WEEK 3 · ANNOUNCING ONTO · HOW
How Treatment Begins.
Treatment at Onto begins with an assessment that unfolds across the first few sessions, because a treatment plan is only as good as the assessment underneath it.
By the time the assessment is done, you will know what we think is going on, which Onto program will be the focus of your work, and which level fits the kind of support you actually need. You’ll also have a sense of what evidence-based interventions you’ll be practicing between sessions, and what we’ll measure to know if therapy is helping.
Not a “we’ll see.” A plan.
The assessment
For the Onto assessment, we use validated screens for common presentations like depression, anxiety, and trauma, take a careful clinical history, and, when helpful, conduct a full structured diagnostic assessment. Two elements are distinctive to our intake: our Values Survey, which asks about the life areas that matter most to you, so the work is anchored to what you actually care about, and our Transdiagnostic Pattern Assessment, which goes underneath diagnosis to identify the patterns driving your struggles.
Two parts of your plan
Every treatment plan at Onto has two parts. The first is the program, which is the clinical focus of the work. The second is the level, which is how much support and structure you have around it. Together they answer the two questions every therapy plan should answer: what is the work, and how much of it do we need to do?
Your program: what we work on
A program at Onto is a defined clinical focus, built around the patterns that drive your struggles. Programs like Mind-Body Resilience, Finding Meaning and Purpose, and Trauma Processing are just a few examples. There are several others, with the full list at ontotherapy.com. Each program has its own focus, its own goals, and its own evidence-based interventions.
The assessment tells us which program, or sometimes which combination, fits what you’re actually dealing with. That program becomes the center of your treatment plan.
Your level: how much we work together
Some clients need a structured weekly session and a clear plan. Others need more, with skills coaching alongside the session, group work, and family work. Others need a deeper level of coordinated care.
We offer three monthly levels: Foundation, Comprehensive, and Complete. Foundation is for clients who want focused, evidence-based weekly therapy with built-in accountability and measurement. Comprehensive is for clients who need more than weekly therapy. We see this often with people who have worked with other providers without the progress they hoped for; the added structure is what makes the difference. Complete is the full Onto program with psychiatric care included.
Your program × your level = your plan.
Because the 167 hours after you leave the room are where the work actually happens.
Measurement, every session
Before each session, short, validated scales calibrated to what you’re working on come to your phone. They guide the work that day and help us decide whether to keep the plan or revise it.
The ending, named at the start
Most outpatient therapy ends when the client tires out and stops coming. Ours ends on a date set in the assessment. Naming the ending up front lowers dropout, raises completion, and makes the work easier to commit to. If you need more time, we’ll plan for it together, with a reason.
A named endpoint isn’t a constraint. It’s a promise that the work is finishable.
For what comes next
When active treatment ends, you don’t lose access to us. Many clients step down from their active level to a lighter one that keeps groups, skill-building, and periodic check-ins available, so care stays close without having to rebuild the relationship every time life calls for it. Wellness isn’t a line you cross once.
Out-of-network, on purpose
We are out-of-network private pay, billed monthly. The reason is structural, not financial. Longer assessments, full-fidelity treatment, between-session coaching, outcome measurement, and provider coordination are the things insurance reimbursement squeezes out. We chose the structure over the squeeze. Superbills, FSA, and HSA accepted.
The two of us
Onto is led by its Founders, Douglas Katz, PhD, and Kerry Rivard, LMHC. Together, they lead the clinical care and treatment at Eliot Community Human Services, a Massachusetts leader in behavioral health. Doug is on staff at Massachusetts General Hospital and an Instructor in Psychiatry at Harvard Medical School. Kerry was previously the Program Director of the 3-East DBT Residence at McLean Hospital.
The bar they hold for clinical work is the bar everyone at Onto practices to.
ONE TIP: After the first few sessions with any provider, ask one question: “What patterns are we working on?” A pattern is what’s actually keeping you stuck. The harsh self-criticism, the loop of avoidance, the emotions that go 0 to 60 in the blink of an eye. Good treatment names your important patterns and applies evidence-based interventions that target them. If your provider’s answer is a list of diagnoses or “We don’t know yet, these things take time,” the treatment doesn’t have a target.
For yourself, your family, or someone you care about, call us at (781) 235-6686.
Related Reading
Precision Psychotherapy: How Onto Works & Why