A mental health practice built for you

Two Chairs is dedicated to making exceptional mental health care accessible to all, and that starts with empowering clinicians to do their best work by making their personal well-being and opportunities to grow and connect a priority.

Today, we’re excited to announce that Two Chairs is one of the first direct-to-consumer mental health startups to receive sponsorship from the American Psychological Association (APA)*. This means the APA recognizes that Two Chairs stays at the forefront of cutting-edge psychology research and regularly trains our therapists to apply it with their clients immediately — putting us alongside institutions like Harvard Medical School, Yale School of Medicine, and the University of Pennsylvania Department of Psychiatry. 

As we continue to grow, we’re proud of our investments in our clinicians’ experience and professional development, because the best way to provide high-quality mental health care is to take care of the people who do the caretaking. 

What This Means for Clinicians

When you become a clinician at Two Chairs, you get built-in access to the most recent mental health research and learning opportunities to earn Continuing Education (CE) credits — and you’ll be able to apply what you learn with your clients right away. 

Continuing Education to maintain your license will no longer need to be something that’s entirely on your shoulders. In fact, we expect our clinicians to take advantage of professional development opportunities, including our clinician development session program. 

The program is designed to meet best-in-class learning standards set forth by the APA. Every month, we bring in expert speakers to lead sessions on topics you might not have learned in grad school — topics like: 

• Understanding Asian-American immigrant families
• Acceptance and commitment therapy
• Culturally sensitive care for the LGBTQIA community
• Motivational interviewing
  

Not only will you learn from highly regarded experts about the most cutting-edge research out there and receive CE credits, you will also walk away knowing how to apply what you learned in sessions with your clients the very next day. 

“Our clinical professional development sessions have been a critical tool in keeping us mindful and aware of what's currently going on in the world and of daily issues clients and clinicians alike may face outside of the therapy room,” says Two Chairs Clinician and Clinical Program Manager Tina Greene, LCSW. “To do so, we regularly gather feedback from our clinicians on what topics they would like to see in future sessions and collaborate with our Diversity, Equity, and Inclusion task force. The information we learn not only helps us further develop our clinical practice, but also helps us fulfill our purpose and responsibility of honoring community and client diversity.” 

What This Means for the Client Experience

We want every client to walk into therapy with Two Chairs feeling confident that they’re receiving best-in-class care, and that’s what APA sponsorship helps us uphold with our programming. 

Someone in need of therapy shouldn’t have to worry whether or not their therapist is staying up-to-date on the latest research. They should know that they’re getting care from a holistic, fully rounded therapist who stays on top of cutting-edge research and can take their new learnings directly to practice. 

“We’re honored to be one of the first direct-to-consumer mental health startups to receive sponsorship from the American Psychological Association,” says Two Chairs CEO Alex Katz. “We care deeply about investing in our clinicians’ experience and dedicating time and resources to their growth to ensure high quality of care, and we look forward to growing our programming and further expanding our ability to provide exceptional mental health care for all.”

We’re excited to keep innovating in our clinician practice and continue building out clinician development content that creates extraordinary experiences for clinicians and clients alike. 

If you’re a clinician interested in practicing with Two Chairs, check out our open positions. If you’re a healthcare provider and want to refer your patients to us, fill out our online referral form. And if you’re interested in starting therapy with us, learn how you can get started.

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*Two Chairs is approved by the American Psychological Association to sponsor continuing education for psychologists. Two Chairs maintains responsibility for this program and its content.

If you’ve recently started therapy, you may be wondering how to tell whether it is working for you. Given the emotional investment, as well as that of time and money, this is an understandable thing to be thinking about. 

Many therapists would say that it can be difficult to answer this question because the definition of “working” varies from person to person. But there are tools and strategies clinicians employ — as well as conversations you can have with your therapist — that can help you better understand the progress you’re making.

As a therapy practice, we believe that you deserve to meet your goals and feel relief from what brings you to therapy as quickly as possible — all so you can feel better in your daily life. One of the most reliable ways to do this is by ensuring clients are matched with the best therapist for their needs and preferences. That’s why care at Two Chairs begins with the matching process, which combines clinical judgment from a trained expert with our matching algorithm to match clients with the right therapist for them. 

After you’re matched with a skilled therapist, they will lead you through a collaborative discussion about your goals for therapy and how you’re going to track your progress. One of the key tools we use for tracking progress at Two Chairs is something called measurement-based care.

What is measurement-based care?

Measurement-based care (MBC) is a key tool for empowering clients to take ownership over their care, and make sure they’re getting what they need out of therapy. Measurement-based care has a few components, one of which is mental health check-ins: short surveys you fill out before each therapy session, designed to help you and your therapist get a better sense of how you’re doing. The questions touch on symptoms of things like anxiety and depression, your quality of life, and your relationship with your therapist. 

The information you share in these check-ins helps identify what’s working in therapy — and what may not be — so you and your therapist can track progress toward the goals you’ve set together, and personalize your collaborative treatment plan. It’s important that therapy happens in an environment that allows for any necessary adjustments to ensure you’re feeling well supported, and feeling better as soon as possible. Yet another benefit of MBC is that it ensures that you’re not a passive recipient of therapy — instead, you’re empowered to be engaged in your own care, which has been shown to help people reach their goals more quickly.

How does measurement-based care help you understand if therapy is working?

There are many benefits of MBC: First, it can help you and your therapist get a better sense of the problems you’re coming to care with, and help you and your therapist set goals around what it will look like to get better. Second, it gives your therapist a consistent source of information about how you’re doing which, over time, can show how far you’ve come from when you started therapy.

You, as the client, also get feedback from these check-ins in the form of mental health snapshots. And finally, MBC is a way for you to feel engaged in your own care. By going through the exercises of understanding and reflecting on your own progress, both on your own and with your therapist, you’ll become an active participant in reaching your mental health goals.

Responses from mental health-check ins

The mental health check-in includes questions from three standardized, clinically validated assessments of anxiety, depression, and quality of life. These are called the Generalized Anxiety Disorder GAD-7 (for anxiety), the Patient Health Questionnaire PHQ-9 (for depression), and Mental Health Quality of Life MHQoL (for quality of life). These three surveys, when used together, do a good job of assessing many of the most common symptoms and concerns that clients come to therapy with. 

When you complete the mental health check-in, which takes about three minutes, you’ll be reminded to answer based on how you’ve been feeling over the past two weeks. Over time, these answers create a picture of whether your symptoms and quality of life are improving, worsening, or not changing. The way your responses are trending can send a strong signal to both you and your therapist about whether or not therapy is working for you. 

Reflection and discussion

The mental health check-ins aren’t just a way for us to gather information that then gets filed away — you and your therapist will discuss the questions, answers, and your overall feelings together. In addition to improved scores, you may also notice that you’re reporting less severe or less frequent symptoms. You might be feeling like your mood or sleep have improved, that you’re having fewer sad or anxious days, or that overall, you’re making progress toward your mental health goals.

If your coping skills have improved, and things don’t bother you as much as they used to — or you feel like you’re handling stress better than you did in the past — these are all indicators that you’re improving. Other indicators of progress that may come up in discussion with your therapist include improved personal relationships, and having an easier time at work or just daily life in general.

The alliance with your therapist

The mental health check-in will also ask you questions about your relationship with your therapist. You and your therapist will discuss these answers together, and it’s important to be honest about how you’re feeling. You should use these questions to communicate with your therapist about any changes you notice in how you are working together, or your satisfaction with how care is going. Our therapists are trained and skilled at open and honest discussion, and are ready to address any issues. One of the best ways to move forward in therapy is to come to a mutual understanding with your therapist about things that are and are not working so you can strengthen the bond together. This ensures that the burden isn’t fully on you to bring up any problems that are impacting your care.

Common concerns about measurement-based care

“The questions in the mental health check-ins don’t capture my full reality.”

The mental health check-in is designed to capture a very specific set of information that helps your therapist understand how you’re feeling from a clinical perspective. The check-in contains questions from three standardized clinically validated assessments:

• GAD-7 – ”GAD” stands for “generalized anxiety disorder,” and this assessment contains seven questions designed to measure the severity of anxiety.
• PHQ-9 – “PHQ” stands for “patient health questionnaire.” This assessment has nine questions, designed to measure the severity of depression.
• MHQoL – This is the “Mental health quality of life” questionnaire, covering topics such as self image, mood, relationships, and physical health.

It’s understandable that the check-ins may not always feel as though they’re capturing your entire experience. The check-in gathers a baselines of common symptoms that enable your therapist to understand progress, or lack thereof, and make adjustments to treatment. It’s also helpful to think of the check-in as a starting-off point for you and your therapist to get into the nuances of your feelings and experiences. You and your therapist may also decide to track and check in on your progress in other ways that are specific to your needs.

“How is my data being used?”

The information you provide in your mental health check-ins is confidential, HIPAA-protected health information and will only be visible to authorized individuals within Two Chairs. Your individual responses are only used to help guide your care and help you understand your progress.

Two Chairs is committed to continuous improvement. Sometimes, we may combine your data with others’ responses to help us learn how to make improvements in the quality of our care, but when we do so we remove any identifying information that could reveal your identity or link the information back to you.

We will never sell or share your data with any outside organization without your consent.

“How will I know how to respond to the mental health check-in questions?”

In these standard questions, you’ll be presented with options to share how often you’re experiencing something, such as a particular symptom or feeling. The answers you have to choose from may not reflect your reality exactly, but remember that these are standardized assessments. Just try to choose the one that feels the closest to your experience, and remember: You can always talk to your therapist about your experiences and feelings in more detail.

It’s also important to remember that the mental health check-ins are meant to help us understand how you’ve been feeling over the last two weeks. This is the best way for us to paint a broader picture of your progress over time. So, no matter when your last session was, try to think about your feelings and experiences over the two weeks prior to the check-in.

Our goal is to make therapy work for you

While our practice at Two Chairs is rooted in science, your unique human complexity is what matters most — not just during care, but after, so you can lead the life you want to live. We strive to provide therapy that’s tailored to you; that’s what measurement-based care and mental health check-ins are all about. By completing the check-ins, and having open, regular conversations with your therapist, you’ll have a solid foundation to work toward accomplishing your mental health goals.

We know that one of the hardest parts of engaging in your mental health journey can be getting started—it is difficult to know where to begin. There are so many different types of therapy treatments and practices. Therapists also work from different theoretical orientations and varied styles, which can be confusing to navigate when choosing the right combination for your specific needs and preferences.

Furthermore, whether or not a therapist will have availability at the times that you can actually see them can also feel like a barrier to care.

Here's how we help

At Two Chairs, we aim to simplify what can be a complicated process. We also know from research that the relationship between the client and the therapist is one of the strongest predictors of whether or not therapy is effective. So we’ve invested in making the perfect match.

To make sure all our clients are matched with the best therapist for them, the first step in starting care with Two Chairs is a virtual matching appointment. Let’s take a look at what happens in that appointment. 

What is a matching appointment?

In a Two Chairs matching appointment, you can expect to be on a video call with one of our licensed matching experts for about 45 minutes. It’s our chance to learn more about you and discuss things like what brings you in, your preferences for therapy, and what you hope to get out of it. 

It’s important to note that the matching appointment is different from a therapy session. The matching appointment is a collaborative but highly targeted discussion, which aims to clarify your goals for therapy and help us match you with the best therapist for you. You can think of it like an intake session where we gain a more holistic understanding of your symptoms, goals, and other factors that contribute to your mental health. The matching expert you’ll meet in this session is a licensed therapist with deep training in making the right match for you.

Therapy is a collaborative treatment based on the ongoing relationship between you and a therapist that is grounded in dialogue. It provides a supportive environment that allows you to talk openly with someone who is objective and nonjudgmental to identify and change patterns that are keeping you from feeling your best. 

Getting to know you and your needs

Once we get through the basics, a Two Chairs matching expert will spend the next half hour getting to know you and understanding what brought you to therapy. 

This is the part of the appointment where you can share some of what’s been weighing on you—we want you to feel seen and heard, so the therapist may ask you questions like: 

• Where would you like to start with what brings you in today?
• Do you find yourself ever missing work because of what you’re feeling?
• What is your social support network like, and do you feel connected to them?
• What have you found, if anything, to be helpful in coping with this?
• Have you tried therapy before? What was helpful or unhelpful about it?
• What are your hopes and expectations for therapy now? What do you want? What do you not want?

You may not know what’s going on with you or what type of therapy you need. But through this conversation between you and a matching expert, we’ll gain a better understanding of your needs and the clinical expertise on our team that can help you and ensure that the therapist you’re matched with is trained in whatever you’re dealing with.

Talking about therapy preferences

Your preferences for therapy may not be something you’ve thought about before—and that’s okay! The Two Chairs matching expert will guide you through some details and help you figure out what might work best for you. This can include things like aspects of your culture, like religion or spirituality, that might be important in your care, and if you prefer interacting with people who share about themselves or are more reflective. 

In addition to preferences about your therapy sessions, we know from research that the identity of your therapist matters. We want to hear about any demographic preferences you may have for who you work with—whether that’s around age, race, gender, or something else—so that we can match you with someone from our diverse and growing team of therapists with whom you’ll feel comfortable. 

And finally, therapy is something that should fit into your life, however works for you. Your matching therapist will talk to you about whether you would rather do online therapy, or in-person sessions at one of our beautiful clinics. 

Understanding what to expect and next steps

After listening to everything you choose to share, the matching expert will reflect on what they’ve heard and may share some initial thoughts on what type of therapy or therapist might be right for you. They will also give you an idea of how long you can expect to be in therapy to reach the goals you talked about. You’re welcome to give feedback on any of this—what your care looks like is a joint decision. 

Following the appointment, our matching expert will take what you’ve shared and use our research-backed methodology to determine who among our therapist staff is the best fit for you.

An expert resource

There are many reasons we have a licensed therapist facilitate the matching appointment, rather than an administrative intake staff member. We know that starting therapy can be intimidating and overwhelming, and we want to make sure you have an expert guiding you through the process so you feel heard and supported in the next step. 

We also know that finding the right therapist is one of the best ways to improve your mental health, so we’ve invested in perfecting the match. And we know our process works—98% of Two Chairs clients find the right therapist on the first try. 

Why matching matters

Why do we focus on this “match” between a client and a therapist? Decades of clinical research shows that the relationship between a client and a therapist (i.e., the connection you feel with your therapist) is the best predictor of success in therapy. Two Chairs eases the process of finding a therapist who’s a great fit based on a client’s personal needs, goals for therapy, and preferences for a therapist.

Our matching process is backed by research and combines clinician insight with data and in-house developed technology. To match a client with a therapist, our matching experts use a combination of clinical expertise and our system to provide a treatment recommendation based on your goals, preferences, and needs and thoughtfully match you with a Two Chairs therapist. 

The Two Chairs matching system matches on factors that lead to a tight-knit therapeutic bond between a client and a therapist.

Indeed, a strong therapeutic alliance with your therapist bolsters and enhances individual outcomes in therapy. This research holds true whether the care is in-person or via online therapy. 

For this reason, we pay a lot of attention to making sure our Two Chairs clients are matched to a therapist they will “click” with in the onset to set them up for a successful therapy journey.

Having a therapist you are well-matched to also saves time, energy, and money as opposed to having to “shop around” for the right fit.

In fact, the American Psychological Association estimates that one in five clients drop out from therapy after just one session. The research focused on the alliance between a client and a therapist shows that clients often cite feeling dissatisfied in their relationship with their therapist as a key motivator for premature termination.

We also know from the research that dropping out from therapy early can leave people with poorer outcomes than those who are engaged in treatment. On the other hand, at Two Chairs, we not only believe matching leads to better clinical outcomes, we also continue to assess how to match our clients to exceptional mental health care by getting their feedback along the way using our measurement-based care approach.

Clearly, it is important to feel connected and emotionally safe with your therapist, which allows for the space to start exploring symptoms and working on achieving the goals that have been set out for mental well-being.

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"The level of care is excellent, and it's sooo much easier to navigate than calling random therapists and hoping you can find one you like."

—Shawn W.

"The questions and conversation before Two Chairs recommended a therapist resulted in a perfect match. I had tried once before to see a therapist (recommended by a friend) and it was one of the worst experiences of my life. I was very uncomfortable with trying again, Two Chairs made it immediately comfortable and I continue to be comfortable with my therapist."

—Suzanne L.

"Being new to therapy, I put it off for the longest time because I wasn’t sure how to find a therapist that was right for me. Your matching process made this stress-free, and I’ve already recommended it to others!"

—Kendal B.

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You can also read our helpful article on how therapy can help with common mental health challenges.