If you are experiencing a mental health emergency, please call 911
or go to the nearest hospital emergency room now.
Diagnostic Evaluation
The Evaluation
The first step for every new patient involves a thorough psychiatric evaluation. This process begins with an online intake questionnaire that must be completed prior to your initial appointment. This helps gather the basic information such as your main concerns & stressors, medical history, psychiatric history, and social background.
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Following this, we will spend 60 to 120 minutes together, where I can hear directly from you about the experiences leading you to seek treatment. Since the intake questionnaire is comprehensive, we can use this time to elaborate on and clarify your responses. My aim is to gain a deeper understanding of not only your symptoms but also your identity and connection to the world around you.
The Assessment
The assessment encompasses pertinent psychiatric and medical diagnoses, and may include conditions that still require further investigation. I utilize terminology from the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the World Health Organization’s ICD-10/11 in my documentation for two main reasons: 1) these resources provide a shared language that facilitates our discussions about next steps, and 2) if you are submitting claims to your insurance, they require this specific coding.
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But I recognize that you are much more than a list of diagnostic codes. Assigning a diagnosis based on checking off a list of symptoms in no way accounts for the context of your life. It is necessary to distinguish between genuine psychiatric disorders and expected psychological reactions to challenging situations. This initial interview marks the beginning of a collaborative exploration, and may generate more questions than answers. As Psychiatrist Allen Frances, MD said, "...a diagnosis should be written in pencil."
The Plan
The information gathered will help in formulating an initial treatment plan. It is essential to ensure that your concerns and personality align well with a dynamic approach to therapy and medication. This plan may encompass various aspects, such as:
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recommendations for psychotherapy and/or medications,
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referrals for evaluations by medical specialists,
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guidance on beneficial lifestyle changes, and
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requests for further lab tests or imaging.
We will review this plan together before making a mutual decision on whether to proceed with working together.​​
Not a Good Match?
There may be several reasons for choosing not to work together after the initial evaluation, the most common being:
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the patient-physician relationship does not feel like a good match,
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a different level of treatment is more appropriate, or
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an alternative therapeutic skill or approach is more suitable.
It’s essential to note that if either the physician or the patient decides not to move forward with treatment, the full evaluation fee remains applicable. Resources for finding a different mental health professional can be accessed here.