Confidential Therapy for Air Traffic Controllers
Your reporting rules are not the pilots' rules. Start there
Almost everything written about aviation mental health is written for pilots, and controllers keep reading it and drawing the wrong conclusion. CEREVITY matches controllers with licensed clinicians who understand what FAA Order 3930.3C actually requires of you. 100% virtual. Private-pay.
The question every controller asks first
What do I actually have to report, and when?
This is the part the internet gets wrong, and getting it wrong is dangerous for your career. Here is the honest version.
The pilot rule does not apply to you
The FAA's May 2026 guidance tells pilots they need not report until their next medical application. In the very same answer it tells controllers something different: you must abide by FAA Order 3930.3C and consult the appropriate flight surgeon prior to performing safety-related duties. Your obligation is immediate and duty-blocking. It is not annual. Anyone telling you otherwise is quoting the pilot half of the page.
What the order actually says about counseling
Order 3930.3C requires you to give the flight surgeon the results of visits to health professionals before performing safety-related duties. It then carves out counseling visits, but voids that carve-out if the visit was for or related to substance use or any mental condition such as anxiety or depression, if medication was prescribed or recommended, or if a psychiatric referral was made. What survives the carve-out is counseling without a specific psychiatric diagnosis, and the order's own example is marital counseling. Read that twice, because it is the whole picture.
Why this argues for getting help sooner, not later
The rules are real, and so is this: the FAA states plainly that psychotherapy is compatible with medical clearance and special consideration, and that self-grounding when you are not fit is a professional safety decision and a sign of good insight. The controllers who lose everything are not the ones who got treated. They are the ones who white-knuckled it for a decade until something broke on position. Knowing the actual rule, early, with a clinician who knows it too, is what protects the career.
What actually walks into session with a controller
Not generic stress. Six patterns our clinicians treat every week in controllers.
01Zero tolerance for error, all day
Nobody outside the room understands that the margin is measured in seconds and that the consequence is a headline. You hold that for eight hours and then drive home.
02A body clock in permanent rebellion
The rattler, the mids, the two-two-one. You are not tired because you are weak. You are tired because the schedule is engineered against human physiology.
03The near miss you never mentioned
The one that still wakes you. You did the paperwork, went back on position, and never said another word about it to anyone.
04Staffing that never comes
Mandatory overtime, six-day weeks, no relief, and a facility that has been short for years with no end anyone can see.
05The trained silence
You learned early that the safe answer to any medical question is no. That reflex protects the clearance and quietly destroys the person holding it.
06Everything riding on the medical
The clearance is the salary, the pension, the identity. That is exactly why the fear of losing it stops people from doing the one thing that would keep them well enough to hold it.
What the work actually looks like
Procedural, briefed, and honest about the system you work inside.
The first month
The opening sessions establish what is actually happening: sleep, the fatigue that is structural rather than personal, the event that still replays, the drinking, and how much of it is the schedule versus something clinical underneath the schedule. Validated instruments give a baseline. Controllers under-report by training, and a clinician who knows this population expects that.
By session three or four you have a formulation, a plan, and a precise understanding of where your reporting obligations actually sit. That precision is not a side note here. It is the thing that lets you make a real decision instead of a frightened one.
A clinician who read the order
A therapist who does not know Order 3930.3C can do real damage: an offhand diagnosis written into a note, a medication started without regard for what it triggers, or a breezy reassurance that none of this needs disclosing. All three have cost controllers their clearance.
What you need is someone who treats the person and understands the file: who documents carefully, who discusses the certification implications of a diagnosis before making one, and who knows the difference between counseling that must be disclosed and counseling that need not be.
What tends to change
Early: sleep quality within the constraints of a rotating schedule, the intrusive replay of an event, the fuse at home. The drinking that had become the only way to come down after a mid starts to look like what it is.
Later the work reaches the fusion between the clearance and the self, so that the medical is a requirement of the job rather than the entire measure of the person holding it.
Therapy, not coaching: the distinction matters here
Much of what controllers 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, insomnia, post-traumatic stress, alcohol use, when something is genuinely wrong and working the next mid on top of it 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 understands FAA Order 3930.3C and treats controllers 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 job is measurably wearing people out
of air traffic control personnel said they had caught themselves about to doze off during work duties in the past year, rising to 70% among those regularly working midnight shifts.
Source: NASA and FAA, Controller Fatigue Assessment Reportof U.S. controllers in a peer-reviewed screening study met the threshold for moderate to severe anxiety, and 12.8% for moderately severe to severe depression.
Source: Rutledge, Romero & Benton, Collegiate Aviation Review International (2024)hours of sleep per night on average for controllers, dropping to 3.25 hours before midnight shifts.
Source: NASA and FAA, Controller Fatigue Assessment ReportTreated by clinicians, reviewed by clinicians
Every CEREVITY clinician is independently licensed and works with controllers 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 had a deal. Nothing happened, nobody got hurt, and I still see it. I worked another four years without saying one word to anyone, because everything I had ever read about aviation mental health was written for pilots and I assumed it applied to me. It did not. When somebody finally walked me through what my rules actually said, it was not the answer I wanted, but it was an answer, and I could finally do something with it.
Certified professional controller, en route facility, 15 months with CEREVITY
Shared with permission by a former client; identifying details altered to protect confidentiality. Individual experiences vary.
You separate aircraft by three miles. Nobody has ever given you any separation at all.
Get Matched NowQuestions controllers ask before starting
Do I have to tell the flight surgeon that I am in therapy?
So is there any point in me starting therapy at all?
What if I need medication?
Does CEREVITY report anything to the FAA or my facility?
How much does private-pay therapy cost?
Why does private-pay matter for someone in my position?
Go deeper
You are back on position in the morning.
The question is how much you are carrying up there with you. Matching takes one conversation, with a clinician who already knows what your rules say.
Seven days a week · 8 AM – 8 PM Pacific Time · Concierge clients receive same-day priority