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Low-fee therapists at the Council for Relationships have helped Christina Gesualdi navigate life’s curveballs for the last five years.
The Kensington resident started with individual therapy, paying $15 per session to cope with financial stress and isolation during the COVID shutdowns. After moving in with her partner, she continued on with couples therapy for $45.
Now, she’s losing that lifeline.
Last week, Gesualdi and her partner learned from their therapist during their regular session that the Council for Relationships (CFR) — a mental health safety net for Philadelphians and one of the nation’s oldest relationship counseling centers — will close on May 29.
“We were like, `Wait, what? Really?’” Gesualdi said. “It’s deeply upsetting.”
The 40-year-old yoga instructor and professional dancer has decided with her partner, Elizabeth Shapiro, to “just do without” therapy for now.
“Access to really good and affordable therapy really doesn’t exist, and the Council for Relationships filled that role,” said Shapiro, 41, who works in billing at a college.
The impending closure has left in a lurch the nonprofit’s thousands of clients across eight Philadelphia-area offices, as well as its more than 60 staff therapists, psychologists, and psychiatrists, and more than four-dozen student interns and trainees.
The organization has struggled financially for years, said CEO Jason Anhorn, citing the loss of external funding and key partnerships at a time of increased overhead costs. Additional pressure has come from competitors, including for-profit virtual therapy platforms, like BetterHelp, that are rapidly growing through aggressive advertising.
“We tried. We did everything we possibly could, and we lasted as long as we possibly could,” he said.
Leadership had discussed ways to attract more outside funding and more clients, but ultimately, the organization’s board decided to cease operations — with only four weeks’ notice, a swiftness that stunned staff.
In an April 30 email to staff, CFR’s Chief Clinical Officer Sara Corse asked therapists to begin transitioning clients quickly to minimize disruption.
“Endings — especially ones we did not choose — can carry a lot for our clients,” Corse wrote, acknowledging that employees were also figuring out their own steps.
“Our ability to support clients through a thoughtful ending depends on clinicians continuing to show up and hold their work here through May, where possible,” she said in the email.
Therapists were given a list of other Philadelphia-area organizations that offer pro-bono therapy, take Medicaid, or provide low-fee sessions. Demand is high, however, and there can be waitlists.
CFR is the latest community-based mental and behavioral health organization undone by significant financial headwinds. Main Line Health will close its Women’s Emotional Wellness Center in June. The Wedge Recovery Centers, formerly a major provider of addiction treatment in the region, closed last year.
» READ MORE: READ MORE: Main Line Health is closing its Women’s Emotional Wellness Center in June
CFR has provided in-person, virtual and group therapy to between 3,500 and 5,000 people each year, according to Anhorn.
The bulk of its roughly $6 million budget comes from the fees clients pay for counseling services. CFR does not accept health insurance.
Clients with financial means pay market-rate fees out of pocket.
CFR also offers no-fee or low-fee therapy through closely supervised student interns who are earning their master’s degrees, as well as sliding-fee sessions from postgraduate therapists working toward licensure.
Anhorn said he and CFR board members were in talks late last week with another nonprofit about a potential acquisition and merger, hoping to salvage parts or all of the organization. Nothing is finalized, he said Thursday, declining to name the nonprofit.
An abrupt ending
CFR’s board of directors voted in late April to “cease all therapy sessions by the end of May,” Anhorn said. Staffers learned about the decision at an April 28 meeting.
Three staffers at the meeting told The Inquirer they felt blindsided. They were taken aback by the closure’s tight timeline and urgency.
“There was a lot of anger, a lot of frustration, a lot of surprise,” said a senior staff therapist who asked for anonymity, fearing that speaking publicly would hurt new job prospects.
“A lot of staff felt like they had no say. It also felt very much like we were misled,” the therapist said. “We were made aware that there were some ‘financial concerns,’ but the word ‘concerns’ is not usually used when we’re about to go out of business.”
Anhorn said he tried “to balance transparency with the responsibility not to create any kind of unnecessary fear and instability.”
But some staffers said being kept in the dark about the degree of financial turmoil dealt a harder blow.
The Inquirer spoke with six current and former staffers who said several senior therapists — with loyal clients and caseloads built over decades at CFR — had left within the last 18 months.
Anhorn said “there was definitely some turnover” after he became CEO in January 2025, which he called common when new leadership comes in.
Anhorn said therapists who leave CFR can take their clients with them since there’s no noncompete agreement, which creates financial unpredictability. Some therapists left to go into private practice, he said.
“If a couple of people leave and they take all their clients with them, that’s a major shift in cash flow,” Anhorn said.
Behind the scenes, Anhorn and board members brainstormed ideas to right the ship, he said.
“There was bouncing between extreme optimism and then also what the realities were,” he said. “My hope is that people realize that I was really fighting for this organization to thrive.”
A training pipeline
Emily Mudd, a visionary in women’s mental health, founded CFR in 1932 as one of the first organizations in the country to offer marriage counseling. It helped pioneer sex therapy and so-called “systemic therapy” — the idea that an individual’s behavior and past trauma impacts the family, CEO Emeritus Steve Treat said.
From the start, CFR’s mission was to serve “the poorest of the poor,” Treat said.
“The people who need it the most are going to be losing one of the places they could go,” he said.
CFR provided free therapy at public schools, veterans’ groups, and group homes, working closely with Project HOME, a Philadelphia nonprofit aimed at ending homelessness.
CFR also became a vital training pipeline for the region’s therapists. In 2006, CFR and Thomas Jefferson University partnered to create a master’s in family therapy program. CFR staff taught classes, trained, and supervised students, who were required to complete more than 300 client hours to graduate.
That partnership, which generated revenue for CFR, ended a few years ago, Treat said.
Many of Jefferson’s master’s students continued to choose CFR for clinical training requirements. CFR also has clinical interns from about 10 other area universities, including Bryn Mawr College, Temple University, and the University of Pennsylvania.
“I was so excited to get selected for an internship with them,” said Heather, who was supposed to start orientation for her clinical internship at CFR on May 11. She asked The Inquirer to withhold her last name because she doesn’t want to risk her prospects.
“I’m scrambling now for a new internship,” she said. “But this closing is bigger than me and my internship — there are all the CFR employees who now have to find new ways and places to work, and even more, the thousands of clients who have depended on CFR for mental healthcare.”