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After entrepreneur Alex Katz witnessed friends and family members struggle to find mental health care, he realized the system needed a makeover.

“My friend was struggling with depression, and it took her months to find a therapist. When she finally began treatment, her therapist wasn’t a great fit,” Katz says.

Because talking openly about mental health is often met with stigma, many people don’t ask their friends or loved ones for therapy recommendations. Instead, they try to find help on their own, relying on referrals from insurance companies, physicians, and the internet.

But none of these referral sources consider therapist and client compatibility, which research shows is a crucial component of treatment success.

Inspired to help people find the right therapist, Katz began Two Chairs, a concierge-like outpatient mental health clinic in San Francisco. Clients meet with an intake clinician who matches them with an appropriate therapist before they begin treatment.

In an interview with Healthline, Katz talked about Two Chairs and the clinic’s mission to increase access to excellent mental health care for the community.

This interview has been edited for brevity, length, and clarity.

At Two Chairs, all clients are matched with a therapist. How does that work?

Matching our clients with therapists is the most unique thing we’re doing. Despite the research, matching isn’t often considered when making a mental health referral. A therapist might have excellent clinical training and experience, but if the client doesn’t connect with them, therapy isn’t effective.

At Two Chairs, we recognize and value the importance of the therapeutic relationship, which is why each client meets with our intake clinician before being paired with their therapist.

Can you say more about how the matching process works?

With a talented team of clinicians, we’ve built a matching approach that combines clinical rigor, an in-person meeting with a consult clinician, and data science. Our matching system utilizes data about a client’s needs, therapeutic preferences, and goals for treatment. All of this information is used in the matching process.

Before the intake appointment, new clients complete several questionnaires asking about their medical and mental health history, symptoms, preferences, and goals for therapy. During the intake session, the consult clinician uses all of this information to make a great match, recommend the appropriate type of therapy, and tailor an individual care plan for the client.

What types of therapy does Two Chairs offer?

We have a diverse range of clinicians with expertise in many different types of psychotherapy. We offer behavioral treatments, such as cognitive behavioral and dialectical behavior therapy, as well as emotion-focused and psychodynamic therapy. We also offer group psychotherapy to help people cope with work stress and anxiety.

Who are your ideal clients?

We see a diverse range of clients of different ages and from various cultural and ethnic backgrounds. Similar to the general population, many of our clients struggle with depression, anxiety, adjustment disorder, eating disorders, or bipolar disorder.

We’re [also] seeing clients who are feeling lonely and isolated and those with technology addictions. We’re finding that existing in the modern world is hard and can culminate in mental health symptoms.

Do you accept insurance?

We don’t accept insurance, but many people have PPO mental health benefits, which means they can see out-of-network providers.

The initial consult is $99, and subsequent sessions are $180. To make billing more manageable, we have a care coordination team who submits insurance claims on our client’s behalf.

How do you measure success with your clients?

Many therapists never ask their clients for feedback, but our clients complete mental health questionnaires, which help our therapists determine how the treatment is working. By focusing on the therapeutic alliance, the client and therapist [can] form an empathic and trusting bond, which lets them openly discuss goals and how the treatment is progressing.

For example, a client may come to Two Chairs because of insomnia, which can be treated with behavioral therapy. During therapy, however, the clinician may uncover that the client’s sleeping difficulties are linked to childhood trauma. With this new insight, the therapist will adjust the treatment plan accordingly.

Bringing personalized care to mental health care makes it more likely that clients receive the treatment needed to bolster their emotional and psychological health.

How does Two Chairs hope to change the way people view therapy?

We want to bring discussions about mental health out of the shadows, turning wellness into something people celebrate. We also want to make it easier for people to find the right care and to offer them quality mental health services.


Juli Fraga is a licensed psychologist based in San Francisco, California. She graduated with a PsyD from University of Northern Colorado and attended a postdoctoral fellowship at UC Berkeley. Passionate about women’s health, she approaches all her sessions with warmth, honesty, and compassion. See what she’s up to on Twitter.