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SAN FRANCISCO, Calif., August 25, 2026— Two Chairs, the leading provider of integrated therapy and psychiatry, today announced new peer-reviewed research showing that its clinical model delivers exceptional outcomes quickly for all members, including individuals with the most complex and costly comorbidities.
The findings build on earlier peer-reviewed Two Chairs research, which found that Two Chairs delivered anxiety and depression outcomes two to 2.5 times better than published results from standard practice settings. The new study demonstrates that the Two Chairs clinical model delivers strong results across a highly complex patient population, with some higher-acuity groups improving even faster than the broader study population. These outcomes extended to patients with chronic medical conditions, greater depression severity or suicidal ideation, and Medicare or Medicaid coverage.
Patients also improved quickly. The Frontiers in Psychology study analyzed 7,161 adults receiving psychotherapy for moderate to severe depression in a real-world care setting. The median time to clinical response, defined as at least a 50% reduction in PHQ-9 scores, was six sessions. Patients who achieved remission reached it in a median of eight sessions.
“Our health care system needs behavioral healthcare that works for the members who are struggling the most and often generate the highest costs,” said Alex Katz, founder and CEO of Two Chairs. “This research shows that Two Chairs can deliver strong outcomes quickly across a broad and clinically complex population, creating an opportunity to improve lives while reducing costs across the healthcare system.”
Exceptional outcomes for patients with chronic medical conditions
People managing chronic medical and mental health conditions are among the costliest health plan members. One analysis found that high-risk patients with both generated 64% higher claims costs than matched patients without a mental health diagnosis. Other research has linked these comorbidities to greater use of ambulatory care, emergency departments, hospitals and prescription medications.
Two Chairs delivered meaningful depression improvement for patients living with heart disease, respiratory problems, diabetes and cancer, with outcomes comparable to the broader study population. The results demonstrate that the Two Chairs model can work for patients whose combined physical and mental health needs often contribute to greater healthcare spending.
Faster improvement for patients with greater clinical acuity
While symptom severity and suicidal ideation are typically associated with higher healthcare costs, Two Chairs patients entering care with greater depression severity or suicidal ideation improved faster than average. Patients reporting suicidal ideation at intake responded in a median of five sessions, compared with six sessions across the full study population.
These results demonstrate that high-acuity patients can improve quickly in outpatient care. Two Chairs delivered particularly timely outcomes for members who may require the most support and generate some of the highest costs.
Consistent outcomes across insurance and demographic groups
Two Chairs delivered timely results across insurance types, including for publicly insured members. Medicare and Medicaid members who responded did so in a median of five sessions, compared with six sessions overall. Age and gender also did not independently affect response. Notably, members identifying as Black or Hispanic, who also often have higher healthcare costs, had a faster response after other factors were considered.
Together, the results demonstrate that Two Chairs delivers strong behavioral health outcomes across populations that have historically faced barriers to effective care, including older adults, publicly insured members and people from different racial and ethnic backgrounds.
“Clinical complexity rarely comes down to a single diagnosis or characteristic. It reflects the combined effect of a patient’s symptoms, physical health, behavioral health history and life circumstances,” said Colleen Marshall, MA, LMFT, Chief Clinical Officer at Two Chairs. “These findings show that patients with complex needs can make meaningful progress when clinicians have the measurement, training and support needed to understand the whole picture and adjust care based on how each person is responding.”
The full study is available in Frontiers in Psychology.
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About Two Chairs
Two Chairs is setting a new standard in mental health care with seamlessly integrated therapy and psychiatry delivered by highly trained clinicians, powered by smart technology, and measured for real impact. The company combines fast access, personalized care, and proven outcomes to create a system that works — for patients, providers, health plans, and clinicians alike. Two Chairs is in-network with national and regional health plans including Aetna, Kaiser Permanente, and Florida Blue, serving over 30 million covered lives. They are also the employer of choice for licensed clinicians across more than 100 areas of expertise and have been widely recognized for both workplace and clinical excellence, including designations such as Great Place to Work, Fortune Best Workplaces in Healthcare, Fast Company Best Workplaces for Innovators, and Inc. Best in Business.
