Online therapy with one therapist follows three steps: a free 15-minute phone consultation, a first video session of about an hour, and regular 45- to 60-minute video sessions after that. At Change.Life, Mariann Arcari Rubin, LCSW, handles every step herself, so the person you speak with on the first call is the person you see in every session.
If this is your first time doing therapy over video, the process can feel convoluted and impersonal, like talking to a black box and waiting for someone you’ve never met to call you back. At Change.Life, we want you to feel comfortable the whole way through, from that first phone call to the months that follow.
What happens during the free 15-minute consultation?
The free 15-minute consultation at Change.Life is a phone call with Mariann Arcari Rubin, LCSW, the same therapist you will see in your sessions. You share a little about what’s bringing you in, ask about insurance and scheduling, and both of you get a sense of whether working together makes sense. There is no cost and no obligation to book.
Each phone call and each consultation is fully personalized, so there’s no intake coordinator or matching system assigning a therapist to you. It’s not always easy to pick up the phone and talk about grief, infertility, or the way you’ve been feeling at work, and we don’t want to make that process any harder.
The call is short and informal. You don’t need to have your entire situation figured out. All you need to do is provide a few sentences about what’s going on in your life. Mariann will then ask follow up questions to get a better sense of your current situation. Finally, you’ll get a chance to clear up any doubts that you have yourself. Some of the questions people find useful to ask include:
- Do you take my insurance, and what will my copay look like?
- What days and times do you usually have open?
- Have you worked with people dealing with something like this before?
- How long are sessions, and how often do people usually meet?
Mariann has over 30 years of experience as a licensed social worker, most of which comes from running her own practice, offering online therapy to Arizona clients before it was common. Since 2020, Change.Life has offered fully online therapy.
On your first call, we’ll honestly discuss whether this is the best choice for you and pick a time for your first full session if it is.
If you decide to move forward with your therapeutic process with us, we’ll also let you know what paperwork you need to fill in before your first appointment.
What happens in the first hour-long video session?
The first video session at Change.Life runs about 60 minutes, which is a bit longer than subsequent sessions because it includes intake paperwork and copay setup. Most of that hour is conversation. You talk about what brought you in, Mariann listens and asks questions, and at the end you decide together whether to schedule the next session.
You might wonder what you’ll need for your first online therapy session at home. You don’t need anything too fancy. As long as you have a nice, quiet space in your house with reliable connection and a device like a laptop, tablet, or phone with a camera, you’re all set.
If you share a living space with other people, it’s also important that you pick a private spot where you can feel comfortable taking your first appointment. A parked car, a bedroom with the door closed, or an empty office at lunch can all work.
The session will begin with Mariann mostly just listening to what’s going on in your life in your own words, and without interruptions. Once you’ve shared all that you need to, Mariann might ask clarifying questions to further understand your situation. The whole process should feel like a comfortable space for you to share your feelings.
“People are often surprised at how easy it is to connect with me,” Mariann shared, “even though we’re not in the same room, or face to face. They’re also surprised at how easy the platform is to use. But I think the connection is what surprises them the most.”
As part of the effort to ensure that you’re comfortable, you’ll also be asked to share your honest feedback about how you felt throughout the session and whether you’d like to book another.
Finally, we’ll end with some housekeeping. This includes any intake forms and setting up your copay through a secure card payment app. Building that into the first hour means it never cuts into your time to talk.
What do regular online therapy sessions feel like after the first one?
Regular sessions at Change.Life run about 45 minutes by video, usually at a consistent day and time. Each session uses the same link and the same therapist, and clients pick up where they left off the week before.
On Ongoing sessions, we might discuss your problems further, explore whatever is on your mind, or discuss something that happened during your week. That’s fully up to you.
Our practice’s focus is on talk therapy, but we draw on methods from cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) if they fit the needs of your treatment. We always prioritize natural, comfortable conversation, drawing on other methods only when they’re useful.
Many of our clients are women in their 30s and 40s, though we see adults of all ages and genders. They often come in for one reason, like grief after a loss, the end of fertility treatment, or a hard medical diagnosis, and find that something underneath keeps showing up too. Often, underlying issues like low self-esteem might come to the surface, and we work to ensure that we’re addressing the root cause of your problems.
Usually, sessions happen once a week, but we can adapt to emergencies or new circumstances. If you need to reschedule, you can contact Mariann directly.
Why does it matter that one therapist handles everything?
Working with the same therapist from the start means that you only have to tell your story once, and that that person understands your needs and worries as there are new developments in your life. At Change.Life, Mariann Arcari Rubin, LCSW, does the consultation, the intake, and every ongoing session, so there are no handoffs between staff and no chance of being reassigned.
That continuity is part of our core philosophy. Some therapy services route your first contact through intake staff or an automated matching process, and you may not know who your therapist is until the first session. That works for some people. Others find it hard to open up when they’re not sure who’s on the other end, or when the first conversation was with someone they’ll never talk to again.
With a solo practice, the relationship starts on the phone. By the time you log on for your first full session, you’ve already heard my voice, asked your questions, and decided you’re comfortable. You don’t have to start over with a stranger. And if a session time needs to move or your insurance changes, you bring it to one person.
Ready to learn more about how sessions work? Visit the Individual Counseling page for details on session length, what Mariann works with, and how to get started.
How common is online therapy now?
Online therapy is now a common way for adults in the U.S. to receive outpatient mental health care. A 2025 study in JAMA Psychiatry found that 27.8% of adult mental health outpatients received all of their care through telehealth, and another 21.5% used a mix of telehealth and in-person visits.
Counseling itself is common, too, especially for women. According to the National Center for Health Statistics’ 2026 data brief on mental health treatment, 14.0% of U.S. adults received counseling or therapy from a mental health professional in 2024. Among women, that figure was 16.9%, and among adults ages 30 to 44, it was 18.7%.
If doing therapy from home appeals to you, you’re in good company.
Which insurance plans and locations does Change.Life cover?
Change.Life serves adults in New York and Arizona entirely by secure video. Mariann Arcari Rubin, LCSW, is in network with Aetna, Blue Cross Blue Shield, Cigna, Medicare, UnitedHealthcare (including Oxford and GHI/Emblem), Carillon, and various employee assistance programs (EAPs). Change.Life does not accept Medicaid.
Mariann is licensed in both New York and Arizona, which means we accept clients who live anywhere in either state. You can confirm a therapist’s license yourself through the New York State Office of the Professions license verification search or the Arizona Board of Behavioral Health Examiners online directory. We encourage you to do that with any therapist you’re considering.
If you have Medicare, it’s worth knowing how the program treats video sessions. Medicare.gov’s telehealth coverage page lists psychotherapy among covered telehealth services and states that Medicare covers telehealth “from anywhere in the U.S., including your home.”
A word about medicaid: Change.Life is not in network with Medicaid plans. If you have Medicaid, your plan’s member services line can point you toward in-network therapists.
When is online therapy with Change.Life not the right fit?
Online therapy with Change.Life is set up for adults in New York or Arizona who want regular, scheduled individual sessions by video. It isn’t the right fit for people who live outside those two states, are under 18, have Medicaid as their only coverage, or are looking for couples or family therapy.
A different setup might also serve you better if you can’t find any private space to talk for 45 minutes, or if you strongly prefer sitting in the same room as your therapist. That preference is worth honoring.
None of these factors carry any judgment calls. Solo, video-only practice can offer a lot of value for some, but it’s not a one-size-fits-all. If you’re having doubts, the consultation call is a good moment to sort them out.
This article is educational and describes how one practice works. It doesn’t replace a conversation with a licensed provider about your own situation.
Frequently asked questions
No special software is needed for an online therapy session with Change.Life. Before your first appointment, you’ll receive a secure video link that opens on a laptop, tablet, or smartphone with a camera. A quiet, private spot and a reliable internet connection are the only other things you need to join.
The first online therapy session with Change.Life lasts about 60 minutes, which leaves time for intake paperwork and copay setup. After that, regular sessions run about 45 minutes. The free consultation call that comes before either one is 15 minutes long and takes place by phone.
Yes. Change.Life is a solo practice, so every client works with Mariann Arcari Rubin, LCSW, from the first phone call on. She handles the free consultation, the intake session, and every ongoing session herself. There are no other therapists on staff and no reassignments, so your history stays with one person.
Yes. Texts to Change.Life go to Mariann’s mobile number, 480-586-8737, and she reads them herself. The practice’s main phone line is 516-544-9322. Messages sent through the contact form on the Change.Life website also go directly to Mariann, so every question reaches the same person.
How do you get started with online therapy at Change.Life?
The first step is the free 15-minute consultation. You can call Mariann directly at 516-544-9322, text 480-586-8737, or book your consultation online. Mariann reads every message herself and gets back to people quickly. To see whether you’re in her service area, visit the Telehealth Locations page for details on New York and Arizona.