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TAKE THE FIRST STEP TOWARD HEALING!

Please complete the information below and we will respond within 24 hours with a therapist recommendation that matches your needs.

Your Name and Age

Our areas of interest include: (check all that apply)

Affair Recovery

Anger Management

Blended Family

Communication Skills

Couples Groups

Cross-cultural harmony

Emotional Intimacy

Go from Good to Great

Inlaws / Extended Family

Neurodiversite Couples / Asperger's

Parenting / Family Dynamics

Pre-engagement / Pre-marital

Private intensive weekend

Sex Addiction

Sexual Intimacy

Separation / Divorce

Major Life Decisions

We prefer a therapist who is:

Perfer FEMALE therapist

Pefer MALE therapist

NO gender preference for therapist

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Prefer therapist to be SPIRITUAL, not religious

Prefer therapist to have a MUSLIM background

Prefer therapist to have an AGNOSTIC OR ATHIEST background

Prefer therapist to have a BUDDIST background

Prefer therapist to have a CHRISTIAN background

Prefer therapist to have a JEWISH background

We do NOT wish to incorporate faith in therapy.

We do wish to incorporate faith in therapy.

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Prefer Telehealth (Zoom)

Prefer In-person

No preference between Zoom and In-person

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Must have DAYTIME openings

Perfer EVENING openings

Must have EVENING openings

N/A - My schedule is FLEXIBLE

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We live IN CALIFORNIA (this impacts whether you are matched with a couples therapist or a couples coach)

We live OUTSIDE of CALIFORNIA

Our fee per 50 minute session varies based on life experience, clinical experience, training, education (master's, doctorate), and special certifications. Please indicate the fee you are able to pay and we will do our best to match you with the appropriate professioal.

$300 and up

$250 to $300

$200 to $250

$150 to $199

$100 to $149 - considered "Sliding Scale". Appointments at this price are limited.

Please provide a brief background of your situation. Include your State (in USA) or Country of Residence.

Information shared on this intake form may be viewed by members of the Couples Recovery Center staff in order to match you with the therapist who is the best fit for you.

By entering your information, you will be added to our mailing list however you will be given the option to unsubscribe at any time.

Thanks for submitting!

World Headquarters: 3880 South Bascom Ave, Suite 216, San Jose, CA 95124

couplesrecoverycenter@gmail.com

We have a team of amazing couples specialists ready to help with your most important relationship.

We also are proud to partner with other counseling centers:

Neurodiverse Couples Counseling Center
Blended Family Counseling Center
Affair Recovery Therapy Center

Couples Recovery Center and Couples Recovery Institute © 2018-2022. All rights reserved. The Couples Recovery Center and Couples Recovery Institute are a part of Harry Motro, PsyD, Marriage and Family Therapist, P.C., a Professional Corporation.

The recommendations on this website do not constitute professional advice, substitute for professional treatment, or establish a therapeutic relationship. If you are in a life threatening situation, do NOT use this site. Call the 24-hour National Suicide Prevention Lifeline at 1.800.273.8255. Your call will be routed to the crisis center near you. If your issue is an emergency, call 911 or go to your nearest emergency room.

Harry Motro, Psy.D., Marriage and Family Therapist, P.C., www.harrymotro.com, harrymotro@gmail.com, 408 823 2822.