Precision Psychotherapy: How Onto Works & Why

WEEK 1     ·     ANNOUNCING     ONTO     ·     WHY

168 hours.

There are 168 hours in a week. Therapy is one of them. Onto is built around the other 167.

For decades, outpatient therapy has been built around the appointment. People come in once a week, talk for fifty minutes, and walk back into a life that mostly happens to them. Sometimes that is enough. Often it is not. Months and sometimes years pass, and little changes.

The research is unambiguous about why. The change that lasts comes from what happens between sessions. The therapy hour is where you learn what to practice, refine what is not working, and figure out what to try next. The rest of the week is where it counts.

So we built Onto around the rest of the week.

The hour is for the 167

A week at Onto looks different from a week of standard outpatient care. You have individual therapy. You have skills coaching between sessions. There is group work when group makes the work move faster. There is family work when families are part of what is needed. And we measure progress every session, on the same validated scales used throughout the field, so the work does not drift.

The point is not to make the hour longer. It is to leave the hour with something specific to practice, something concrete to notice, and something to bring back the following week.

Care at Onto starts with an assessment that runs across the first few visits, long enough to be thorough and short enough not to become its own treatment. By the end you have a written plan: the program we are recommending, what it includes, what you will be working on between sessions, and the measures we will use to know whether it is helping.

The therapy you came for

People go to therapy because they want to feel understood. To sit with someone who is actually listening, who gets them, who has their back. None of that changes at Onto. The relationship is still where the work happens.

Our clinicians are people, not technicians running a protocol on you. They pay attention. They notice what matters to you. They remember what you tell them. They stay in your corner across the week, not only during the hour. Everything else that we offer is built on top of that, not in place of it.

Precision psychotherapy

We call the approach precision psychotherapy. Four things define it.

The first is targeting what is maintaining the problem, not just the diagnosis on the chart. Two people who meet criteria for depression can be running entirely different patterns underneath the label. One is trapped in rumination; the other has stopped doing the things that used to give the day shape. They need different treatments. The diagnosis names the symptom. The pattern is what we treat.

The second is values. Every plan starts with what the person is trying to move toward, not only what they want to move away from. Symptom relief alone is a low bar.

The third is using what the evidence supports. Values-Based Precision Therapy, our flagship, targets the patterns running underneath several presentations at once. It draws skills from across the major evidence-based therapies, including CBT, DBT, ACT, and somatic and mind-body approaches, matched to the pattern and what the client needs. When PTSD is part of the work, we add the manualized protocols the research supports for it (CPT, PE, WET), delivered in full when the full protocol is what is called for, and folded into the larger treatment rather than running parallel to it.

The fourth is measurement. Brief validated scales at the start of every session, chosen to fit what you are working on. When the numbers are moving, we keep going. When they are not, we change the plan instead of waiting another month to notice.

All of it pointed at the same outcome: moving onto the rest of your life.

Who we are

Onto was built by two clinicians who have spent their careers working out what good treatment looks like and what it takes to deliver it consistently.

Douglas Katz, PhD, and Kerry Rivard, LMHC, are Onto's founders. Together they lead clinical care at Eliot Community Human Services, one of the largest behavioral health organizations in Massachusetts, where they have spent years building, teaching, and supervising treatment teams.

Doug is on the staff at Massachusetts General Hospital and an Instructor in Psychiatry at Harvard Medical School, where he has also run clinical trials and published peer-reviewed research on evidence-based treatments. Kerry was the Program Director of the 3-East DBT Residence at McLean Hospital.

Onto is what they wanted to build when they thought about what good private practice should look like. Precise. Warm. Accountable. Built to end when the work is done.

Who Onto is for

Adults, teens, young adults, and the families around them. People who want treatment to do more than fill an hour.

It is just as much for the clinicians and community professionals who refer them. Pediatricians. Primary care doctors. School counselors. Clergy. Other therapists. The people who help people stay well day to day. We are here to help you help the people you care for, in a way that makes a real difference.

One More Tip

Before starting with any therapist, ask one question: What will I be practicing between sessions, and how will we know it is helping? A specific answer means there is a plan. A vague answer is the answer.

For yourself, your family, or someone you are trying to help — call us at (781) 235-6686.