Service Details
At a glance
Who it’s for: Couples facing communication breakdowns, lost trust or a big life change. You don’t need to be on the edge of separation to start.
Why two therapists: Each partner has someone following their side closely. One of us leads while the other watches how you talk to each other.
What to expect: 75-minute sessions with both partners in the room. Most couples start weekly.
Good to know: Both partners attend couples sessions. Sessions are in person in Pleasantville, or online for clients located in New York.
Cost: $375 per 75-minute session, self-pay.
Why two therapists?
In most couples therapy, one therapist sits with two people, and sometimes one person feels outnumbered. With two licensed therapists in the room, each partner has someone following their side closely. One of us can lead while the other watches how you talk to each other.
We can’t promise it works for every couple, and we’ll tell you honestly if a different approach would serve you better.
Who you’ll meet
Lara Fastman, LCSW-R, CASAC, is a licensed clinical social worker and credentialed addiction counselor with more than 25 years in full-time private practice. She is trained in EMDR.
Stephen Terzuoli, LCSW, is a licensed clinical social worker in New York who works with couples, individuals and teens on relationships, anxiety and grief. His approach draws on cognitive behavioral, psychodynamic and family and marital therapy. His office is in the same Pleasantville building.
Lara and Stephen are married. We work together because we think two therapists in the room helps.
You can verify any New York license on the NYS Office of the Professions website.
When it feels like the same fight on repeat
Most couples don’t come in because of one big thing. They come in because the same argument keeps happening, or they’ve stopped talking, or something happened and trust hasn’t come back. If that sounds familiar, you’re in the right place.
What sessions are like
Sessions are 75 minutes and both of you are in the room. We slow things down so you can actually hear each other, and we work on the patterns underneath the arguments. Most couples start weekly and adjust the pace as things improve.
Who it helps
Couples facing communication breakdowns, a loss of trust, or a big life change like a new baby, a move, or a career shift. You don’t need to be on the edge of separation to start.
Good to know
Couples usually begin together. If one of you later wants individual sessions, we’ll talk it through first so nobody feels sidelined.
Why couples come to therapy
Couples come for many reasons. Some are stuck in the same argument and can’t find a way out. Some have stopped talking, or feel more like roommates than partners. Others are recovering from broken trust, including infidelity, or facing a major change such as a new baby, a move, a job loss, or an empty nest. Some come to decide whether to stay together. Others simply want a stronger relationship. You don’t need to be in crisis to benefit.
What we work on
Most couples work on a few connected areas: communication and the patterns behind recurring conflict, rebuilding trust and safety, closeness and intimacy, parenting and household stress, and navigating big life changes. We help you slow conflict down, say what you actually need, and listen in a way your partner can hear. The aim isn’t to eliminate disagreement. It’s to disagree without damaging each other.
How sessions are structured
Couples sessions run 75 minutes with both partners in the room. Early sessions focus on understanding your history, the pattern between you, and what you each want to change. From there we practice new ways of talking and responding, often by working through real conflicts in the room, with guidance. Most couples begin weekly and space sessions out as things improve. We don’t take sides, and nobody is put on trial.
What happens between sessions
Change happens at home, so we suggest small practices between visits: a daily check-in, a way to pause an argument and return to it, an appreciation exercise, or a conversation about a specific issue. Small, consistent steps tend to matter more than big gestures. We’ll choose exercises that fit your lives, and review how they went at the next session.
When couples therapy isn’t the right starting point
Individual sessions alongside couples work
Sometimes one or both partners also benefit from individual sessions, for example to address anxiety, trauma, or a decision about the relationship. We’ll talk with you about how to arrange this so the work stays clear and fair. Couples usually begin together, and if one partner later wants individual sessions, we’ll talk it through first so nobody feels sidelined.
What progress looks like for couples
Early progress is often small: you catch the cycle sooner, arguments end faster, you listen a little longer before reacting, or you feel more curious than defensive. Over weeks and months, many couples notice more warmth, more honest conversations, and fewer blowups. Progress isn’t a straight line, and some sessions are harder than others. We check in regularly on how things are going and adjust.
Preparing for your first couples session
Common misconceptions about couples therapy
Many people think couples therapy is a last resort, that the therapist will decide who’s right, or that it’s only for troubled marriages. In practice, many couples come earlier, a good therapist doesn’t take sides, and couples at every stage use it to strengthen the relationship. Another misconception is that it will fix things quickly. It takes time, effort, and willingness from both of you.
Questions to ask a couples therapist
Ask about their training and experience with couples, how they approach conflict and trust, how they handle it if one partner shares something privately, how often they suggest meeting, what the fees and cancellation policy are, and how they know when therapy is working. You should both feel respected and heard. If one of you feels outnumbered or dismissed, say so, and a good therapist will adjust.
Cost
$375 per 75-minute session.
Self-pay rate. You have the right to a Good Faith Estimate of expected costs before your first session.
Common questions
How long will we need?
It depends on your goals. Many couples see meaningful change within a few months, and some continue longer. We’ll check in regularly.
What if my partner is reluctant?
That’s common. You can start with individual sessions, or invite your partner to a first session without pressure.
Do you offer online couples sessions?
Yes, for clients located in New York. In person sessions are at our Pleasantville office.
You’re married. Does that matter?
Yes, we’re married. We work together because we think two therapists help. In sessions, the focus is on the two of you.
Do we both have to come?
For couples sessions, yes.
How often will we meet?
Usually weekly at first, then we adjust together.
Why do you work as two therapists?
Two therapists mean each partner has someone closely following their side, and the work stays balanced. One of us can lead while the other watches how you talk to each other.
How much does it cost?
$375 per 75-minute couples session. It is self-pay, and we can provide a superbill if your plan reimburses out-of-network care. You have the right to a Good Faith Estimate before your first session.
Do you take insurance?
Joint sessions are self-pay. Check your out-of-network benefits first, since reimbursement depends on your plan.
Is couples therapy safe for every relationship?
No. If one of you is afraid of the other, individual support and safety planning come first.
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