Confidential Therapy for Pilots and Aviation Professionals
The FAA now says therapy is compatible with your certificate
In May 2026 the FAA published guidance stating that counseling is encouraged when medically appropriate, and that psychotherapy is compatible with an unrestricted medical certificate. CEREVITY matches pilots with licensed clinicians who understand the aeromedical system and will tell you the truth about it. 100% virtual. Private-pay.
The question every pilot asks first
Will talking to someone cost me my medical certificate?
Aviation runs on hangar rumor about this, and the rumor is now out of date. Here is what the FAA actually published on May 27, 2026, including the part that is inconvenient.
The FAA says therapy is compatible with flying
On May 27, 2026 the FAA added three documents to the Guide for Aviation Medical Examiners, one of them written for the psychotherapists who treat you. Its language is plain: counseling or therapy is encouraged when medically appropriate, and psychotherapy is compatible with both an unrestricted medical certificate and a special issuance. The FAA also states that speaking with a therapist does not automatically create a diagnosis.
Nothing is reported by us. The disclosure is yours, at your next medical
CEREVITY files nothing with the FAA. No claim, no diagnosis code, no carrier record exists, because private-pay creates none. What the FAA does require is that you list visits to licensed healthcare providers on your own MedXPress application, and its May 2026 FAQ is explicit that the timing is yours: you are not obliged to report until your next application for a medical certificate. Listing therapy is not the same as being deferred, and where there is no diagnosis an examiner may record the history as not significant and issue.
Your records almost never travel, and ours are built for it
The FAA's own answer to whether it will see your therapy records is: usually not, and if documentation is requested it is usually a brief summary from the therapist. The agency also published guidance for the psychotherapists who treat pilots: keep process notes separate from progress notes, use precise DSM-5-TR language, and neither inflate nor minimize. It closes by telling therapists unwilling to meet those requirements to think hard before taking a pilot as a client. Most therapists have never read that document. Ours work to it.
What actually walks into session with a pilot
Not generic stress. Six patterns our clinicians treat every week in aviation professionals.
01The silence that is trained in
You learned early that the safe answer to every medical question is no. That habit does not stay confined to the exam room, and it is the thing the new guidance is trying to undo.
02A life measured in cycles
Body clock permanently displaced, sleep debt as a professional condition, and a physiology that never fully lands.
03The marriage conducted by text
Home four days out of fourteen, an entire domestic life happening without you, and the strange status of a guest in your own house.
04Grief and incident carryover
The event you flew through, the loss you took a leave for, the diversion that still runs on a loop. And a job where you are expected to be the calm one.
05Retirement as a cliff
A mandatory end date and an identity built entirely on the left seat, approaching at a known speed.
06Alcohol at the edge of the rules
The layover culture, the bottle-to-throttle math, and the private knowledge of exactly how close you have run it.
What the work actually looks like
Procedural, briefed, and honest about the system you are operating inside.
The first month
The opening sessions establish what is actually happening: sleep, mood, drinking, the incident or loss that is still active, and how much of it is the schedule rather than something clinical underneath the schedule. Validated instruments give a baseline. Pilots tend to under-report by reflex, and a clinician who knows this population expects that and works with it rather than against it.
By session three or four you have a formulation, a plan, and a clear-eyed picture of where, if anywhere, the aeromedical system intersects with it. Very often the answer is that a course of therapy with no diagnosis and no medication is exactly the situation the FAA's 2026 guidance was written to make survivable, and the relief of knowing that specifically is itself part of the treatment.
A clinician who has actually read the FAA's guidance
The FAA's May 2026 release included a document addressed to the psychotherapists who treat pilots and controllers, and it tells you to hand it to your therapist at the first visit. It asks specific things of them: keep psychotherapy process notes separate from clinical progress notes so that a request for records does not sweep up the raw material of your sessions, write in precise DSM-5-TR terms, and avoid both upcoding and minimization. It ends by telling therapists who cannot work that way to think carefully before accepting a pilot at all.
That is not an academic point. A therapist who does not understand aviation can end a career that did not need to end: an offhand diagnosis written into a note, a medication started without regard for certification, or a well-meaning assurance that none of this needs disclosing. What you want is a clinician who treats the person and understands the file, and who was already working this way before the FAA wrote it down.
What tends to change
Early: sleep quality, the intrusive replay of an event, the fuse at home in the seventy-two hours you actually get there. The drinking that had quietly become structural starts to look like what it is.
Later the work reaches identity: the fact that the certificate has become the person, so that any threat to it feels like a threat to your existence, and retirement reads as death rather than as a change. That fusion is treatable, and it is far easier to treat before the date arrives than after.
Therapy, not coaching: the distinction matters here
Much of what pilots find when they search for help is executive coaching. It has value for skill-building, but it cannot diagnose, treat, or legally protect what you disclose.
| CEREVITY, Licensed Therapy | Executive Coaching | |
|---|---|---|
| Who provides it | Licensed psychologists & clinicians (PhD, PsyD, LCSW, LMFT) | Unregulated; anyone may use the title |
| Can treat anxiety, depression, burnout | Yes: evidence-based clinical treatment | No; outside its scope, and often unrecognized |
| Confidentiality | Legally protected; HIPAA-governed clinical record you control | Contractual at best; no legal privilege |
| Insurance paper trail | None. Private-pay by design | N/A |
| Right for | Anxiety, depression, grief, sleep disruption, alcohol use, when something is genuinely wrong and pushing through the next rotation has stopped working | Skill-building and performance goals when nothing is clinically wrong |
Concierge by design: you never browse a directory
You tell us the seat you sit in. We match you to the clinician who already knows it.
- Confidential intakeA dedicated coordinator, not a call center, handles everything from the first message on.
- Matched to a specialistWe pair you with a clinician who treats pilots and aviation professionals as core caseload, not the closest available calendar slot.
- In session within ~48 hoursEarly mornings, late evenings, weekends. Sessions fit your calendar, not the reverse.
- Measured progressValidated instruments at intake and ongoing, so you can see whether it is working.
Where we practice
Nationwide
Coverage across the United States: our psychologists hold PsyPact authority spanning the participating states, and individually licensed clinicians cover the rest, including states outside the compact. You tell us where you are; matching handles the licensure.
No office. On purpose. No commute, no waiting room, no chance encounter with someone from your board, your OR, or your firm.
The avoidance is documented, and the FAA is trying to fix it
of surveyed U.S. pilots reported a history of healthcare avoidance behavior because they feared losing their aeromedical certificate.
Source: Hoffman et al., Journal of Occupational and Environmental Medicine (2022)of airline pilots responding to a validated depression screen met the threshold for clinical depression, and 4.1% reported suicidal thoughts within the prior two weeks.
Source: Wu et al., Environmental Health, Harvard T.H. Chan (2016)is the FAA's stated initial deferral rate for mental health diagnoses, while only about 0.1% to 0.2% of cases end in a final denial.
Source: Federal Aviation Administration, Fact Checking Medical Myths in AviationTreated by clinicians, reviewed by clinicians
Every CEREVITY clinician is independently licensed and works with pilots as core caseload, not a curiosity. This page is clinically reviewed by Martha Fernandez, LCSW, Co-Founder and Licensed Clinical Social Worker.
- PhD & PsyD psychologists with PsyPact mobility authority
- LCSW / LMFT / LPCC clinicians, multi-state licensed
- Evidence-based care: CBT, ACT, psychodynamic & somatic approaches
- HIPAA-secure telehealth; records stay between you and your clinician
One seat, one story
I flew for eleven years telling nobody anything. Not my AME, not my wife, not the guy in the right seat. After my father died I was not sleeping and I was drinking on every layover, and I still would not call anyone, because I had convinced myself that one phone call ends the career. What finally moved me was getting a straight answer about what was actually true instead of what the crew room says is true.
Airline captain, narrow-body fleet, 15 months with CEREVITY
Shared with permission by a former client; identifying details altered to protect confidentiality. Individual experiences vary.
You run a checklist before every flight. You have never once run one on yourself.
Get Matched NowQuestions pilots ask before starting
Does CEREVITY report anything to the FAA, my AME, or my airline?
Does therapy show up as a diagnosis, or get me deferred?
What if I need medication?
I live in one state and am based in another, and I am rarely in either. How does licensure work?
How much does private-pay therapy cost?
Why does private-pay matter for someone in my position?
Go deeper
You are back on the line next week either way.
The question is what you are carrying into the flight deck with you. Matching takes one conversation, with a clinician who knows what the FAA actually published and what it actually means.
Seven days a week · 8 AM – 8 PM Pacific Time · Concierge clients receive same-day priority