Stedfast Psychiatry offers individual psychotherapy using cognitive behavioral therapy (CBT), DBT skills, acceptance and commitment therapy (ACT) and supportive therapy, in 45 to 55 minute sessions, in person or by video in Florida and South Carolina. Therapy is coordinated with medication management when both are needed. Most insurance plans and Medicare are accepted.
We use approaches with strong evidence behind them: cognitive behavioral therapy, dialectical behavior therapy skills, acceptance and commitment therapy, and supportive therapy. Which one fits depends on what you are dealing with and what you want to change. Most courses are time-limited and goal-focused. You should be able to say, at any point, what you are working on and whether it is helping.
Who it is for
Therapy is appropriate for most conditions we treat and is the first-line treatment for several. Mild to moderate depression, generalized anxiety, social anxiety, panic disorder, PTSD, OCD, insomnia, adjustment to a loss or life change, relationship and work stress, and grief all respond to therapy, often without medication. For moderate to severe depression, bipolar disorder and ADHD, therapy works best combined with medication.
Therapy is also for people who are already on medication and are better but not well. Medication can lift the floor of mood; therapy changes the habits of thinking and avoidance that keep problems coming back. And it is for people who do not want medication, or cannot take it, and want an active treatment rather than waiting. We see adults, adolescents and, with some therapists, younger children. If you are not sure whether you need a therapist or a prescriber, start with either; our clinicians refer across the practice.
How it works
The first session is an assessment. Your therapist asks what brought you in, what you have tried, what a good outcome would look like, and about your history. Together you set two or three concrete goals: sleep through the night, stop avoiding driving on the highway, get through a week without a panic attack, be able to think about your father without the day collapsing. Goals give the work direction and let you measure progress.
Cognitive behavioral therapy works on the link between thoughts, feelings and behavior. You learn to catch automatic thoughts, test them against evidence, and change behavior that keeps the problem alive, often with homework between sessions. Dialectical behavior therapy skills teach four sets of tools: mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness; they are useful far beyond the borderline personality disorder DBT was developed for. Acceptance and commitment therapy focuses less on changing thoughts and more on changing your relationship to them, so that difficult feelings stop dictating behavior and you can act on what matters to you. Supportive therapy is less structured and is right for people who need a steady place to process a hard period rather than a skills curriculum.
Sessions are weekly at the start, 45 to 55 minutes. Most CBT and ACT courses run 8 to 20 sessions. Progress is checked with the same scales your prescriber uses, so a falling PHQ-9 or GAD-7 tells both of you the plan is working. When therapy and medication are combined, your therapist and prescriber share notes within the practice and adjust together.
Psychotherapy produces a medium to large effect size across common mental health conditions, with about 75 percent of people who enter therapy showing benefit.
Source: American Psychological Association, 2012 resolution on the effectiveness of psychotherapy
For moderate to severe depression, combining psychotherapy with antidepressant medication produces higher response and remission rates than either treatment alone.
Source: Cuijpers et al., World Psychiatry, 2020 meta-analysis
CBT delivered by video shows outcomes equivalent to in-person CBT for depression and anxiety across multiple randomized trials.
Source: Journal of Anxiety Disorders and Journal of Affective Disorders meta-analyses, 2018 to 2021
About 55 million US adults received mental health treatment in 2022, including roughly 23 percent who had counseling or therapy.
Source: NIMH / SAMHSA National Survey on Drug Use and Health 2022
What to expect
Expect to work. Effective therapy involves practicing between sessions: logging thoughts, doing an exposure, trying a new behavior, tracking sleep. People who do the homework improve faster, and your therapist will say so plainly. Expect the first few sessions to feel slow while the assessment and goals are set, and expect some sessions to be uncomfortable, especially when the work involves facing something you have been avoiding.
Therapy is available at all 13 Stedfast offices and by secure video for patients in Florida and South Carolina. Video therapy performs about as well as in-person therapy for most conditions and is often easier to keep up with. If you are also seeing a Stedfast prescriber, visits can sometimes be scheduled on the same day. You should notice some change by session six to eight; if you do not, we revisit the approach rather than continuing on momentum.
Benefits
- Evidence-based methods (CBT, DBT skills, ACT) matched to your diagnosis
- Concrete goals set in the first session and measured with scales
- Time-limited courses for most conditions, typically 8 to 20 sessions
- Therapist and prescriber in the same practice, sharing a plan
- In person at 13 offices or by video across Florida and South Carolina
- Skills that keep working after treatment ends
Risks and side effects
Therapy has few physical risks, but it is not free of discomfort. Talking about trauma, loss or shame can temporarily increase distress, and exposure-based work for anxiety and PTSD deliberately brings on anxiety in a controlled way before it reduces it. A small number of people feel worse for a period before they feel better. Your therapist will pace the work and tell you what to expect.
The main practical risk is a poor match. Not every therapist suits every patient, and the relationship matters to outcomes. If after three or four sessions it does not feel like a fit, say so; we will change the approach or the therapist without any awkwardness. The other risk is drift: therapy that continues for years without goals or measurable change. We guard against that by reviewing goals regularly and by ending a course when it has done its job.
Cost and insurance
Psychotherapy is covered by most commercial insurance plans and by Medicare under behavioral health benefits. Your cost is the copay or coinsurance for outpatient mental health visits, which under federal parity law must be comparable to your medical copay. Some plans manage behavioral health through a separate company; we verify this before your first session and tell you what to expect. Some plans limit the number of sessions per year or require authorization after a certain number; we track those limits for you.
Self-pay rates for therapy sessions are available for patients without insurance or out of network. Ask our front desk for the current schedule. We do not charge for brief portal messages between sessions, but missed appointments without 24 hours notice may be billed a fee that insurance does not cover.
Which approach for which problem
Matching the method to the condition is where training shows. For depression, CBT and behavioral activation have the longest track record; ACT performs comparably. For panic disorder, CBT with interoceptive exposure (deliberately bringing on the physical sensations of panic until they lose their power) is the standard. For social anxiety, CBT with graded exposure to feared situations. For OCD, exposure and response prevention, a specific form of CBT, is the treatment of choice, and standard talk therapy does not substitute. For PTSD, trauma-focused CBT, cognitive processing therapy and prolonged exposure are first line. For insomnia, CBT-I outperforms sleep medication over the long term. For intense, fast-shifting emotions, self-harm or chaotic relationships, DBT skills are the right starting point.
Supportive therapy earns its place for people in the middle of something: a diagnosis, a divorce, a bereavement, a career collapse. The aim there is not to restructure thinking but to hold steady, problem-solve and prevent a hard period from becoming a disorder.
How therapy pairs with medication
Medication and therapy act on different parts of the problem. An antidepressant can lift energy and sleep enough that doing the behavioral work becomes possible. Therapy then builds the habits that keep mood up after the medication is tapered. Across many trials, the combination outperforms either treatment alone for moderate to severe depression, and therapy added to medication reduces the chance of relapse.
In practice this means your therapist and prescriber need to be looking at the same information. At Stedfast they are. A therapist who notices that a patient's mood has dropped sharply can flag it to the prescriber the same day; a prescriber who starts a stimulant can ask the therapist to watch for sleep problems. That coordination is harder when the two are in different practices and often simply does not happen.
What good therapy looks like from the inside
You know what you are working on. Sessions have a structure: a check-in, a review of what you practiced, the work of the day, and a plan for the week. You leave with something to do. Your therapist is warm but will challenge you. Progress is measured with a scale every few sessions, not guessed at. When the goals are met, the course ends, sometimes with a few spaced booster sessions, and you know how to find your way back if you need to.
What therapy is not
It is not a place to be told what to do. It is not open-ended companionship billed to insurance. It is not a substitute for medication when medication is clearly needed, and it is not something you have to earn by being sick enough. Many people benefit from a short course of therapy during an ordinary hard season. If you are weighing whether to start, the cost of a first session is low and the assessment alone is often clarifying.
Frequently asked questions
How do I know if I need therapy, medication or both?
Mild to moderate depression and most anxiety disorders can be treated with therapy alone. Moderate to severe depression, bipolar disorder, ADHD and psychotic conditions usually need medication, and do better with therapy added. If you are not sure, a psychiatric evaluation sorts it out, and our prescribers refer to our therapists in the same visit. There is no wrong door.
How long does therapy take?
Most CBT and ACT courses run 8 to 20 weekly sessions. Insomnia often resolves in 4 to 8 sessions of CBT-I. PTSD and OCD typically take 12 to 20. Supportive therapy during a hard stretch of life may be open-ended but is reviewed regularly. You should see movement by session six to eight; if not, we change the approach.
What is the difference between CBT, DBT and ACT?
CBT changes unhelpful thoughts and avoidance behavior through structured exercises and homework. DBT skills teach mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness, and suit people whose emotions run intense and fast. ACT teaches you to make room for difficult thoughts and feelings while acting on your values rather than waiting to feel better first. Many therapists blend them.
Does video therapy work as well as in person?
For most conditions, yes. Randomized trials of video-delivered CBT for depression and anxiety show outcomes equivalent to office visits, and attendance is often better. Some patients prefer the office, and some situations (young children, high-risk periods) favor it. You can switch between the two. Video sessions require you to be in Florida or South Carolina at the time.
Is therapy covered by insurance?
Usually. Most commercial plans and Medicare cover outpatient psychotherapy, and federal parity rules require mental health copays comparable to medical copays. Some plans use a separate behavioral health network or cap sessions; we verify your benefits before the first visit and tell you. Self-pay rates are available for the uninsured and out of network.
Will my therapist talk to my psychiatrist?
If both are at Stedfast, yes, they share your chart and coordinate the plan. If your prescriber or therapist is outside the practice, we coordinate with your written permission. Having the two halves of treatment talk to each other is one of the main reasons to have them under one roof.
Do you see teenagers and children for therapy?
Yes. Several of our therapists see adolescents, and some see school-age children, with minimum ages varying by clinician. Parents are involved in the plan, and for younger children much of the work is with the parent. We will match your child to a therapist who works with their age group at scheduling.
What if I do not click with my therapist?
Tell us. The working relationship predicts outcomes, and a poor fit is nobody's fault. We will switch you to another therapist in the practice or adjust the approach. Give it three or four sessions first, since the early sessions are mostly assessment, but do not stay in a mismatch out of politeness.
Where this treatment is offered
- Boynton Beach, FL
10301 Hagen Ranch Rd, Suite D720 and Suite B710 - Palm Beach Gardens, FL
11641 Kew Gardens Ave, Suite 209 - Stuart, FL
729 SW Federal Hwy, Suite 104 - Royal Palm Beach, FL
420 South State Road 7, Suite 112 - Jacksonville, FL
2950 Halcyon Lane, Suite 605 - Port St. Lucie, FL
266 NW Peacock Blvd, Suite 203 - Melbourne, FL
6300 North Wickham Road, Suite 110 - Fort Lauderdale, FL
3107 Stirling Road, Suite 107 - Jupiter, FL
3893 Military Trail, Suite 3 - Goose Creek, SC
118 Springhall Drive, Suites B and F - Lexington, SC
120 Brookside Parkway, Suite C - Bluffton, SC
25 Clarks Summit Drive, Suite F201 - Hilton Head Island, SC
19 Shelter Cove Lane, Suite 202
Conditions this treats
If you are in crisis, call or text 988 or go to the nearest emergency room. Educational content; individual results vary. Reviewed by Dr. David Husted, board-certified psychiatrist.