Therapy for Miami, from wherever you actually are.
See a Florida-licensed therapist by secure video, anywhere in Miami-Dade. You get matched to the right approach for your situation, not just the first open slot, and without a waiting room.
- Florida-licensed therapyReal, named clinicians who see you by secure video, so specialty and schedule can actually line up.
- Matched to the right approachCBT, EMDR, or DBT chosen for your situation, not assigned at random.
- Video from anywhere in FloridaSessions run on a secure, HIPAA-compliant platform. You just need a private space and to be in Florida.
Free · Confidential
Request a callback
A therapist coordinator calls you within one business day. No cost, no obligation.
Got it. We will be in touch.
A therapist coordinator will reach out within one business day. If you would rather not wait, call (813) 670-3005.
The obstacle is rarely the therapist. It is getting to one.
In a metro where a cross-town appointment costs three hours door to door, the reason people stop looking is logistics, not motivation. Remove that obstacle and the question becomes a much better one: who is actually the right clinician for this?
Request a callbackThere is no Ascend office in Miami-Dade. Everything on this page happens over secure video, and saying so first seems fairer than burying it.
Ascend sees Miami-area adults by secure Florida telehealth. A Florida-licensed therapist and supervised graduate interns cover CBT, DBT skills, EMDR preparation, IFS, and ERP for anxiety, depression, trauma, PTSD, OCD, ADHD-related difficulties, grief, and relationship patterns. There is no Miami office; every session is by video, and most new clients start within a week. Call (813) 670-3005 or request an appointment online.
Start with what this is not. Ascend has no building in Miami-Dade, none in Broward, none anywhere in South Florida. The in-person offices are in the Tampa Bay and Central Florida area. If sitting in a room with someone is what you want, this page is not the right answer for you, and you should know that in the first thirty seconds rather than after a booking.
What remote care does buy you in a metro this size is real. It takes the getting-there problem out of the equation, which is what actually stops most people here — not stigma, not cost, but the arithmetic of a 4 PM appointment on the other side of the county. It also widens the pool: instead of choosing among clinicians who happen to have an office near your zip code and happen to be accepting clients, you are matched on specialty.
And the pairing matters more than most people expect. Fit between client and clinician is one of the most consistently identified predictors of whether therapy helps, which is why we match deliberately at intake, tell you who you are getting and why, and let you move to someone else on the team after a session or two without repeating your history to a stranger.
Illustrative
The therapists you can see by video
Ascend's talk-therapy service is delivered by a Florida-licensed therapist and supervised graduate interns, each with a distinct specialty, so the team covers a wider range of presentations than a single-therapist practice can, and all of it is available to Miami-area clients by secure video.
- Licensed Mental Health Counselor
- Clinical supervisor
- EMDR-trained care
- Secure video sessions
Kaylee Mills Brenneman, Ed.S, MEd, LMHC is a Licensed Mental Health Counselor and Clinical Supervisor with graduate training at the specialist level (Ed.S). She carries her own caseload of adult telehealth clients and supervises the intern team. Her focus areas are anxiety, depression, life transitions, and clinical supervision, and she is the reviewer of record for this page.
Skyler Anderson, RMHCI is a Registered Mental Health Counselor Intern whose focus is trauma, PTSD, and anxiety. She practices under Kaylee's direct clinical supervision. Ashley Huston is a Graduate Student Intern completing her clinical training under Kaylee's supervision; she offers EMDR therapy for trauma as part of a mind-body integrative approach.
Because Skyler and Ashley are pre-licensure clinicians working under Kaylee's direct supervision, supervised-intern sessions are offered at a lower cost while the standard of care, weekly case review, and documentation are the same as for a licensed clinician. At intake we tell you exactly who you would be working with where they are in their licensure.
When you request a callback, a coordinator confirms which clinician on the team is the right fit for your concern, specialty needs, and schedule, and then books your first secure video session. You are never assigned a random name from a queue.
Getting paired when nobody is in the same room
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A phone call before any video call
A coordinator asks what is happening, what you have already tried, what your plan covers, and which hours you could actually keep given your working pattern. Remote care widens the possible slots; it does not read your schedule for you.
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Say what you need in a clinician, out loud
Language, cultural background, faith, experience with immigration stress or first-generation family dynamics — these are clinical requirements, not preferences, and this is the moment to name them. We tell you honestly whether we have the match rather than booking you and hoping.
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You are told who and why, before booking
You get a name, their licensure stage, and the reasoning behind the pairing. You are never handed an anonymous slot or rotated between clinicians week to week the way subscription apps often do.
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Switching is free and expected
If the fit is wrong after a session or two, you move to another clinician on the team at no penalty. Fit is among the strongest predictors of whether therapy helps, so raising it early is doing the work, not quitting it.
Reading the letters after a therapist's name
Credentials are not decoration, and remote care makes them easier to gloss over because you never see a wall of certificates. Here is what each actually means.
- LMHC — a Licensed Mental Health Counselor. Graduate degree completed, roughly 1,500 to 2,000 supervised post-graduate clinical hours logged, national licensure exam passed. Practices independently.
- Ed.S — an Education Specialist degree, between a master's and a doctorate, typically a further year weighted toward assessment, supervision, or advanced practice.
- RMHCI — a Registered Mental Health Counselor Intern. Degree finished, registered with the State of Florida, accruing supervised hours toward licensure.
- Graduate student intern — completing a required practicum under direct, active supervision as part of a graduate program.
What differs is independence of practice. What does not differ is the structure of the work, the weekly case review behind it, or the documentation standard. Every Florida clinician on this team is licensed or registered in Florida, which is what makes seeing you in Miami-Dade lawful in the first place.
What Miami-area adults bring to a video session
Anxiety and depression account for most of the caseload. Beyond that: trauma and PTSD, OCD, the day-to-day fallout of adult ADHD, grief and life transitions, and relationship patterns that keep repeating. Care is affirming for LGBTQIA+ and neurodivergent clients. Everything here is delivered by secure video to clients physically located in Florida.
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AnxietyMost common
Worry that will not shut off, social dread, panic attacks, or health fears that outlive a normal test result.
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Depression
An episode that took the floor out, or a flat, joyless baseline you have stopped expecting to change.
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Trauma and PTSD
Trauma-focused CBT and stabilization work by video; reprocessing protocols are handled in person.
Read more -
OCD
ERP delivered remotely, which puts the exposure work in the rooms where the compulsions actually happen.
Read more -
Adult ADHD
The downstream cost, not the diagnosis: dropped commitments, late everything, and the shame that follows.
Read more -
Grief and transitions
Loss, divorce, a job ending, relocating, a new baby, leaving a country. Disruptions, not disorders.
Read more
If you are in immediate danger right now, a scheduled video appointment is the wrong tool. Call 988 or 911. For everything short of that, a first session obligates you to nothing.
Anxiety disorders
Anxiety is the most common reason people book a first video session. Generalized anxiety, social anxiety, panic disorder, health anxiety — the National Institute of Mental Health ranks anxiety disorders among the most prevalent conditions in U.S. adults, and CBT has the strongest research base for treating them. Remote delivery has a specific advantage worth naming for social anxiety in particular: a client who would have found sitting in a waiting room among strangers hard enough to cancel can start from a room they already feel safe in, then work outward from there. That is not a shortcut around exposure work. It is a lower barrier to beginning it.
Depression
The NIMH depression overview notes that for moderate to severe depression, psychotherapy plus medication management where clinically indicated tends to outperform either alone, and Ascend can coordinate both because Florida telehealth psychiatry runs inside the same practice. Depression work usually starts with behavioral activation: doing small specific things on a schedule before the motivation shows up. There is one honest thing to say about depression and video sessions. When the depression is severe enough that leaving the house is the problem, remote delivery is what makes treatment possible at all — and it is also why your clinician will watch attendance closely, because a client quietly dropping off the schedule is easier to miss when nobody notices an empty chair.
Trauma and PTSD
Trauma-focused CBT, stabilization and grounding work, and the preparation phases of trauma treatment all run well by video, and both the American Psychological Association's Clinical Practice Guideline for PTSD and the VA/DoD Clinical Practice Guideline for PTSD list trauma-focused CBT among strongly recommended treatments. EMDR reprocessing is the piece we handle differently: Ascend delivers it in person, at a Central Florida office, and for a Miami-area client that means either a planned trip or a local referral. We would rather tell you that in advance than start you on something we cannot finish the way it should be finished.
OCD
Exposure and Response Prevention is the first-line psychotherapy for OCD according to the International OCD Foundation, and it is the one approach on this page that remote delivery can genuinely improve. Compulsions are location-bound. They happen at your own front door, your own stove, your own sink. A clinician on a video call can be present while you stand in front of the trigger and do not perform the ritual, which is closer to the real target than describing it later from an office chair. The standard caution applies here as anywhere: ask directly about ERP-specific training, because a clinician who responds to your fear with reassurance is feeding the compulsion rather than treating it.
ADHD-related challenges
Therapy does not produce an ADHD diagnosis, and formal testing is administered in person rather than by video. What therapy addresses is the wake behind it: emotional dysregulation, relationships worn down by things you meant to do and did not, and the shame that accumulates when the explanation you were given for years was insufficient effort. Remote sessions have an unglamorous practical benefit here — a client with executive-function difficulties is measurably more likely to attend an appointment that does not require getting across the city first, and attendance is most of the battle.
Autism and neurodivergence
Affirming, non-pathologizing therapy for autistic and otherwise neurodivergent adults. Goals come from you, not from a template of what looks socially typical, so masking, eye contact, and social scripts are not treated as targets. Many autistic clients specifically prefer video: predictable environment, control over sensory input, no fluorescent waiting room, and the option to keep the camera at an angle that does not demand face-to-face eye contact for fifty minutes.
LGBTQIA+ affirming care
Ascend is an affirming practice across every service line. Your identity is not treated as the presenting problem unless you say it is, and whatever you did come in for gets the same evidence-based treatment anyone else would receive. For clients who are not out at home or at work, video sessions carry an obvious practical advantage and one obvious risk, and both are worth naming: no waiting room means nobody sees you walk in, but a shared household means privacy has to be planned rather than assumed.
Grief, relationships, and life transitions
Loss, divorce, a job ending, relocation, a new baby, retirement — grief and transition work is a large share of what walks through a virtual door. South Florida adds a category most of the country does not carry at the same volume: immigration and separation from family who are still elsewhere, including the specific grief of losing someone in another country and not being able to be there. That is real, it is not a lesser kind of loss, and it does not require a diagnosis to deserve fifty minutes a week. Individual therapy can also address a relationship pattern without the other person present, focusing on your half of a dynamic you keep re-entering; see couples therapy if you want both people in the session.
Find out who is available this week
One call tells you which clinician fits what you are dealing with, whether your plan covers video sessions, and the soonest appointment that works around your hours. Asking commits you to nothing.
Secure video only. No Miami office, no waiting room, anywhere you are in Florida.
How each approach is delivered by video
Illustrative
Most of what therapy does travels down a video link without losing anything. A few things do not, and you deserve to hear which is which before you book.
Structured talk-based work — CBT, DBT skills, IFS, ERP — was largely built around conversation and between-session practice, so it carries over to video with little friction and, in the case of exposure work, sometimes gains something. EMDR reprocessing and formal psychological testing are the two places where a screen genuinely costs you, and we will say so rather than sell around it.
CBT: translates cleanly, and screen sharing helps
Cognitive Behavioral Therapy is agenda-driven and worksheet-driven, which happens to be exactly what a video call handles well. Your clinician can share a thought record on screen and fill it in with you in real time, and you keep the file afterward instead of a photo of a page you lost. Between-session practice — the part that carries most of the change — is unaffected by delivery format entirely. If anything, clients who would have skipped an in-person appointment after a long day tend to keep video appointments, and consistency matters more to CBT outcomes than almost anything else.
DBT-informed skills: practice where you actually need them
We offer DBT-informed skills rather than a full multi-component DBT program, and we say that plainly rather than implying more. Over video the skills work has one real advantage: you are practicing distress tolerance and emotion regulation in the room where you usually lose your temper, not in a neutral office you then have to leave afterward. A clinician can walk you to your own kitchen sink for a cold-water skill. What video costs here is small but real — subtle shifts in posture and breathing are harder to read through a webcam, so your clinician will ask more direct questions about what your body is doing than they would in person.
EMDR: the honest exception
EMDR is the one approach on this page where we will tell you a screen is a genuine constraint. The preparation phases — history, stabilization, building coping resources — work fine by video. The reprocessing phases are where a clinician most needs to read pacing closely and be present if a session opens more than expected, and a dropped connection at the wrong moment is not a neutral event. For Miami-area clients who want EMDR specifically, the practical options are an in-person referral closer to you, or beginning stabilization and adjacent trauma work by video with an Ascend clinician while you arrange reprocessing in person. Ascend's in-person EMDR is delivered at the Lakeland office in Polk County, which is a long way from South Florida, and we are not going to pretend otherwise. Responses to EMDR vary in any case: some clients shift quickly, others need many more sessions, and a small number do not respond.
IFS: a format some clients prefer over video
Internal Family Systems asks you to turn attention inward and describe what you find, often with your eyes closed for stretches of the session. A number of clients report that doing this at home, without another person physically in the room, feels less exposed and lets them go further sooner. IFS has a newer evidence base than CBT or EMDR and we do not overstate it. It fits people who describe an internal argument that never resolves — a relentless, critical voice on one side and something younger and more frightened on the other.
ERP: the approach video can genuinely improve
Exposure and Response Prevention for OCD often works better remotely, and the reason is straightforward: most compulsions live at home. A clinician in an office can only ask you to describe the locked door, the stove, or the contaminated cabinet. A clinician on your phone can be with you while you stand in front of it and do not check. Exposures are planned together and ranked in advance, from mildly uneasy to genuinely hard, and nothing gets sprung on you. One warning that matters regardless of format: a clinician without specific ERP training can strengthen OCD by offering reassurance, which is itself a compulsion. Ask about ERP experience directly at intake.
Trauma-focused CBT and grounding work by video
For repeated or long-running trauma, trauma-focused CBT sits between open-ended talk therapy and EMDR reprocessing, and it carries over to video without the constraint EMDR has. Sessions alternate between the beliefs trauma leaves behind — about safety, about trust, about blame — and grounding techniques for the physical side. Doing that grounding work remotely has a practical benefit: you are building the skill in the environment where you will need it at two in the morning, not in an office. Tell your clinician at intake if your trauma shows up mainly in your body rather than as intrusive thoughts, because it changes where they start.
A note on what does not go over video at all
Formal psychological and psychoeducational testing — the kind that produces a scored report for an ADHD, autism, or learning-disability question — is administered in person at Ascend's Central Florida offices. If your goal is a diagnostic report rather than therapy, telehealth is the wrong door and we would rather tell you now than three sessions in.
What travels well, and what does not
A plain summary of the tradeoffs, so you can decide before you book rather than after. Your clinician confirms the actual plan at intake.
| Approach | Over video | What changes |
|---|---|---|
| CBT for anxiety and depression | Works as delivered in person | Worksheets are shared on screen and kept as files |
| DBT-informed skills | Works, with one adjustment | Clinician asks more directly about physical cues they cannot see |
| ERP for OCD | Often works better remotely | Exposures happen where the compulsions actually live |
| IFS | Works; some prefer it | Inward attention can feel less exposed at home |
| Trauma-focused CBT and grounding | Works | Grounding is rehearsed in the room you need it in |
| EMDR reprocessing | Preparation only; reprocessing is in person | We refer out locally or coordinate around it |
| Psychological and psychoeducational testing | Not delivered by video | Administered in person at a Central Florida office |
Space, bandwidth, and the backup plan
Remote therapy fails for boring logistical reasons far more often than clinical ones. Almost all of them are solvable in advance.
Finding fifty minutes of privacy
This is the single biggest practical obstacle for South Florida clients, and it is worth solving before session one rather than improvising at 4:58 PM. Multigenerational households are common here, apartments are close together, and plenty of people share a bedroom wall with someone whose opinion of therapy they would rather not hear. Options clients actually use: a parked car with the windows up, which is private and works fine as long as you are not driving; a scheduled block in a spare room while someone else takes the kids; an early-morning session before the household is awake; a session from an office with a door that closes. Headphones do most of the heavy lifting — they mean only your half of the conversation is audible in the room.
Two things are worth agreeing with your clinician in the first session rather than discovering later. The first is what happens if someone walks in: most clinicians will simply pause, and saying "someone is here" is enough, so you are not left choosing between abandoning a difficult topic and being overheard. The second is note-taking and recording. Your clinician keeps a clinical record, and you are entitled to ask what goes into it. Sessions are not recorded by us, and we ask that you do not record them either, because a recording of a therapy session is a document that can be subpoenaed, shared or found, and knowing one exists changes what people are willing to say.
Bandwidth, and what happens when it drops
You need a device with a camera and microphone and a connection steady enough for video. That is a lower bar than people expect; if streaming works, this works. Cellular data is usually fine. What matters more is the plan for when it fails, because at some point it will. We take a backup phone number before your first appointment. If the video drops and does not come back within a minute or two, your clinician calls that number and you finish by phone. Florida permits audio-only sessions when video is not workable and you consent, so a bad connection costs you a few minutes, not the appointment.
Where you have to physically be
Inside Florida. Not "usually," not "as a rule" — Florida law requires you to be physically located in the state at the time of the session, and your clinician confirms your location at the start of every visit. This catches people out in specific, predictable ways. A work trip to Atlanta means that week's session gets rescheduled or moved to a day you are home. A cruise out of PortMiami puts you outside state waters. Snowbirding north for the summer means your sessions pause or you find a clinician licensed where you are. Tell us your travel in advance and we will schedule around it rather than cancel on the day.
Your first appointment, step by step
Before. Intake forms arrive by email and take about fifteen minutes. A secure video link comes separately. Open it once before the day of, on the device you plan to use, so you find out about the camera permission then rather than during the appointment.
During. Fifty minutes for individual work. Your clinician asks what brought you in, what you have already tried, and how the days actually go. You are evaluating them as much as they are assessing you, and that is not a courtesy — fit is one of the strongest predictors of whether any of this helps.
After. You book the next one before you close the window. Weekly to start is standard. If a specific protocol looks right, the clinician walks you through what it involves before it begins.
Asking for a clinician who fits, in a city like this one
Miami-Dade is one of the most linguistically and culturally varied places in the country, and "a therapist who gets it" is a legitimate clinical requirement rather than a preference. Say what you need at intake and we will tell you honestly whether we have it. If your first language is Spanish or Haitian Creole and you would rather not do the work of translating your own emotions in real time, say so — and if we cannot match it, we will tell you that instead of booking you anyway. Same for immigration-related stress, first-generation family dynamics, and faith background. A clinician who has to have culture explained to them before you can get to the problem is spending your sessions on the wrong thing.
Scheduling around shift work and long days
The reason many people in Miami-Dade and Broward never start therapy is not cost or stigma. It is that a 4 PM appointment across town costs three hours door to door, and shift work, hospitality hours, and healthcare rotations do not bend around a standard clinic day. Video removes the getting-there problem entirely, which changes which appointment slots are realistic for you. It also means a move from Kendall to Aventura, or a new job in Fort Lauderdale, does not force you to start over with a new clinician.
What we do when video is not the right answer
Some situations need more than an outpatient video appointment can provide: active psychosis, an eating disorder needing medical monitoring, a substance use disorder needing detox or structured programming, or a level of acute risk that belongs in an emergency department rather than on a call. If any of that is what is actually going on, we will say so and point you toward the right level of care rather than take you on and hope. If you are in immediate danger right now, call 988 or 911.
Things people believe about remote therapy that are not true
- "It is therapy-lite." It is the same clinicians, the same protocols, the same documentation and case review. The delivery changed, not the standard.
- "You cannot build a real relationship through a screen." Plenty of clients report the opposite — that being in their own space made it easier to say the hard thing sooner.
- "You can just text your therapist whenever." Not how this works. Sessions are scheduled appointments with a licensed clinician, not an always-on chat subscription.
- "Needing medication means therapy failed." Needing both is ordinary, which is why Florida telehealth psychiatry sits inside the same practice.
When both therapy and medication are on the table
Talk therapy and psychiatry are separate services with separate scopes, and each clinician makes independent decisions. What sitting inside one organization changes is the handoff: a telehealth therapy client whose depression looks like it would benefit from a medication evaluation can be referred internally rather than starting a fresh intake somewhere else, and the two clinicians can actually coordinate.
For the small subset of clients with treatment-resistant depression who have not responded adequately to therapy and standard medication management, Ascend also offers ketamine therapy at its in-person locations. Ketamine is a Schedule III controlled substance. The ketamine used at Ascend is a compounded preparation that is not FDA-approved; no compounded medication is FDA-approved for any use. It is given under the supervision of a licensed prescriber for treatment-resistant depression and select indications; it is not a first-line option, individual responses vary, and no particular result is promised. Those locations are in the Tampa Bay and Central Florida area, so for a South Florida client this means a planned trip, not a local appointment.
Confidentiality on your side of the call
Sessions run on a HIPAA-compliant video platform, not a consumer video-call app. The part we cannot control is your end, so: close the door, use headphones, and do not take the session on shared or public wifi in a place where people can hear you. Treat it exactly as you would a visit to an office.
Coverage, superbills, and what to ask your plan
Coverage depends on your specific plan, and telehealth adds a wrinkle worth checking before you book. Our licensed clinician holds several carrier panels; supervised-intern sessions are fee-for-service with itemized superbills provided. You hear the fee for whichever option applies before your first appointment.
The telehealth question most people forget to ask
Nearly every major plan now covers outpatient mental health delivered by video, but the details still vary in ways that cost people money. Two things are worth confirming for your own plan: whether telehealth sessions are reimbursed at the same rate as in-office ones, and whether your plan applies a different copay or place-of-service rule to remote visits. Ask both questions explicitly. "Do you cover therapy" is not the same question as "do you cover therapy delivered by video at the same benefit level."
What is in-network and what is not
- Kaylee Brenneman is in-network with UnitedHealthcare, Aetna, Cigna, ChampVA, and Oscar Health Plan.
- Skyler Anderson and Ashley Huston see clients fee-for-service; Ascend issues itemized superbills for out-of-network submission.
- Plans differ inside the same carrier, so call (813) 670-3005 and let a coordinator check yours before you commit to anything.
Therapy is an eligible expense under most HSA and FSA plans, which is worth knowing before you rule out a fee-for-service option.
The call to your insurer, question by question
Use the member services number on the back of your card rather than the general line, and expect it to take about ten minutes.
- "Do I have out-of-network outpatient mental health benefits?" HMO and many marketplace plans do not; PPO and POS plans usually do.
- "Is telehealth covered at the same level as an in-office visit?" Get this on the record.
- "What is my out-of-network deductible, and how much of it have I met?"
- "Once it is met, what percentage do you reimburse — and is that on the billed amount or on your allowed amount?" The second answer is the one that surprises people.
- "Are CPT codes 90791 and 90837 covered under that benefit?" Those are the initial evaluation and a sixty-minute individual session.
- "How do I submit an out-of-network claim?" Most carriers now accept an online upload.
- Take the call reference number. If you are told something that later turns out to be wrong, that number is your only leverage.
What a superbill actually gets you
A superbill is an itemized receipt showing your diagnosis code, the CPT code, the date of service, and what you paid. You submit it; your insurer decides. It is not a promise of reimbursement. Whether you get anything back depends on having an out-of-network mental health benefit in the first place, on your deductible, and on the percentage your plan pays. Some clients recover a meaningful share. Some recover nothing, because their plan has no out-of-network behavioral health benefit at all. The phone call above tells you which one you are before you spend anything.
If cost is the actual barrier
Say so at intake rather than booking one session and disappearing. Supervised-intern sessions exist precisely for this, HSA and FSA dollars apply, and if what you need genuinely sits outside what we can offer at a workable rate, we would rather point you toward a community mental health center or a sliding-scale clinic in your county than let you start something you cannot sustain. Therapy that stops after two sessions because of money does not help anyone.
Measuring whether it is working
Your clinician may use brief standardized symptom measures at intake and at intervals afterward, which gives both of you something objective sitting next to your own read on the weeks. If neither is moving after a reasonable stretch, that is the prompt for a direct conversation about changing approach, changing clinician, or referring you on — not a reason to quietly keep booking.
The other ways to get therapy in Miami
Each of these is the right answer for somebody. Here is where each one actually lands.
| Route | Who you end up with | Travel required | Continuity if you move or travel |
|---|---|---|---|
| Ascend by Florida telehealth | Named clinician, matched at intake | None, anywhere in Florida | Same clinician anywhere in-state |
| A local Miami-Dade practice | Whoever has an opening | A weekday cross-town trip | Tied to that office |
| A subscription therapy app | Algorithmically assigned, often rotating | None | Depends on clinician turnover |
| An employer EAP | Assigned from a network panel | Varies | Ends with the session allotment |
An EAP is genuinely useful for a short, defined problem and runs out exactly when longer work would begin. An app is the fastest to start and gives you the least say in who you get, with rotation that undercuts the one variable most predictive of whether therapy helps. A local practice gives you a room to sit in, at the cost of a fixed weekday appointment that a lot of people in this metro cannot reliably make.
A supervised-intern session is not a stripped-down version of therapy. Same structured approach, same weekly case review, same documentation, delivered by a clinician earlier in the licensure path under active supervision.
Illustrative
Illustrative only. This is not an Ascend location, and there is no Ascend office in South Florida. Clients take sessions from wherever they can close a door.
No office here, and what that actually means for you
Ascend has no location in Miami-Dade, Broward, or Palm Beach. Care reaches you by secure video anywhere in Florida. What you need is a private space, a device with a camera, and to be physically inside the state when the session starts.
Ascend's in-person offices sit in the Tampa Bay and Central Florida area — Wesley Chapel, Tampa, and Lakeland. None of them is a realistic weekly appointment from South Florida, and we are not going to describe them as though they were. If in-person therapy is the requirement, the right move is a local clinician, and saying that costs us a booking we would rather not take.
What we can offer is a Florida-licensed clinician who sees you every week from wherever you are, matched on specialty rather than on proximity. The license attaches to the state, not the county, which is the whole reason this works.
Three steps to a first appointment
- Request a callback or call (813) 670-3005.
- A coordinator matches you to a clinician, confirms what your plan covers for telehealth, and books the first session.
- You complete intake paperwork online and receive a secure video link. Open it once in advance on the device you plan to use.
Most new clients are on the calendar within a week.
What you need on your end
- A phone, tablet, or computer with a working camera and microphone, and a connection steady enough for video. If streaming works, this works.
- A private space where you will not be interrupted for fifty minutes. Headphones do most of the work in a shared home.
- A backup phone number on file, so a dropped connection turns into a phone call rather than a lost appointment.
- To be physically located in Florida at the start of the session. Your clinician confirms it every time, because state law requires it.
Traveling, moving, and the Florida rule
This trips people up in predictable ways, so plan for it. A work trip out of state means that week gets rescheduled. A cruise puts you outside Florida once you clear state waters. Spending the summer up north means sessions pause or you arrange care where you are. Moving within Florida changes nothing at all — Orlando, Jacksonville, Naples, Tampa, you keep the same clinician and the same slot. Tell us about travel in advance and we schedule around it rather than cancelling on the day.
Who we see
Adults across Miami-Dade — Miami, Miami Beach, Coral Gables, Hialeah, Kendall, Doral, Homestead, Aventura and the surrounding communities — plus Broward, Palm Beach, and the rest of Florida. In a metro this large the two things that most reliably stop people from starting therapy are finding a specialist who is both close by and accepting new clients, and physically getting to a weekday appointment. Video removes the second problem entirely and makes the first one much easier.
When we are the wrong service
We will tell you rather than take the appointment. Formal psychological and psychoeducational testing is administered in person at a Central Florida office. EMDR reprocessing is delivered in person. Active psychosis, an eating disorder needing medical monitoring, a substance use disorder requiring detox, and ongoing acute risk all need a higher level of care than outpatient video therapy, and for those we point you toward appropriate South Florida resources. If you are in immediate danger right now, call 988 or 911.
Ascend runs four service lines — primary care, psychiatry, ketamine therapy, and talk therapy — which is why a telehealth therapy client who would benefit from a medication evaluation can be referred internally instead of starting over somewhere else.
Related care: couples therapy, Florida telehealth psychiatry when medication support is indicated alongside therapy, and in-person therapy in Lakeland if you are ever in Central Florida.
The limits we will tell you about up front
Video therapy is real therapy for most of what people bring to it. It is not the right tool for acute crisis, it cannot deliver EMDR reprocessing or formal testing, and it depends on you having somewhere private to sit. None of that is a reason to skip it. All of it is a reason to know before you book.
The limits specific to this format come first, because they are the ones nobody else on your search results page will state. A video session cannot do a physical exam or take a blood draw. It cannot deliver EMDR reprocessing the way we think it should be delivered, so we refer that out or coordinate around it. It cannot administer formal psychological or psychoeducational testing. And it is a poor instrument in an acute crisis: if you are in immediate danger, the answer is 988 or 911, not a scheduled appointment.
Then there are the limits therapy has regardless of format. Research summarized by the National Institute of Mental Health shows psychotherapy helps most people who stay with it. That is a statement about populations, not a prediction about you. Your response depends on your condition, your history, and how much of the work happens on the days you are not in session.
One limit worth stating plainly for a metro like this one: therapy changes your relationship to a situation, not the situation. If you are working two jobs to hold a household together, or carrying immigration uncertainty for someone you love, we can help you think clearly, decide well, and not be destroyed by it. We cannot make the underlying circumstance smaller, and any clinician implying otherwise is selling something.
What is genuinely within our control: matching you to a clinician who fits, which is among the most reliable predictors of whether therapy works at all; using structured approaches for specific diagnosable problems, because structure beats open-ended for those; and telling you when this is not working instead of letting a mismatched pairing quietly run for a year.
When to change something
- Six to eight sessions of genuine engagement and no movement in the thing you actually came for.
- You dread logging on in a way that reads as avoiding the work, not as normal discomfort with a hard topic.
- The same approach shows up every week regardless of what you bring, rather than adapting to it.
- You have started managing the session — saying the version that keeps it pleasant.
- Connection problems, interruptions, or a lack of private space keep eating the hour. That is a fixable logistics problem, but only if you raise it.
Any of these is a prompt to switch clinicians on the team, switch approach, or reconsider whether remote is the right delivery for you right now. None of them means therapy has failed.
Where we are not the right answer
Outpatient telehealth is not the correct level of care for active psychosis, an eating disorder needing medical monitoring, a substance use disorder requiring detox or structured programming, or ongoing acute risk. If that is the picture, we will say so and point you toward appropriate local care in South Florida rather than take you on remotely and hope.
For more on any single condition: anxiety, depression, PTSD, OCD, adult ADHD, grief and loss, and life transitions.
What Miami-area clients ask before their first video session
Straight answers about the format, the privacy problem, insurance, and where telehealth stops being the right tool.
Does Ascend have an office anywhere in Miami-Dade?
No. There is no Miami office, no Coral Gables office, and no South Florida location of any kind. Everything described on this page is delivered by secure video to clients physically located in Florida. Ascend's in-person offices are in the Tampa Bay and Central Florida area. We would rather state that plainly than let you discover it after booking.
Do I have to be physically inside Florida during the session?
Yes, and it is not a formality. Florida law requires you to be physically located in the state at the time of a telehealth session, and your clinician confirms your location at the start of every visit. A work trip to another state, a cruise once you are outside state waters, or a summer spent up north all mean that week's session gets rescheduled or handled some other way. Tell us your travel in advance and we schedule around it.
What happens if my internet drops in the middle of a session?
We take a backup phone number before your first appointment. If the video fails and does not recover within a minute or two, your clinician calls that number and you finish the session by phone. Florida permits audio-only sessions when video is not workable and you consent, so a bad connection costs a few minutes rather than the whole appointment.
I share my home with family. Where do people actually take these sessions?
The most common answers, in rough order: a bedroom with the door shut and headphones in, a parked car with the windows up, an early-morning slot before the household is awake, or an office with a door that closes. Headphones do most of the work, because they mean only your half of the conversation is audible. This is worth solving before session one rather than improvising at 4:58 PM.
Can I take a session from my car?
Yes, parked. A lot of clients do, and for people in shared housing it is often the only genuinely private option available. What you cannot do is take the session while driving. Park somewhere you feel safe, keep the windows up, and treat it as you would any other appointment.
Is a video session billed differently from an in-office visit?
That depends on your plan, and it is the question people most often forget to ask. Most major plans now cover outpatient mental health by video, but some apply a different copay or a different place-of-service rule. Ask your insurer two separate questions: whether therapy is covered, and whether telehealth is reimbursed at the same benefit level as an in-office visit.
Can I request a clinician who speaks Spanish or shares my cultural background?
Ask at intake and we will tell you honestly what we have rather than book you and hope. Miami-Dade is one of the most linguistically varied places in the country, and needing a clinician you do not have to translate yourself for is a clinical requirement, not a preference. If we cannot match what you need, we will say so directly instead of taking the appointment.
What if I move out of the Miami area partway through therapy?
Nothing changes as long as you stay in Florida. A move to Orlando, Jacksonville, Tampa, or anywhere else in the state means you keep the same clinician and the same appointment slot, because the license attaches to the state rather than to a neighborhood. That continuity is one of the concrete advantages of remote care over a practice tied to one building.
Can I get EMDR through telehealth?
The preparation and stabilization phases work well over video. The reprocessing phases are the part we deliver in person, at a Central Florida office, which for a South Florida client means either a planned trip or a local referral closer to you. We will tell you this before you start rather than midway through, and in the meantime an Ascend clinician can do trauma-focused CBT and grounding work with you remotely.
Do you provide ADHD or psychological testing remotely?
No. Formal psychological and psychoeducational testing, the kind that produces a scored diagnostic report, is administered in person at Ascend's Central Florida offices. If a diagnostic report is what you actually need, telehealth therapy is the wrong door and we would rather say so now than three sessions in. Therapy for the effects of ADHD, as distinct from diagnosing it, is available by video.
How quickly can I start?
Most new clients are scheduled within one week. Call (813) 670-3005 or request a callback, and a coordinator will match you to a clinician and book the first session rather than adding you to a waitlist.
Who will I be matched with, and do I get a say?
You do. A coordinator asks what you are dealing with, what you have already tried, your budget, and your scheduling constraints, then matches you to the clinician on the team whose specialty and approach actually fit. You are never assigned a random name out of a queue. If the fit turns out to be wrong after a session or two, you can move to a different clinician at no penalty.
What equipment do I need?
A phone, tablet, or computer with a working camera and microphone, and a connection steady enough for video. If streaming works where you are, this will work. Cellular data is usually fine. Open the secure link once before the day of your appointment so you sort out camera permissions then rather than during the session.
Is the video platform actually secure, or is it just a video call?
Sessions run on a HIPAA-compliant platform, not a consumer video-call app, with encryption on the call. The part outside our control is your end of it, which is why we ask you to use a private space and headphones and to avoid taking sessions on shared or public wifi in a place where you can be overheard.
Do you see clients in Broward and Palm Beach as well?
Yes. Ascend is licensed statewide, so we see adults across Miami-Dade, Broward, Palm Beach, and the rest of Florida. The clinician does not change based on which county you are sitting in.
How long is a session and how often would I have them?
Individual sessions run about fifty minutes. Weekly is the standard starting cadence because early momentum matters, and many clients step down to every other week once things are moving. That decision gets made with your clinician rather than set by a subscription tier.
I am not out to my family. Does video therapy make that easier or harder?
Both, and it is worth planning for. Easier because there is no waiting room and nobody sees you walk into a building. Harder because privacy at home has to be arranged rather than assumed. Headphones, a door, and a time when the house is empty solve most of it, and a parked car solves the rest. Ascend is an affirming practice, and your identity is not treated as the presenting problem unless you say it is.
Can I get a prescription through this?
Not through talk therapy, which does not prescribe. Ascend does run a separate Florida telehealth psychiatry service, so a therapy client whose presentation looks like it would benefit from a medication evaluation can be referred internally rather than starting over at an unrelated practice. Each clinician makes independent decisions; what improves is the handoff.
What if I need a higher level of care than a video appointment can provide?
We say so and point you toward appropriate local care in South Florida. Outpatient telehealth is not the right level for active psychosis, an eating disorder needing medical monitoring, a substance use disorder requiring detox or structured programming, or ongoing acute risk. If you are in immediate danger right now, call 988 or 911 rather than waiting for an appointment.
Is therapy by video genuinely as effective as sitting in a room?
For most anxiety, depression, and adjustment-related work, the American Psychological Association's telepsychology guidance supports video delivery as a legitimate format with comparable outcomes. The honest exceptions are EMDR reprocessing and formal testing, both of which we handle in person. For exposure work in OCD, remote delivery can be an advantage, because the compulsions live in your home rather than in an office.
Can I use this through my employer's assistance program?
Employer assistance programs typically assign you a clinician from their own network for a fixed number of sessions, so it depends entirely on whether Ascend is in that network. Ask your program directly. Worth knowing in advance: those programs are useful for a short, defined problem and tend to run out at exactly the point longer work would start.
I have never done therapy and do not know how to begin. Is that a problem?
No, it is the ordinary way this starts. The clinician asks the questions in the first session, and you do not need a prepared account of your own psychology. Saying you are not sure why you are here but something has been wrong for a while is a perfectly workable opening.
What if I log on and cannot get any words out that day?
That happens, in person and on video, and it does not waste the session. A clinician can work with a difficult day directly, and a bad week is often more informative than a polished summary. You are not expected to perform being ready.
Which Florida communities do you serve by telehealth?
Adults anywhere in Florida, including Miami, Miami Beach, Coral Gables, Hialeah, Kendall, Doral, Homestead, Aventura, and the wider Miami-Dade area, plus Broward, Palm Beach, and the rest of the state. Telehealth removes the two things that most often stop people from starting in a large metro: finding a specialist who is both nearby and accepting new clients, and physically getting across town to a weekday appointment.
Still have a question? Talk it through with our team.
813 670-3005Sources
- American Psychological Association, Clinical Practice Guideline for PTSD: Cognitive Behavioral Therapy
- American Psychological Association, Guidelines for the Practice of Telepsychology
- U.S. Department of Veterans Affairs / Department of Defense, Clinical Practice Guideline for PTSD
- World Health Organization, mhGAP Intervention Guide
- International OCD Foundation, Exposure and Response Prevention (ERP)
- National Institute of Mental Health, Anxiety Disorders
- National Institute of Mental Health, Depression
- National Institute of Mental Health, Mental Illness Statistics
Reviewed by Kaylee Mills Brenneman, LMHC on 2026-07-05.
This page is educational and does not replace an individualized clinical evaluation. Ketamine is a Schedule III controlled substance. The ketamine used at Ascend is a compounded preparation that is not FDA-approved; no compounded medication is FDA-approved for any use. It is given under the supervision of a licensed prescriber for treatment-resistant depression and select indications; individual responses vary and no particular outcome is promised.
One call, then a time that fits your week
Tell us what has been going on and we will name the clinician who fits, confirm what your plan covers for video visits, and book a time that survives your actual week. Most people start within seven days.
In crisis right now? Call or text 988 anytime. Therapy is not an emergency service.