Frequently Asked Questions

KAREN LEWIS LCSW – UPDATED FAQ’s Page

Q1: What kind of therapy do you offer?

I work primarily from a psychodynamic and psychoanalytic perspective - which means we spend time looking at the patterns, beliefs, and relationships that shape how you're experiencing your life right now. This isn't about giving you a to-do list. It's about understanding what's driving the difficulty so you can change it at the root. I draw from an extensive toolbox using evidence-based tools from cognitive and somatic approaches depending on what a client needs.

Q2: What issues do you specialize in?

My core areas are generalized anxiety (specializing in high functioning anxiety), grief and loss, trauma, depression, and work induced stress. I also work with couples and with parents - including parents of children with special needs and those with children with Type 1 Diabetes. I have a particular interest in clients who appear to be managing well on the outside while carrying significant weight underneath. If that sounds like you, you're likely in the right place.

Q3: How do I know if I need therapy?

If something is getting in the way of how you want to live - your relationships, your work, your ability to rest or feel settled - that’s worth exploring. You don't need to be in crisis to benefit from therapy. Many of my clients come in because they're functioning but not thriving. That's a completely valid reason to start.

Q4: What is high-functioning anxiety, and do you work with it?

High-functioning anxiety is what it looks like when someone appears productive, capable, and 'fine' to the outside world - but internally they're driven by worry, overthinking, and a persistent sense of unease. It often shows up as over-preparing, people-pleasing, difficulty relaxing, and replaying conversations after the fact. Yes, this is one of my primary areas. I work with a lot of clients who don't identify as 'anxious people' but recognize themselves in that description.

Q5: I'm dealing with grief. How does grief therapy work?

Grief isn't just about death - it includes loss of a relationship, a role, a future you expected, or a version of yourself. As a Certified Grief Educator, I'm trained specifically in the processes of grief and bereavement, not just general therapy applied to loss. We work at your pace. There's no timeline I'll put you on, and no expectation that you'll simply 'move on.' Instead, we work toward integrating the loss in a way that allows you to carry it without it carrying you.

Q6: What is Seasonal Affective Disorder, and do you treat it?

Seasonal Affective Disorder (SAD) is a type of depression that follows a seasonal pattern - most commonly appearing in late autumn and winter when daylight hours are shorter. Symptoms include low mood, fatigue, increased sleep, appetite changes, and difficulty concentrating. Yes, I have specific training and experience in SAD, and I can help you understand whether what you're experiencing is seasonal, develop coping strategies, and explore additional support (like light therapy) might help.

Q7: Do you work with couples?

Yes. I offer couples counseling for partners working through communication breakdowns, conflict patterns, life transitions, intimacy challenges, and trust issues. Couples work is different from individual therapy - it requires attention to the dynamic between two people, not just two individual histories. I work to help partners understand each other's patterns and build a more sustainable way of being together.

Q8: Do you work with trauma?

Yes. Trauma work is a significant part of my practice. I am trained in EMDR (eye movement desensitization and reprocessing). This modality can help resolve traumatic experiences in a gentle manner.

Q9: What is your approach - and how is psychoanalytic therapy different from other kinds?

Psychoanalytic therapy goes deeper than symptom management. Rather than focusing only on what you're thinking or doing, we explore what's underneath - the patterns, defenses, and relational templates that developed over a lifetime. This is not about blaming your past; it's about understanding it, so it stops running the show. It tends to produce more lasting change than short-term approaches because we're working on the source, not just the surface.

Q10: Do you offer teletherapy?

Yes. I offer teletherapy for clients in New Jersey, New York, and Florida. Many of my clients prefer teletherapy for the flexibility it offers - you can attend a session from your home or office without commuting. The quality of the therapeutic relationship and the work itself is not diminished by the online format. Sessions are conducted via a secure, HIPAA-compliant platform.

Q11: What does a first session look like?

The first session is a conversation. I'll ask you what's brought you in, what you're hoping to get from therapy, and a little about your history. You don't need to have a perfect answer prepared. This is also your chance to get a sense of whether you feel comfortable with me - the fit matters. By the end of the first session, we'll usually have a clearer picture of what we want to focus on and how we might work together.

Q12: How often will we meet, and how long does therapy take?

Most clients begin with weekly sessions. This frequency allows us to build momentum and get traction on what you're working through. As for how long: it depends entirely on what you're bringing in, your goals, and how the work progresses. Some people come for a focused period of a few months, then uncover more issues along the way. Others find that longer-term work is what creates the depth of change they're looking for. We'll discuss this as we go - it’s not something that's fixed at the outset.

Q13: Do you accept insurance?

I am a private-pay practice and do not bill insurance directly. I can provide a superbill (a detailed receipt) that you can submit to your insurance provider for potential reimbursement if you have out-of-network benefits. I recommend checking with your insurance company about your out-of-network coverage before we begin. I accept payment by credit card, health savings account (HSA), and Venmo.

Q14: What is the cost per session?

Please contact me directly for current fee information. I'm happy to discuss this during our initial consultation call. If cost is a concern, I encourage you to reach out anyway - it’s worth having the conversation.

Q15: Can I speak with you before committing to sessions?

Yes. I offer a free 15-minute phone consultation so you can ask questions, get a sense of how I work, and decide whether you'd like to move forward. There is no pressure and no obligation. You can reach me at (201) 290-5550 or email lewisk728@gmail.com.

Q16: What if I've tried therapy before and it didn't help?

That's worth exploring, not dismissing. Therapy is not one-size-fits-all, and a poor fit - with the therapist, the approach, or the timing - can genuinely get in the way of progress. If you've had a prior experience that felt flat or unhelpful, I'd encourage you to tell me about it. Understanding what didn't work is useful information that shapes how we approach things.

Q17: Do you see clients in person or only online?

My primary mode is teletherapy via secure video session. If you're in Bergen County, NJ, across the state of NJ, NY or FL (licensed in all three states), please reach out directly and we can discuss what's available.

Q18: I'm a high-achieving professional. Will you understand the pressures I'm under?

Yes. A significant portion of my clients are professionals, executives, and high achievers who are managing demanding careers while dealing with anxiety, burnout, grief, or relationship strain. I understand that this population often comes in with specific concerns: they don't want to be slowed down, they're used to solving problems, and they're sometimes skeptical of whether therapy can actually help. I work in a way that respects your intelligence while challenging the assumptions that may be keeping you stuck.

Q19: How do I get started?

The easiest first step is to call (201) 290-5550 or email lewisk728@gmail.com to schedule a free 15-minute consultation. Alternatively, you can visit the contact page on this website. You don't need to have anything figured out before you reach out. That's what the first conversation is for.