Therapy and coaching for aviation professionals.
I work with pilots at any stage: students, time-builders, CFIs, regional and airline, GA, and military. Controllers, mechanics, dispatchers, and crew are welcome here too. If the FAA Medical question is what you’re stuck on, that is covered here. If it isn’t, so are sleep, family, a hard year, and the things you haven’t said out loud. Therapy is available in Michigan and Ohio, and coaching anywhere.
Why you may have been putting this off
The next medical is already on the calendar, and somewhere in your mind you’ve decided this isn’t the year to bring anything up. Maybe that is the whole reason you’ve put this off. Or maybe the medical isn’t the issue, and it’s a failed check ride, a hotel night that turned into more drinks than you meant, a strained marriage, a hard stretch at work, or something from years back that you still replay on the drive to the airport.
I’m a pilot myself, with a Private Pilot Certificate. I can walk you through what the FAA’s own guidance says, and I’ll tell you when the right next step is AOPA, your AME, or someone other than me. The about page has more on my background.
If you’re the partner or family of a pilot and the strain has reached your own life, you’re welcome here too.
The job asks for a particular mode
The flight deck, the tower, the ramp, and the dispatch desk all ask for calm on a schedule: decisions on time, problems contained, nothing allowed to become someone else’s problem. That mode doesn’t always switch off after shutdown. You drive home and you’re not actually in the car. You sit across from your partner at dinner and you’re still in the airplane. The tone that settles a problem on the radio sounds cold at your own kitchen table.
Rotating shifts, overnight flights, redeyes, time zone changes, and working overnight for days at a time all disrupt sleep. The FAA’s own fatigue brochure for pilots names shift work, night flying, and time zone changes among the causes. You lie in a hotel bed at 3 a.m. knowing you need to be sharp in five hours, and the harder you try to sleep the more awake you get. Or you sleep fine on the road and crash for four days at home, then start the next trip already short.
Things from the job add up too: a peer’s incident or accident, a check ride that didn’t go the way you wanted, an error or a loss of separation you keep replaying, a sign-off you second-guessed, or a passenger event you handled correctly and still think about. A base change, a furlough that never fully left your memory, or an upgrade timeline that doesn’t match the life you’re actually living can weigh on you as well.
The “I’m fine” habit is most of what I see. The job rewards composure, so composure becomes the default answer to “how are you doing,” including when a real answer would actually be useful.
And then there’s the certificate itself. For pilots and controllers, the medical is what lets you do the work you organized your life around, paid for, and moved for. Worrying about losing it is rational.
Where I start with aviation professionals
FAR/AIM references, what it means when your Aviation Medical Examiner (AME) defers, why the medical factors into so many decisions: none of it needs a glossary here. MedXPress, the AME Guide, Special Issuance, and HIMS are things I track for clinical work with aviators. You won’t have to make a clinician comfortable with the way pilots talk about risk before we can get to what’s actually wrong.
The sessions themselves are practical. We start by getting clear on what’s actually going on. From there we figure out the right frame, what’s helping, what isn’t, and what to try between sessions. The aim of the first few sessions is to give you something specific to work with: a way to wind down between the last leg and home, a way to handle hotel-night sleep without making it worse, a plan for the next layover or the next disagreement with a partner, a way to think about the next medical appointment.
The right frame depends on what’s actually going on
Coaching and therapy serve different needs. The right frame depends on what’s actually going on, not on which feels less risky for your medical. If therapy is what you need, the question is how to do it well, not how to avoid the conversation.
Coaching fits a lot of what pilots come to work on: a checkride you failed or one that’s coming up, an interview you’re nervous about, the first year at a new operator, deciding whether to relocate so you can stop commuting, a base change or airline transition, strain at home, a captain who makes every trip miserable, CFI burnout, and figuring out who you’ll be after the last trip.
Coaching is non-clinical, goal-focused work. It isn’t psychotherapy and doesn’t generate a clinical diagnosis or treatment record. Whether coaching visits with me go on your MedXPress application is a question for your AME or AOPA Pilot Protection Services. If a coaching conversation moves into clinical territory (anxiety, depression, substance use, trauma symptoms), I’ll tell you.
Therapy is the right frame for clinical concerns like active anxiety, depression, PTSD, or substance issues. What therapy means for your medical is decided case by case, and the reporting it involves is not a reason to pick coaching when therapy is what you need. The questions below cover what therapy means for your medical and what has changed since 2024.
For Special Issuance situations, HIMS pathways, or any active FAA enforcement matter, AOPA Pilot Protection Services and your AME, or a HIMS-trained AME, are the right next step. I can help you think through what fits your situation, but those are the formal answers.
For partners, parents, and family of pilots
You catch yourself pausing when the pilot in your life mentions a back twinge or a rough month of sleep, because part of you is already wondering what it could mean for their medical certificate. The FAA’s own advisory committee names fear of losing the medical as one of the main reasons pilots avoid care, and one 2022 study found that 56 percent of pilots surveyed reported avoiding health care for fear of losing their medical certificate.
The schedule is its own problem. The monthly schedule comes out and the family calendar gets redrawn from scratch, with school events, appointments, and birthdays planned around a month that keeps moving. That’s not a complaint to talk yourself out of. It’s how the job works, and a clinician who knows it won’t hand you a standing Wednesday date night as the fix.
Then there are the smaller signs: the flight-tracker tab open while you finish making dinner, the seat at the gate you picked without noticing because it had the best view of the boarding door.
If the HIMS program is part of your life right now, the recovery process comes with FAA requirements attached. The Aviation Family Network, listed in the resources below, was founded to support the families and friends of pilots dealing with addiction and mental health, including the HIMS process.
All of this applies whoever you are to the pilot: spouse, partner, someone six months into dating who just learned what reserve means, the parent of a student pilot watching the training bills climb, an adult child, a sibling, chosen family.
One thing to be clear about: you’d be here for your own life, not the pilot’s file. I don’t see family members as a way to reach the pilot, and I can’t treat anyone by proxy. If the pilot in your life needs help, they’d need to reach out themselves.
Questions pilots actually ask
Short answers below. None of this is legal or medical certification advice for your specific situation. For that, AOPA Pilot Protection Services and your AME are the right resources.
Yes. You can bring the medical question, and you can bring the rest of your life: training debt and instructing years that barely pay, the push to reach 1,500 hours for an airline transport pilot certificate, the strain hour-building puts on a family, a stretch at home that got hard.
If you’re a military aviator, one thing to be upfront about: my flying is general aviation and my clinical work is civilian. I’m glad to work with you on your life. For military aeromedical questions, your flight surgeon and your service’s aeromedical channels are the right route.
Coaching is goal-focused work on decisions, performance, and transitions, and it isn’t psychotherapy. Ask your AME or AOPA Pilot Protection Services whether coaching visits with me belong on your application.
Therapy is different. The FAA’s therapy FAQ for pilots, published in May 2026, says visits to licensed providers, including therapists and counselors, go on your medical application. The exceptions it lists are educational counseling, religious counseling from clergy who are not also licensed counselors, couples counseling unless you were referred for individual therapy, and employee assistance program (EAP) visits that did not lead to a referral for psychiatric evaluation or treatment. Starting therapy doesn’t require reporting anything until your next medical application, and the FAA usually does not see the therapy records themselves; when it asks, it is usually for a brief summary from the therapist.
If there is a diagnosis, the application asks about that too, and what it means for your medical is decided case by case. The FAQ says the AME weighs the diagnosis, how severe your symptoms are now, and related risk factors, then either issues the medical without further FAA review or defers the case to the FAA.
The changes since 2024, which have continued through 2025 and 2026, have broadened what AMEs can handle at the exam without further FAA review, particularly for several anxiety and depression diagnoses. In December 2025, the FAA also cut the time you must be on a stable antidepressant dose before it will consider a Special Issuance, from six months to three. Under the AME Guide’s disposition table for anxiety and depression, an AME can issue a medical at the exam for some of these diagnoses even while you’re in talk therapy, as long as no mental health medication has been taken, prescribed, or recommended for you in the past two years.
The same therapy FAQ also says not to fly if your symptoms are severe enough to impair your concentration, judgment, or emotional stability. The right answer for you is one your AME and AOPA Pilot Protection Services should help you reach.
HIMS, the Human Intervention Motivation Study, is a program for commercial pilots with alcohol or substance use problems that coordinates their treatment and their return to the cockpit. If you want a medical certificate while taking an approved antidepressant, the FAA’s antidepressant guidance requires an evaluation by a HIMS-trained AME.
If your situation looks like one HIMS would cover, I’ll tell you so, and we’ll think together about what that pathway involves and who the right professionals are to bring in.
Special Issuance, authorized under 14 CFR 67.401, is the mechanism the FAA uses to grant a medical certificate to a pilot who would otherwise not meet a specific medical standard, when the pilot can demonstrate they can perform their duties safely. It carries conditions, documentation requirements, and periodic re-evaluation. It is used both for conditions that require case-by-case review and as the pathway back to certification for some pilots with specifically disqualifying conditions. At the end of 2024, about 40,000 active airmen, roughly 6 percent of all FAA medical certificates, were flying under Special Issuance, including about 21,000 with first-class medical certificates (FAA 2024 statistical handbook).
Whether your situation would lead to Special Issuance, and on what terms, is case-by-case. AOPA Pilot Protection Services and your AME are the right people to map out the specifics. I can talk through the options and the trade-offs with you.
That worry is worth thinking through carefully rather than dismissing.
The FAA’s own therapy FAQ encourages pilots to seek help early, before conditions get severe. In April 2024, an FAA advisory committee on pilot and controller mental health made 24 recommendations in its report. Since then, the FAA has added therapy and counseling guidance to the AME Guide in May 2026 and created a new AME-assisted Special Issuance for anxiety and depression in July 2026. It has not adopted the committee’s recommendation that talk therapy no longer have to be disclosed: the May 2026 therapy FAQ still asks pilots to report therapy visits.
Current FAA medical standards list four specifically disqualifying mental conditions: psychosis, bipolar disorder, severe personality disorder (one that has repeatedly manifested by overt acts), and substance dependence. The same rule also bars substance abuse within the preceding two years, which is a separate item from dependence, and gives the Federal Air Surgeon discretion on other conditions.
“Specifically disqualifying” is a regulatory term and does not always mean permanently disqualified, but the pathway back varies sharply by condition. For commercial pilots with substance dependence, HIMS is a structured route back to flying that involves the airline, the FAA, and peer pilots, and the program reports that more than 4,500 professional pilots have been successfully rehabilitated and returned to their careers (HIMS). For bipolar disorder, psychosis, and severe personality disorder, the AME must deny or defer, and you can ask the FAA for a Special Issuance, which the FAA decides case by case (AME Guide). It is not a pathway to plan a return-to-flying timeline around without AOPA Pilot Protection Services and your AME involved. Most other concerns, including depression, anxiety, and PTSD, are considered case-by-case rather than automatically disqualifying. The FAA’s own published figures put final denials at about 0.1 to 0.2 percent of applicants who disclose a health issue and complete the process. Initial disqualification for mental health diagnoses is more common: the FAA’s advisory committee put that rate at about 20 percent.
A good next step is to get clear on what you’re dealing with and which frame fits, and to ask AOPA Pilot Protection Services and your AME what disclosure would involve for your situation before you file.
Yes, as your own client, for your own life. That can be therapy in Michigan or Ohio, or coaching anywhere. What I don’t do is family-of-pilot consultation, where the goal is managing the pilot’s situation from the outside. If what’s going on in your life runs through aviation, the schedule, the medical fear, the HIMS structure, I already know what those mean.
Go to the source
The information on this page comes from public sources, and the sources are better than any summary of them. These are the ones worth reading directly.
The FAA’s own answers, published May 2026, on what therapy means for your medical and what the FAA actually sees.
The public guide AMEs work from, including the mental health sections and a change archive that shows what moved and when.
The right first call for questions about your certificate, disclosure, and enforcement matters.
The committee’s 24 recommendations to the FAA on the barriers that keep pilots and controllers from seeking care for mental health issues and reporting them.
The program for commercial pilots with alcohol or substance use problems, from treatment to the return to flying.
Support for partners and family members of pilots in recovery, built around the HIMS-program experience.
ALPA runs a Pilot Peer Support line staffed by trained pilot volunteers, and the Allied Pilots Association runs Project Wingman; ask your own union what it offers. The Pilot Mental Health Campaign lists the airline peer support lines. For a crisis, call or text 988.
For air traffic controllers: the union’s critical incident stress management team, call or text 202-505-2476. On call around the clock, with calls returned.
Call or text 988. Free, confidential, 24/7.
1-800-662-4357. Free, confidential, 24/7 referral line for mental health and substance use.
FAA policy moves. This list and the framing on this page were last reviewed against the AME Guide in September 2026 and get re-checked at least annually.
What working with me looks like
Start with the contact form: a few questions, then your first name and email. Within 48 hours you get a link to book a free 20-minute call, by phone or video.
Nothing on this page is legal or medical certification advice. FAA policy and guidance change over time; the framing here reflects public guidance as of September 2026 and isn’t a substitute for current information specific to your situation. For specific questions about your medical, AOPA Pilot Protection Services and your AME are the right people to talk to.