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 know the aeromedical system you actually work inside, including the parts of it that are not the pilots' parts. 100% virtual. Private-pay.

Start Therapy How it works

The question every controller asks first

Does the pilot answer apply to me?

This is the part the internet gets wrong, and getting it wrong is expensive. Here is what the FAA actually published, and where the real answer for your situation comes from.

The FAA answered pilots and controllers in separate sentences
In its published Therapy, Psychotherapy, and Counseling FAQs for Pilots and ATCS, the FAA answers the question "Must I report to the FAA immediately?" twice. For pilots: "No. You are not obliged to report until your next application for medical certificate." For controllers: "Air Traffic controllers must abide by FAA Order 3930.3C 9.e.1-5 and should consult with the appropriate flight surgeon prior to performing any safety-related duties." Two sentences, two professions, and almost every article you have read quotes only the first one.
CEREVITY does not generate a record for anyone to find
We are not a flight surgeon, we are not part of the FAA, and we have no reporting channel to your facility, your union, or your employer. Private-pay means no insurance claim is filed, no diagnosis code is created, and no carrier record exists, because none is ever generated. Your clinical record is held by your licensed clinician alone under HIPAA and legal privilege. What you are obliged to report is a separate question: it is governed by FAA rules and by your own circumstances, and it is not something a website should settle for you.
The FAA is not telling you to stay away
The same FAA document states that psychotherapy is compatible with both an unrestricted medical certificate and special issuance or special consideration, that many pilots and controllers continue therapy while on one, and that all are encouraged to seek help early before conditions get severe. It also says that stepping back from duty "is a professional safety decision and is also viewed as a sign of good insight." The rules are a reason to be deliberate and informed. They are not a reason to run on nothing for ten years, which is its own risk and the one nobody files paperwork about.

What actually walks into session with a controller

Six things controllers describe once the headset is off, week after week, in our clinicians' offices.

Zero 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.

A 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.

The 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.

Staffing 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.

The trained silence

You learned early that the safe answer to any medical question is no. That reflex protects the clearance and quietly wears down the person holding it.

Everything 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 looks like once you are off position

Procedural, briefed, and honest about the system you work inside.

The first month: baseline before plan

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 and works with it rather than against it.

By session three or four you have a formulation and a plan, plus a clear-eyed picture of where the aeromedical system does and does not intersect with any of it. Knowing which questions belong to your flight surgeon, instead of assuming that all of them do, is itself part of the relief.

A clinician who has read the FAA's guidance

Alongside the FAQ for aviators, the FAA publishes a document called Information for Psychotherapists Treating Pilots and ATCS, and it asks specific things of the clinician: "maintain psychotherapy process notes separately from clinical progress notes," document all clinical opinions in DSM-5-TR terminology, and "avoid both upcoding and minimization." It closes by telling therapists unwilling or unable to work that way to think carefully before accepting a client who must adhere to FAA criteria. Most therapists have never seen it.

That is not an academic point. A therapist who does not understand this system can do real damage: an offhand diagnosis written into a note, a medication started without regard for what it touches, or a breezy assurance about disclosure that was never theirs to give. What you want is someone who treats the person, documents carefully, talks through the implications of a diagnosis before making one, and says plainly when a question belongs to your flight surgeon rather than to them.

What moves first, and what takes longer

Early: sleep quality within the constraints of a rotating schedule, the intrusive replay of an event, the fuse at home. The drinking that had quietly become the decompression routine after a run of mids starts to look like what it is.

Later the work reaches the fusion between the clearance and the self, so that the medical becomes a requirement of the job again rather than the entire measure of the person holding it. That fusion is workable, and it is far easier to work on before something forces the issue.

Licensed treatment, peer support, and the EAP: what each one is actually for

What most air traffic controllers reach for first is CISM or the employee assistance program, and both exist for good reason. NATCA's CISM team is trained controllers offering peer-to-peer support after a hard event, and in the first day or two it is often exactly the right call. Neither one is a course of licensed clinical treatment, and neither runs through a clinician you chose independently of the agency and the union.

	CEREVITY, Licensed Therapy	Peer Support & the EAP
Who you get, and what they answer to	Licensed psychologists and clinicians (PhD, PsyD, LCSW, LMFT) who carry controllers as core caseload, each answerable to a state licensing board	A trained fellow controller, or a counselor assigned to you through the program
Treats insomnia, anxiety, post-traumatic stress, alcohol use	Yes: a course of evidence-based clinical treatment, carried week over week for as long as it takes	Not designed for it. Built for immediate support after an event and for pointing you somewhere next
Who holds the record, and under what protection	A HIPAA-governed clinical record held by your clinician, covered by therapist-client privilege. Privilege is strong but not absolute; narrow legal exceptions exist and your clinician names them at intake	Governed by each program's own policy. Peer supporters are not licensed clinicians, so no therapist-client privilege attaches, and the program sits inside the agency or the union rather than outside both
What it puts in a file outside the room	Nothing at all. Private-pay by design: no claim is filed, so no diagnosis code and no carrier record ever come into existence	No insurance trail either, and no cost to you. The program itself, though, lives inside your workplace
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	The hours right after an event, when what helps most is reaching someone fast who has worked the same position, plus a no-cost first conversation and a referral onward

Start with a licensed clinician →

Concierge by design: you never browse a directory

Tell us what the facility and the rotation are actually doing to you right now. We match you to a clinician who has worked with controllers before you got here.

Confidential intakeOne coordinator carries your intake from the first message to the first session, so you never explain the schedule, the facility, or the medical twice.

Matched to a specialistWe pair you with a clinician who treats air traffic controllers as core caseload and knows the aeromedical system you work inside, not the closest available calendar slot.

In session within ~48 hoursSessions run seven days a week, 7 AM to 9 PM Pacific, so the hour moves with the rotation instead of dying inside it: a morning after a mid, an afternoon before a swing, a weekend in the middle of a six-day stretch.

Measured progressThe instruments you complete at intake are repeated on a set schedule, so sleep, mood, and drinking get judged on numbers rather than on how the last set of mids happened to go.

Where we practice: nationwide. Our psychologists hold PsyPact authority across the participating states, and individually licensed clinicians cover everywhere else. Licensure follows where you are physically sitting during the session, not where your facility is, so a transfer, a detail, or two weeks at your parents' house is a scheduling question we handle rather than something you discover. No office, by design: no drive after a mid, no waiting room, no running into anyone from the area.

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The job is measurably wearing people out

61%

of the air traffic control personnel surveyed said they had caught themselves about to doze off during work duties in the past year, rising to 70% among those with regularly scheduled midnight shifts.

Source: NASA Ames and FAA, Controller Alertness and Fatigue Monitoring Study

19%

of the 47 U.S. air traffic controllers in a 2024 peer-reviewed screening study met the threshold for moderate to severe anxiety, and 12.8% met it for moderately severe to severe depression.

Source: Rutledge, Romero & Benton, Collegiate Aviation Review International (2024)

5.8

hours of sleep per night on average across the work week for the controllers monitored in the NASA and FAA fatigue study, dropping to 3.25 hours before midnight shifts.

Source: NASA Ames and FAA, Controller Alertness and Fatigue Monitoring Study

Choose your depth

Three session lengths, matched to the work in front of you. Most air traffic controllers settle into a weekly rhythm; some open with a longer block to build the map faster.

50minStandard

The weekly slot, rebooked around the rotation. Where most controllers settle: steady, cumulative, small enough to fit a day off.

90minExtended

Half again as long, for the event that takes twenty minutes to even start saying out loud.

3hoursIntensive

One long block on a stretch of days off, to map the whole picture before the next cycle starts.

Treated by clinicians, reviewed by clinicians

Every CEREVITY clinician is independently licensed and works with air traffic 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 position, 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 where my rules actually came from, 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.

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Questions air traffic controllers ask before starting

Do I have to tell my flight surgeon that I am seeing a therapist?

We are not going to rule on that for you, and you should be wary of any website that does. What we can do is point you at the source. The FAA's Therapy, Psychotherapy, and Counseling FAQs for Pilots and ATCS answers "Must I report to the FAA immediately?" separately for each group, and the controller sentence reads: "Air Traffic controllers must abide by FAA Order 3930.3C 9.e.1-5 and should consult with the appropriate flight surgeon prior to performing any safety-related duties." What that means for you depends on the current text of that order and on your own circumstances, so the flight surgeon is the person to confirm it with. Your clinician will read the current FAA guidance through with you honestly instead of pretending the question away.

So is there any point in me starting therapy at all?

Yes, and the FAA says so in that same document: psychotherapy is compatible with both an unrestricted medical certificate and special issuance or special consideration, many pilots and controllers continue therapy while on one, and all are encouraged to seek help early before conditions get severe. The rules are a reason to be deliberate and informed. They are not a reason to spend a decade untreated, which is the outcome the fear usually produces.

What if medication comes up?

That is a slower and more involved path, and it should be a deliberate decision rather than the accident of a fifteen-minute appointment. Psychiatric medication in safety-sensitive aviation roles runs through FAA review rather than being a routine prescription, only some medications are considered at all, and the requirements have changed more than once in recent years. It is exactly the decision you want made with a clinician who understands the aeromedical system and will check the current FAA guidance with you rather than guess at it, and then confirmed with your flight surgeon. Many of the controllers we work with are doing talk therapy only, and this question never comes up for them.

I transferred facilities once already and I may transfer again. How does licensure work?

Telehealth licensure follows where you are physically located during the session, not where your facility sits or where your home of record is. Within the PsyPact member states, your psychologist's authority moves with you automatically. Outside that footprint it is state-by-state, so we plan for it up front: tell your intake coordinator where you actually are and where a transfer, a detail, or an extended leave might put you, and we match you with clinicians licensed for those places. A move nobody accounted for is the failure mode here, and heading it off is our job, not yours.

What does this cost, and how does paying for it actually work?

Current session fees are listed on our pricing page, so you can price out a run of weekly sessions before you book the first one. CEREVITY is 100% private-pay: we do not bill insurance and we do not provide superbills, so no claim is ever filed, in week one or in week fifty. The fee is the entire transaction.

Why does private-pay matter for someone in my seat?

Because a billed session has to carry a diagnosis code. A diagnosis code is a clinical label attached to your name for billing purposes; it goes to the insurance carrier and it stays in the carrier's records, where it can be pulled up later in places that have nothing to do with the therapy that produced it, such as life-insurance underwriting or a coverage application or litigation. Private-pay produces none of that: no claim, no code, no carrier file, because nothing is ever billed to anyone. What you are obliged to disclose is a separate question entirely. That one is governed by FAA rules and by your own circumstances, and it belongs to you and your flight surgeon, not to us and not to any website.

Go deeper

Therapist for pilotsThe same FAA document, a different answer for the other seat.→ Therapy for security clearance holdersThe sibling seat where the vetting paperwork, not the medical, is the worry.→ Therapy for first respondersCare that stays off the department record.→ Therapy for flight crew and cabin staffThe other roster-driven seat in aviation: rosters, jet lag, and privacy.→

Clinically reviewed by Martha Fernandez, LCSW, Co-Founder and Licensed Clinical Social Worker · Last reviewed July 2026

You are back on position in the morning.

The question is how much you are carrying with you when you plug in. Sessions run seven days a week, 7 a.m. to 9 p.m. Pacific, which is what a rotating schedule actually needs, and matching takes one conversation.

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Seven days a week · Sessions 7 AM – 9 PM Pacific · Client support 8 AM – 8 PM Pacific · Concierge clients receive same-day priority