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Why Private Practice Looks So Different Now | Lex E Santí | TPOT 433
Description
Private practice has changed a LOT over the last few years… and therapists are still trying to figure out what comes next.
In this episode, Gordon talks with Lex E. Santi about the evolution of therapy after telehealth, online platforms, insurance shifts, and changing client expectations. They dive into why more clinicians are entering private practice, why clients still crave in-person connection, and how companies like BetterHelp, Alma, and Headway are reshaping the profession.
They also explore the pressure therapists feel to market themselves, build niches, and create an online presence in a rapidly changing industry. Toward the end of the conversation, Lex shares how writing, narrative therapy, mindfulness, and storytelling intersect in his clinical work and creative life.
Resources Mentioned In This Episode
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Meet Lex E Santí
Lex Enrico Santí is a therapist, clinical supervisor, and the founder of A Key Therapy PLLC, where he works at the intersection of evidence-based practice and the deeper human questions that bring people into therapy in the first place. Trained as a licensed clinical social worker and currently completing his doctorate at the University of Kentucky, Lex brings a grounded, integrative approach to his work — drawing on modalities like CBT, ACT, and mindfulness alongside his own framework for healing he calls the AMI model.
The son of Cuban immigrants and a former Peace Corps volunteer in Romania, Lex carries a lifelong fluency in crossing cultures — literally and emotionally. He speaks three languages and brings that same attunement to difference, displacement, and belonging into his clinical work. In the therapy room, he holds space for individuals navigating anxiety, identity, and the transitions that quietly reshape a life. He also supervises emerging clinicians, teaches workshops on meditation and understanding anxiety, and is building A Key Therapy into a group practice rooted in presence, curiosity, and care. He believes that good therapy — like good writing — is about learning to tell a truer story about yourself.
Beyond the therapy room, Lex is a published author with an MFA in Creative Writing from George Mason University — the author of four books of poetry and a collection of short stories and essays. A meditator and someone who thinks seriously about the spiritual dimensions of mental health, he lives in the Finger Lakes region of New York with his family. He is a proud husband, father, and has another child on the way.