High functioning does not mean healthy.

Therapy for high-achievers navigating anxiety, attention, apathy, and the tensions that won't resolve on their own.

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The high-achievers in my practice usually walk in with some combination of:

You’re still showing up…

You are still meeting the due dates, still connecting with for friends and family, still in the relationship, still perusing the dream career.

But you snapped at someone you love last week and it didn't feel like you. You woke up at 3 a.m. again. You sat in your car in the parking lot for twenty minutes before you could drive home. You read the same paragraph four times. You cried in the bathroom for reasons you couldn't name. You poured the second glass… and then the third.

What's underneath isn't a character flaw. It's usually anxiety, depression, attention difficulty, burnout, or some combination of all of them, carried by a high-achiever who has been compensating for too long.

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Clinical psychologist

Dr. Kathryn Esquer

I'm a clinical psychologist, and I built my practice around women like the ones I kept meeting everywhere I worked. Bright, capable, doing too much, and quietly running out of room.

I hold a doctorate in clinical psychology and an MBA, a combination that lets me move fluently between the inner life of a person and the outer life of a career, a family, and the responsibilities that come with both. My professional training has taken me through university counseling centers, integrated primary care, and organizational consulting, which means I have spent my career sitting across from women who are highly capable, deeply invested in their lives, and quietly carrying more than the people around them realize.

The people I work with are high performers. They are physicians, attorneys, executives, founders, academics, and senior leaders. They are also wives, mothers, daughters, and women in the middle of the questions a high-performing life eventually surfaces. They are smart. They are tired. They are ready to heal themselves.

My clinical work is psychodynamic, integrative, and depth-oriented. I pair scientific rigor with humanity. I take symptoms seriously and I take you seriously.

If you're curious whether this is the kind of work you've been looking for, I'd love to hear from you.

How the work actually goes

Most therapy stops at symptom management. The work I'm trained to do goes further. Anxiety, burnout, and decision paralysis are rarely the whole picture and my work is widening the frame.

As a clinical psychologist with a doctorate and an MBA, work with me is psychodynamic, integrative, and depth-oriented. I pull from a range of empirically supported methods so the work adapts to your needs.

Know a friend that I can help? Send them my info.

What this is not

  • This isn't crisis care. If you're in acute crisis, you need a different kind of support, and I'll help you find it.

  • This isn't coaching. There's overlap in what I do and what an executive coach does (I hold both backgrounds), but this work is therapy, with the depth and protection that implies.

  • This isn't advice-giving. I'm not going to tell you whether to have the baby, take the job, or leave the marriage. I'm going to help you become someone who can hear her own answer.

  • This isn't a quick fix. If you're looking for a total transformation after one session, this isn't the right room.

THE PATH TO WORKING TOGETHER

  • Step 01

    Schedule a consultation

    A conversation, not commitment

    Fifteen minutes on the phone to talk through what's bringing you here, what you've already tried, and what you're looking for now. We'll cover fees, insurance, scheduling, and any questions you have. By the end, you'll know whether this is the right fit and what your next step looks like.

  • Step 02

    Begin Together

    Your first sessions

    If we're a fit, we'll schedule your first session within the week and I'll send paperwork ahead of time so we can use our time well. The first few sessions are about clinical orientation, understanding the full picture of what you're bringing in, and calibrating our approach to meet your specific needs.

  • Step 03

    Establish a Cadence.

    Regular sessions, virtual

    We'll start by meeting weekly by secure video. Then we’ll adjust the frequency as needed to meet your changing needs. Most clients see meaningful shifts within the first months and stay for the deeper work that follows.

Frequently Asked Questions

  • Probably, yes. Most therapy that high-achieving people have access to is short-term, manualized, and oriented toward coping skills. That work has a real place, and it has likely already helped you. What it tends to miss is the deeper layer underneath the symptoms, the patterns that keep showing up no matter how many tools you have, the parts of you that are running the show without your permission. My training is specifically built to work at that layer. Many of my clients tell me they had useful therapy before and found that this work goes somewhere the other work could not reach.

  • No lying on a couch (unless you want to) and no three-times-a-week analysis with a blank slate therapist.

    Depth therapy means I am working with both the symptom and what is underneath the symptom at the same time. We will absolutely address the anxiety, the burnout, the decision you cannot make, and we will also be tracking the patterns, the body cues, the relationships, and the parts of your story that those symptoms are pointing toward. The work is collaborative, conversational, and grounded in evidence-based methods.

  • Not in the workbook sense. The work happens in the room. Occasionally I will recommend a book or an exercise if it seems genuinely useful for a specific client, but I do not run a curriculum. You are not going to leave here with a pre-determined workbook. Every client has a customized treatment plan to address their specific needs.

  • No. I will not tell you whether to take the job, go back to school, leave the marriage, have the baby or move across the country. What I will do is help you become the kind of person who can hear her own answer clearly. The clients who come to me having tried a more advice-oriented approach almost always tell me that the answer they actually trust is the one they arrived at themselves, with support, rather than the one a clinician handed them.

  • If sleep, a vacation, or a job change would have worked, you would have done one of them by now. The fact that you are reading this page suggests you already suspect the situation is layered. Therapy is the appropriate next step when the usual self-management strategies have stopped fully working, when symptoms are interfering with your day-to-day life, or when you are aware that something underneath needs attention you cannot give it on your own.

  • I am an out-of-network provider, which means I do not bill insurance directly. Many of my clients use their out-of-network benefits to get partial reimbursement, and I provide superbills monthly to make that straightforward. On the discovery call I can walk you through how to check your benefits before you commit to anything.

    There are three reasons for this: First, in-network rates do not support the kind of clinical care I offer, which depends on having the time and freedom to work at depth. Second, insurance requires a diagnosis on your permanent medical record, which many of my clients prefer to avoid. Third, insurance dictates session length, frequency, and treatment approach in ways that often interfere with good clinical care. Out-of-network keeps the work between you and me.

  • It depends on what you are bringing in. Some clients come for focused work around a specific concern and stay for eight to sixteen sessions. Some stay weekly for a year or more. Some stay for years because there is always more to do. The honest answer is that we will know more after a few sessions, and I will tell you what I am seeing as we go. The first step is to schedule an initial call to determine if we’re a good fit for your goals.

  • Most clients start at once a week. That cadence gives the work room to build, especially early on. After a few months, we may adjust together. Some clients move to every other week. Some stay weekly for years and I become an integrated part of their caring community.

  • Sessions are around fifty minutes, unless we schedule a longer period of time.

  • All sessions are virtual, by secure HIPAA-compliant video. A secure link is emailed to clients after booking an appointment.

  • I will work with local laws and requirements to keep meeting as scheduled. If you move permanently, we look at whether I am able to serve you in your new state. If it is, the work continues. If it is not, I will help you transition to a clinician I trust.

  • I hold limited evening hours for working professionals. Weekend hours are rare but occasionally available. We will work out a schedule that holds during the discovery call.

  • I hold a doctorate in clinical psychology (PsyD) and an MBA from Widener University in Chester, PA. I am a licensed psychologist, and I have spent my career working in university counseling, integrated primary care, hospital systems, and executive consulting. My clinical work draws on psychodynamic therapy, internal family systems, narrative therapy, and somatic and expressive methods. The combination of clinical depth and organizational fluency is what allows me to work effectively with high-functioning, ambitious people.

    You can learn more about my education and training on my LinkedIn page.

  • Yes. I would not ask my clients to do work I do not do myself.

  • Yes, and that is what the discovery call is for. You do not need to be ready to commit before the call. The call exists so you can ask the questions you have, get a sense of how I work, talk through fees and logistics, and decide whether and when to start. There is no obligation to schedule a first session at the end of the call.

  • I am not the right therapist for everyone, but the initial call will help you figure it out. If we are a fit, we will schedule. If we are not, I will help you think through who might be. I would rather you find the right clinician than start with the wrong one.

  • You are not alone in that. A significant portion of the people I work with have done one or more rounds of therapy that helped some but did not fully resolve what they came in with. That is often what brings them here. On the discovery call, I will ask about your prior therapy experience so I can give you a real assessment of whether this work is likely to go somewhere new.

  • If you are in acute crisis, including thoughts of harming yourself or others, please call or text 988 (the Suicide and Crisis Lifeline) or go to your nearest emergency room. My practice is not built for crisis stabilization, and you deserve immediate support that I am not positioned to provide. Once you are stabilized, I am happy to talk about ongoing work.

  • Yes. The work depends on it, and confidentiality is real. The only exceptions to confidentiality are the standard legal ones (acute risk of harm to self or others, abuse of a vulnerable person, court order) which I will explain in detail in our paperwork. Otherwise, what you say in session stays in session.

  • The people who say this on the discovery call are almost always exactly the professionals I am built to work with. High-functioning, high-achievers are systematically the most likely to underestimate what they are carrying. The discovery call is the place to find out whether starting work together makes sense.

  • About fifteen minutes. We will talk about what is bringing you here, what you have already tried, and what you are hoping for. I will answer your questions about fees, insurance, scheduling, and how the work goes. By the end, you will have a clear picture of whether this is the right fit and what your next step looks like, whether that is scheduling a first session, taking time to think, or being referred to a different clinician who might better help you achieve your goals.