden, or any of the other structural realities of modern medicine. Anyone who tells you that physician burnout is just a personal resilience problem is ignoring the conditions you actually work in at best—and actively gaslighting you at worst. We will never do that. In our work, the systemic stuff gets named and processed for what it is.

But there's also usually personal layers underneath, and those parts are absolutely workable. Why you absorb more than your share, why guilt kicks in the moment you consider protecting yourself, why rest feels unearned even when you're running on fumes. Those patterns tend to have roots that predate medicine, and understanding them can help to shift how much medicine takes out of you.

And some of what doctors carry isn't always fully structural. Bad outcomes, complications, patient deaths, moral injury. Those experiences absolutely need somewhere to actually get emotionally processed, and for many physicians, therapy is the first place where they’ve ever fully had space and permission to do that.

Weekly therapy is our standard rhythm, and it's how we work with most clients. Depth-oriented therapy needs enough continuity to build on itself. With long gaps between sessions, therapy tends to stay at the surface level of life updates and catching up. And some clients meet more often than weekly, whether it’s during intensive stretches of therapy where it feels needed or wanted, or simply because they want more room in the work—meeting more often isn't a sign that something's wrong.

That said, we know for some physicians, their schedule genuinely can't hold a standing weekly appointment. Call schedules and inconsistent weeks on service, for starters. This is why we offer two therapy intensive formats as alternative time containers for therapy. 

Monthly Intensive Therapy means longer sessions on a monthly or biweekly cadence: therapy still has continuity, but each meeting gives enough room to settle in and go deep, rather than trying to squeeze everything into a standard hour every week. Focused Therapy Intensives are different: a longer session, or a short series of them, that are built around one specific thing that needs concentrated attention. That might be a decision you've been circling, a transition, burnout that's come to a head, or a stuck pattern you want real time with. And some physicians use a Focused Therapy Intensive to start therapy with momentum, while some use it alongside ongoing work. You can read about both formats on our Therapy Intensives page.

If you're not sure what would fit with your life, that's a normal topic for us to discuss on a consult call.

Yes. Helm Psychology operates exclusively online through a secure, HIPAA-compliant platform. We're licensed in California and Texas and participate in PSYPACT, which lets us work with clients in 40+ states across the U.S.

Most of the physicians we work with actually prefer it this way. No commute, and sessions can happen from your office, home, wherever you are. It also means therapy doesn't get interrupted by a job change or a move, so if you relocate, then your therapy can stay with you. You can read more about how depth-oriented work translates to a virtual setting on our online therapy page.

Helm Psychology is a private-pay practice. We are not in-network with any insurance companies, and we don't bill insurance directly.

For a lot of the physicians we work with, that's actually part of the appeal. Paying privately means no diagnosis gets submitted to an insurance company, no treatment records enter an insurance database, and no third party gets a say in how long or how deep the work goes. You know better than most how insurance shapes clinical decisions. Therapy here isn't subject to that.

If your plan includes out-of-network benefits, you can still pursue them if you choose. We can provide monthly superbills, and depending on your plan, we can often submit out-of-network claims electronically on your behalf. Reimbursement rates vary a lot between plans, so it's worth calling your insurer and asking specifically about out-of-network outpatient psychotherapy. Check our main FAQs for more detailed information on this. 

One thing to know before you decide: a superbill has to include a diagnosis code, and your insurance company will see it. Some physicians look at their reimbursement rate and decide it's worth it. Others would rather keep therapy completely outside the insurance system, even at a higher out-of-pocket cost. There's no wrong answer, but it should be your call, made with full information. We can go over things with you before anything gets submitted anywhere.