Elite Access.
Clinical Sovereignty.
A private concierge clinical practice delivering elite outpatient psychotherapy, behavioral risk management, executive advisory, and integrated multidisciplinary Care Coordination—seamlessly In-Situ across Manhattan, Westchester, and Fairfield County.
Seamless NY & CT Care Continuity
Direct Entry Virtual Advisory • Standard Hours
Capacity Governance • Strictly Capped at 15 Roster Slots
100% Cash-Pay & HITECH § 13405(a) Protection
We do not treat symptoms in a vacuum. We treat the entire ecosystem.
High-performing executives, founders, and complex family estates do not benefit from standard, transactional therapy. They require precision diagnostics, absolute privacy protection, and seamless operational access across their primary, secondary, and weekend residences.
Uncompromised Cross-Border Continuity: Our full dual licensure in both the State of New York and the State of Connecticut eliminates administrative friction for principals commuting between Manhattan executive suites and Connecticut estates. Your clinical care transitions fluidly without jurisdictional interruptions or third-party handoffs.
Standard healthcare models force clients into rigid administrative structures—resulting in fragmented care, rotating clinicians, and siloed specialists. Drawing on over two decades of lifespan clinical leadership, we bring a comprehensive diagnostic perspective that aligns individual care with broader ecosystem governance.
Clients can engage the practice directly through Tier 1 Focused Virtual Psychotherapy on a pure fee-for-service basis during standard business hours without an upfront retainer, or upgrade to Tier 2 Concierge Clinical Residency to secure 1 of 15 capped roster positions, Priority Same-Day Triage, In-Situ estate visits, and dedicated interdisciplinary Care Coordination. Operating strictly cash-pay, we execute statutory privacy elections under HITECH § 13405(a) and 42 CFR Part 2, keeping diagnostic records completely insulated from commercial insurers and Health Information Exchanges.
Clinical Leadership & Institutional Pedigree
Over two decades of clinical mastery and relational precision.
High-performing executives, founders, and legacy family systems do not benefit from standard outpatient therapy. They require a highly protective, clinically grounded environment operating without administrative friction or public exposure.
Brian A. Tessier brings over two decades of senior diagnostic expertise and behavioral risk management to the executive domain. An alumnus of New York University (MSW, '07), he maintains active clinical licenses in both New York and Connecticut—providing uninterrupted, cross-border continuity for Tri-State leaders commuting between Manhattan suites and Fairfield County estates.
His clinical pedigree spans the full continuum of high-acuity care. Having directed psychiatric emergency programs, architected intensive outpatient stabilization units, and governed interdisciplinary clinical teams, Brian offers a level of systemic diagnostic insight that isolated private practitioners simply cannot match.
Operating strictly as a clinical strategist and diagnostician, he engineers integrated care plans that guide principals and their surrounding ecosystems through critical transitions with precision, absolute privacy, and uncompromised clinical sovereignty.
Brian A. Tessier, MSW, LCSW
Founder & Lead Clinician • NYU MSW ('07) • Dual NY & CT LicensureDiagnostic & Behavioral Scope
Lifespan Capabilities.
Comprehensive outpatient assessment, psychotherapy, and discrete behavioral stabilization adapting fluidly to every developmental stage of your family ecosystem.
Adolescents & Academics
In-Situ Care deployments for complex adolescent challenges. We provide direct intervention within the home environment to address academic disengagement, school refusal, and high-functioning anxiety, executing discrete Care Coordination with school leadership.
Young Adults & Legacy
Clinical architecture for emerging adults facing critical life transitions. We deliver outpatient psychotherapy to address failure-to-launch dynamics, mood regulation issues, and the psychological pressures associated with family expectations.
Executives & Founders
Behavioral risk management tailored for high-profile leaders requiring privacy. We offer executive clinical access to address C-suite burnout, behavioral dependencies, decision fatigue, and complex marital strain.
Multidisciplinary Care Coordination
We stabilize the surrounding infrastructure alongside the individual. Serving as your central clinical coordinator, we align concierge physicians, legal advisors, and wealth managers under unified clinical oversight.
Confidential Case Studies.
How executives and family estates deploy Tier 1 and Tier 2 structures to resolve complex clinical breakdowns.
Founder Burnout & Anxiety
A C-suite founder undergoing a corporate liquidity event experiences acute decision fatigue and severe anxiety. Splitting time between a Manhattan office and a Greenwich estate, they require senior clinical psychotherapy without an ongoing retainer.
Our Intervention: The client enters via a Provisional Virtual Assessment. Weekly Virtual Psychotherapy sessions are scheduled under strict statutory cash-pay privacy protections (HITECH § 13405(a)), providing continuous care across NY and CT borders.
Prep School Academic Freefall
An adolescent at an elite prep school experiences severe school refusal and emotional dysregulation. Initial virtual sessions escalate into a broader family crisis requiring home deployment and school negotiation.
Our Intervention: Following an In-Situ evaluation, the family upgrades to Tier 2 Concierge Residency. We deploy In-Situ Care directly to the estate while coordinating collaterally with school administrators under Priority Same-Day Triage protocols.
High-Asset Family Transition
A family undergoes a volatile estate reorganization. Interpersonal tension threatens alignment while financial and legal advisors operate in separate silos without clinical guidance.
Our Intervention: Admitted directly to Tier 2 Residency. Collateral family members are onboarded via Member Integration. We align estate counsel and wealth managers under unified Care Coordination, utilizing Legal Alignment during critical court filings.
Practice Engagement & Financial Architecture
Tiers & Rate Schedule.
A streamlined dual-structure model separating direct Fee-For-Service (FFS) clinical care from dedicated Concierge Capacity Governance.
Tier 1: Focused Outpatient Virtual Advisory
Tailored for senior executives, founders, and individuals seeking senior clinical diagnostic expertise and total privacy for targeted personal challenges via 60-minute virtual sessions during standard business hours.
- Pure Fee-For-Service: Billed per active 60-minute virtual session ($450) with zero monthly retainer overhead.
- Dual NY & CT Licensure: Uninterrupted virtual delivery across New York and Connecticut jurisdictions.
- Admin & Extended Coordination: Extended proxy consultations, document analysis, and collateral liaisons billed separately at the Executive Admin Rate ($250/hr).
- Tactical Overrides Access: Ability to activate off-calendar, after-hours, acute, virtual mobilizations via activation surcharge ($1,000).
- Absolute Data Sovereignty: 100% Cash-Pay under HITECH § 13405(a) statutory elections—zero superbills, zero CPT codes submitted to insurers.
Tier 2: Concierge Clinical Residency
Our premier ecosystem governance package for high-net-worth families, executives in active transition, and complex estates requiring guaranteed clinical priority and multi-stakeholder alignment.
- Capacity Governance Retainer: $2,500/month securing 1 of only 15 active practice positions worldwide.
- Included Monthly Review: Includes 1 monthly 60-minute Virtual Review session per billing cycle.
- Bundled Care Coordination & Admin: Routine interdisciplinary liaison with concierge physicians, estate counsel, wealth managers, and school leadership covered under retainer.
- Priority Same-Day Triage: Elevated communication SLA with direct secure portal messaging and rapid response windows.
- Dual-State Estate Deployment: Priority scheduling for In-Situ home, compound, or executive suite deployment ($1,000/hr) across Manhattan, Westchester, and Fairfield County.
Master Rate Schedule Matrix
Direct Outpatient & Diagnostic Services
Provisional Intake Evaluation
Comprehensive diagnostic evaluation required prior to active care admission.
Virtual Clinical Advisory
Scheduled 60-minute clinical psychotherapy session via encrypted virtual portal across NY & CT.
Tactical Override (TO) Activation
Unscheduled, weekend/after-hours, acute, virtual mobilization surcharge. Tier 1 primary (waived for Tier 2).
Concierge Capacity & Governance Services
Monthly Base Access Retainer
Tier 2 capacity reservation securing 1 of 15 capped roster slots, Priority Same-Day Triage, Care Coordination, and 1 included monthly virtual session.
In-Situ Clinical (Mobile Estate Visit)
Scheduled 60-minute clinical psychotherapy session deployed directly to your estate, compound, or executive suite across NY/CT. Transit logistics are handled by the Practice and are not billed.
Priority Capacity Governance & SLA
Guaranteed same-day triage, dedicated portal messaging, routine care coordination, and 1 monthly virtual session included.
Universal Practice Services & Ancillary Terms
Executive Administrative Governance
Extended proxy consultations (>20m), complex document analysis, IEP reviews, and multi-provider liaisons for non-retainer accounts (included in Tier 2).
Legal & Forensic Alignment
Depositions, court appearances, attorney alignment sessions, and pre-litigation consultation. Billed against an upfront non-refundable $10,000 legal retainer.
Member Integration (MI) Surcharge
One-time clinical onboarding fee to evaluate and integrate a collateral family member, spouse, or proxy into the care ecosystem. Subsequent sessions billed at standard FFS rates.
Acceleration Protocol Surcharge
One-time mobilization surcharge for expedited off-market intake evaluation when the active Tier 2 Concierge Residency roster is at capacity.
Application Gateway
Request Placement Inquiry
Select your preferred practice engagement tier. Submissions are reviewed directly by clinical leadership within one business day.