Yes- I currently see couples on Fridays 9am-5pm EST and Saturday mornings. But if those days don’t work for you, please feel free to email me because I can still likely accommodate you.

Most couples come to me with at least some (if not all) differing opinions about how to handle boundaries with their addicted adult child. This doesn’t mean your family is doomed: It often means you both can offer helpful solutions during different parts of your child’s recovery journey. My job is to help you practice healthy relationship skills that you can use in all your relationships. I believe in the phrase, “the way you do one thing is the way you do everything”.

Couples family systems therapy with me will most likely reduce if not eliminate the guilt. I’m serious.

Guilt is oftentimes a placeholder for the incredibly painful fear that there were (and still are) many things we could be doing to prevent our adult child from getting sicker. The reality is that no one is perfect and humans are biologically primed for codependency due to the way our physical bodies cope with trauma.

Guilt will dissipate as you will learn about factors that support your child’s continued addiction and take concrete steps to influence the things you have control over.

What will remain after treatment is a clear-eyed assessment. You may still feel sadness at times, but you will also feel a sense of optimism that hasn’t existed in years, and especially if (very likely) you notice your adult child starting to make some healthier choices.

The trauma-driven reactions- fear of setting boundaries, constant worry about their recovery (are they going to meetings? Are they taking their medications?), and looping thoughts about where your parenting went wrong- will begin to quiet as I guide you to step outside of those cycles.

What will remain is a grounded sense of hope, along with clarity about your role in your child’s recovery- one that supports both their well-being and your own. We’ll also repair the strain their addiction has placed on your marriage and help you move toward a deeper, more connected partnership than you even had before the addiction.

After years or decades of chronic stress, it is completely understandable that you feel “at the end of your rope”. Couples family systems therapy will help you finally let go of the difficult emotions that are keep you “stuck in a holding pattern” with your ex, partner, and/or adult child. Once those emotions are no longer controlling you, you can respond rather than react. Even if relationships end or you take more space, you’ll no longer be at risk of second guessing yourself.

Codependency therapy can keep you in a holding pattern or not go far enough to create lasting change. It often focuses heavily on unmet childhood needs and how they’re repeating in your current relationships.

Couples family systems therapy takes a broader, more effective approach. We examine your families’ generational patterns, which helps depersonalize what’s happening now- reducing blame, stress, and anxiety. From there, we create a clear, actionable path forward and actively work with both partners to shift patterns at the relationship level, where real change happens. I believe family groups offer valuable support and a sense of not being alone, and I encourage clients to attend those in conjunction with therapy if it feels helpful.

Clients have consistently told me that doing therapy with me allows them to bring deeper insight into family groups- so they’re not just using them to cope, but actually working on changing their long-standing patterns in a meaningful and lasting way.

12-step groups can provide important community and structure as well.

A final tip about groups: some clients find themselves stuck in cycles of over-identifying with others’ experiences, absorbing conflicting advice, or unintentionally avoiding making necessary changes in their relationships.

In our work together, the focus is on helping you step out of those cycles- so you can stay connected to your loved one while holding clear, grounded boundaries. We also clarify how to use outside resources in a way that supports your growth, rather than overwhelms or derails it.

I’m really glad you’re interested in working together!

Unfortunately, I’m unable to offer free consultation calls due scheduling constraints. To make things easier, I’ve put together detailed information on my website that walks you through what it’s like to work with me and answer most questions immediately.

That said, I know every situation is unique. If you’re unsure that I am the best fit, or you have a question that isn’t addressed on the site, please feel free to email me.

You may also decide to complete an Initial Appointment with me and then make a decision about whether you’d like to work together.

Most clients say therapy with me is much more useful, supportive, and impactful than past therapies.

Unfortunately, no. Therapy sessions are exclusively virtual through a secure, HIPAA-compliant platform.

I work with clients located anywhere throughout Pennsylvania, New Jersey, and New York.

If you are located outside of the United States, there is a chance I can still work with you. Please contact me to discuss your situation.

My rate is $500/ 50 minute session. I meet with couples at a minimum of one 50 minute session per week. We can also meet more frequently if you wish.

Upon request, I can design a short-term “Intensive” exclusively for you. Intensives are prorated. Intensives are short-term therapy and extended sessions, for a pre-defined period of time, and focus on a specific therapeutic goal (e.g., 3 hours per week for 3 weeks to get on the same page with your partner about how you will handle boundaries and your child’s most recent relapse). These can be beneficial if you have a short timeline or scheduling challenges.

I do not accept insurance and am considered an “out-of-network” (OON) provider with insurance companies. However, many insurance plans offer “OON benefits” to help offset the cost of patients seeking an OON provider.   If you have OON benefits covered by your insurance plan,  I am happy to provide you with a receipt you can submit the insurance company for possible reimbursement. Please note that I do not interface with insurance companies nor am I under contract to follow their guidelines. They decide what they will reimburse.

Please use my self-scheduling link here. You can also email me before you schedule if you have any questions.

The Initial Appointment is 70 minutes and subsequent appointments are 50 minutes.

Based on my past experiences with couples, most clients experience significant reduction in stress and an increase in hopefulness after the first session. It typically takes 3-6 months to thoroughly learn the ability to hold boundaries, overcome guilt, and be confident that the changes you’re making are creating an environment where it is as likely as possible that your adult child can recover (as much as is in your control).

Yes, though out-of-network reimbursement differs considerably across plans. My 70-minute intake and 50-minute sessions may fall outside of standard insurance time increments, so reimbursement can be uncertain.

A monthly Superbill can be provided upon request for insurance submission.

I use a HIPAA-compliant app called Ivy Pay. Within 24 hours of booking your Initial Session, you will receive a text to your phone from Ivy Pay to “add a card on file”. Your card will always be charged on a weekly basis after each appointment for the following week’s session.

I see couples on Friday from 8am-5:30pm and Saturday 8am-12pm Eastern Standard Time.

If you need a time outside of my schedule please feel free to reach out via my contact form.

After you request a session via my contact form, or book a session via my calendar, I will send you your electronic intake forms within 24 hours. I will also send you your confidential session link and text you a HIPAA-compliant link for payment.

If you don’t receive the information, please email me at ayla@aylaflemingllc.com.

Yes! If you are uncoupled, divorced, single, or prefer to do therapy alone, I am happy to still work with you.

Yes! I use to specialize in generally helping clients set boundaries with family. I still enjoy helping the following populations learn to set boundaries with family: first/second generation immigrant families, multicultural families, adult children of alcoholics (ACoA), people with an addicted spouse, addicted sibling, “love addicts”, trauma bonded families, or “black sheep” or other rigid family roled individuals seeking to break limiting generational patterns. Although the nuances of each specific type of experience are different, the boundaries work will have some similarities.