Couples therapy in Chapel Hill
Exhale is a two-clinician practice for partners who are queer, and for the people who love them. Two of you, three or more, newly together or years in: we start from how you describe it, not from a form we hand you.
Where we can begin
Each one starts with the same question: how would you describe your relationship today?
For two partners, whatever the two are: newly together, long married, long distance, or living apart in the same city.
Couples therapyFor three or more, open or closed, in a household or across several. Everyone who wants to take part can.
More than twoFor when one of you is coming out or changing, and the other is working out what that means for you both.
TransitionsFor staying, leaving, or not knowing yet, and for ending in a way you can both live with.
Deciding and endingWho comes, and how
Couples therapy usually assumes two people heading in one direction. We don't. Here is what the first weeks look like for three common shapes.
| Two of you | Three or more | The shape is changing | |
|---|---|---|---|
| Who is in the room | Two of youBoth of you, together. | Three or moreEveryone who wants to be there, together or in smaller combinations you agree on at the start. | The shape is changingWhoever is part of the conversation now, and it can change from one session to the next. |
| How we begin | Two of youEighty minutes to hear each of you describe the relationship in your own words. | Three or moreThe same, plus a first conversation about who is involved, what is agreed and what stays private. | The shape is changingA first session that decides nothing. Staying, opening up, closing down and ending are all allowed on the table. |
| What we don't assume | Two of youThat you are married, living together, monogamous, or queer in the same way. | Three or moreThat there is a primary pair, a ranking, or a shape the relationship is heading toward. | The shape is changingThat the relationship should continue, or that it should end. |
| Who pays | Two of youOne of you, or half each. We put the fee in writing first. | Three or moreHowever you divide it. We never assume one person carries the bill. | The shape is changingWhoever is coming. You can change how it is split as things change. |
The space
Armchairs you can pull closer or turn away from, light from a tall window, and a door that closes.
Sample photos.
How we work
We draw on attachment-based and systemic approaches to couples work. In your first sessions we name the one we are using and why, and you can ask us to change course.
We don't treat your identity as the problem, and we don't treat it as the whole story. Most of what brings people in is what brings anyone in: money, sex, family, time, a fight that keeps coming back.
Your clinician sets the pace with you. We never promise a number of sessions.
Your clinicians
You choose who you start with, and you can change your mind after the first session.
Couples and relationship therapist
Lemuel works with couples and with groups of three or more. He asks each person early on what they would most like the others to understand, and he keeps the pace slow enough for everyone to answer.
Couples and transitions therapist
Amira sees couples, and partners of people who are coming out or changing. She is plain about what she sees, kind about how she says it, and clear about where her work ends.
Getting started
Tell us how to reach you safely and when. You don't have to say anything more than that.
It is a 15-minute call to see whether we are a good fit. It is not therapy, an evaluation or an assessment.
Eighty minutes. We hear each of you, and we agree on what we are working on and what stays private.
Many people meet weekly at first, then less often. Your clinician sets the pace with you.
We are out of network with every insurance plan, and we do not bill Medicare or Medicaid. Some plans reimburse part of an out-of-network session, and we give you the receipt to claim it. Couples work is often not reimbursed at all, because many plans pay only when one person has a diagnosis.
Out of network with all plans
Medicare and Medicaid are not billed
Many PPO plans reimburse some out-of-network care; yours decides
Your fee for each session is given to you in writing before you start. Either of you can pay, or you can split it any way you like. HSA and FSA cards work. We hold a limited number of reduced-fee spots, and you can ask about one without explaining why.
The fee is in writing before session one
Split between you however you decide
A late cancellation notice is 24 hours
Each month we send an itemized receipt (a superbill) that you may send to your plan, with the dates, the fee and the codes. It carries a diagnosis code that the insurer will see, so we go through what goes on it with you first. Your plan decides what it reimburses, and reimbursement is not guaranteed.
If you pay without insurance, you have the right to a good faith estimate of what care will cost before you begin. We send it in writing before your first session. It is not a contract, and if a bill comes in $400 or more above the estimate, you can dispute it.
Your plan is the one that knows. Before the first session we send you the questions to ask it about out-of-network mental health benefits, and the codes we would use, so you can decide with the answers in hand.
Licenses
Each clinician holds a license from a North Carolina board. The board can confirm it, and each license appears in the footer of every page.
Lemuel Mayfield, Licensed Marriage and Family Therapist (LMFT)
NC Lic. 000000 · North Carolina Marriage and Family Therapy Licensure Board
Licenses the clinician to practice marriage and family therapy in North Carolina.
Amira Barakat, Licensed Clinical Mental Health Counselor (LCMHC)
NC Lic. 000000 · North Carolina Board of Licensed Clinical Mental Health Counselors
Licenses the clinician to practice clinical mental health counseling in North Carolina.
Before you write
No. You don't need to be married, living together, monogamous or the same kind of queer. You can be two people or more, new or long together, or unsure what to call it. We start with how you describe it.
We are out of network with every insurance plan, and we do not bill Medicare or Medicaid. Some plans reimburse part of an out-of-network session, and we give you a monthly receipt to claim it. Couples work is often not reimbursed, because many plans pay only when one person has a diagnosis.
If you pay without insurance, you have the right to receive a written estimate of what care will cost before you begin. It is not a contract. If a bill comes in $400 or more above the estimate, you can dispute it. We send the estimate before your first session.
It runs 80 minutes. We hear each of you describe the relationship in your own words, ask what you hope will be different, and agree on what we are working on and what stays private. Nothing is decided for you.
What you tell your clinician is confidential, with limits the law sets: a serious risk of harm to you or someone else, and a report the law requires. In couples work we also agree early on how we handle something one of you tells us alone.
Please give us 24 hours' notice to change or cancel a session. A later cancellation may be charged at the session fee, which you will have seen in writing. If something urgent comes up, call us and we will talk it through.
Tell us who you are and how to reach you. We will take it from there, at your pace.
Share how to reach you, and when it is safe to. We reply from a private inbox.