From below, this route appears to be a very ominous dark gash into the middle of the mountain. It is not at all inviting, and yet we found it to be simultaneously irresistible.
The route difficulty depends a lot on the conditions. The first ascent was put up in September, when it sounds like the ice was snot thin, and there was a lot of rock climbing on dubious stone. We did the route at the end of May, and found copious amounts of snow and fat ice, although we did still have to climb some rock as well.
I will describe the route as we found it at the end of May 2014. For the AAJ account of the first ascent, see this link: publications.americanalpineclu...
From the north face cirque, climb steep snow or alpine ice to the base of the gash (about 2 pitches). Once in the gash, we found fat ice leading up to a large "snow chockstone". This overhanging snow obstacle was about 15 feet high. Some mixed moves and stemming between the chockstone and rock wall on the right lead to a tricky mantel onto the snowy blob. Above this was a rock chockstone, which was surpasses by more mixed moves involving, rock, ice, and snow. We belayed just above this chockstone using nuts and pins placed on the left wall. The final pitch consisted of slightly lower angle ice and snow up the shaft to the cornice on top, which was pulled with some more fun mixed moves.
Follow the ascent as noted on the North Face of Mt. Borah page up the Rock Creek Drainage until you get a view of the north face cirque. Psycho Therapy climbs the obvious dark gash in Borah's northwest ridge, far to the right of the actual summit.
Note that I have also included a photo on an alternate, shorter (but sketchy) approach.
Descent: From the top of the shaft turn right, and down-climb the exposed 4th class northwest ridge (which quickly turns and heads due north). Eventually you will get to a large scree field. If you follow this scree field down to the northwest, you will eventually end up on a sub-ridge which will take you down to Rock Creek a short ways upstream from the parking area.
Alternatively, from the top of the route, you could continue to climb Mount Borah's northwest ridge (supposedly class 4) all the way to the summit, and then descend as per the description on the North Face route page. Note that this route tops out far down the ridge from the summit, so this would likely add a lot of time to your day.
Knifeblades, small nuts, and ice screws.