The outline below describes my sleep-focused process; when our primary focus is anxiety/mood/life transitions, the structure is similar—assessment, a clear plan, and between-session practice—without the sleep diary and with different skills emphasized.

Before Your First Appointment: Sleep Diary

Before your first session, I will ask you to keep a brief sleep diary for at least one week. You will record the following information when you go to bed: how long it takes to fall asleep, any awakenings during the night, the time you wake up, and any thoughts or feelings you have about sleep. I review your diary before and during our work to better understand your patterns and track changes over time.

Initial Sleep Assessment

Your first appointment is a 75-minute clinical assessment. We will review your sleep history, your sleep diary, and a few brief questionnaires. The goal is to develop a clear understanding of your current sleep patterns and how your difficulties emerged over time.

During the assessment, we will talk about:

• Life before your sleep problem.
  Whether your sleep has been difficult for decades or changed more recently, we will examine your usual routines, personality style, approach to stress, and any relevant health issues.

• Possible triggers.
  Sometimes there is a clear starting point for insomnia, such as a stressful event, health scare, or life transition. Other times it begins more gradually. We will explore both possibilities.

• What is keeping the problem going?
  We will look at current habits, coping strategies, and patterns of thinking about sleep. Some of these may be helpful, and others may be unintentionally making it harder to sleep. These are often the focus of later CBT-I and ACT-based work.

• Sleep medications and other aids.
  If you have used sleep medications, over-the-counter remedies, supplements, or devices, we will review what you have tried, what has helped, what has not, and whether you hope to continue, reduce, or stop any of these.

• Medical and physical factors.
  We will discuss any medical conditions, snoring, breathing concerns, leg movements, or pain that might be affecting your sleep. If needed, I may recommend that you speak with your primary care physician or a sleep specialist about further medical evaluation. For most people with insomnia, a full sleep study is not necessary, but sometimes it can be helpful.

Personalized Treatment Plan

At the end of the assessment, I will share my impressions about your sleep difficulties and outline a recommended treatment plan. We will discuss what therapy will involve, how many sessions are likely to be helpful, and what you can expect between appointments. Many people notice meaningful improvements within eight sessions, although this can vary based on history and severity.

Monitoring Progress

Follow-up sessions are 50 minutes. In these sessions, we will apply CBT-I and ACT-informed strategies to adjust your sleep schedule, refine your habits and environment, and change the way you relate to worry and frustration about sleep. As we go along, we will track progress and fine-tune the plan as needed. Many people notice meaningful improvements within eight sessions, although this can vary based on history and severity.

Insurance and Scheduling

The first appointment is a 75-minute assessment and is $300. Ongoing 50-minute sessions are $250. I am an out-of-network provider, which means I do not work with insurance companies. I can provide a detailed invoice (superbill) so you can submit for possible out-of-network reimbursement.

Cancellation Policy

If you need to cancel or reschedule an appointment, please provide at least 24 hours' notice on business days. Sessions cancelled with less notice are subject to the full session fee.

Telehealth Sessions in NJ and NY

All sessions are conducted via secure telehealth for adults residing in New Jersey and New York.