The comprehensive psychiatric evaluation is necessarily thorough. We will discuss the parents’ interpretation of the teen’s symptoms as well as the teen’s interpretation of their own symptoms. Obtaining information about the teen’s developmental history, prior psychiatric evaluations and treatments, interpersonal relationships, and academic performance will allow me to formulate a diagnosis and recommend a treatment plan. The evaluation is divided into 3 sessions:

• Parent evaluation session (45 min.)

• Teen evaluation session (45 min.)

• Wrap-up session with teen and parents (45 min.)

*All services can be provided virtually or in-office.

Based on the evaluation, I may recommend that the teen see me for psychotherapy. My approach to psychotherapy depends on the individual needs of the patient, but I am largely informed by evidence-based psychodynamic principles (i.e., examining the patient’s relationships, including their relationship with me, to untangle defense mechanisms that are keeping the patient “stuck”). My casual interpersonal style and use of humor allow me to connect with my patients and facilitate a nonjudgmental exploration of their current challenges in life. If a specific modality of psychotherapy is indicated (e.g., DBT, CBT, EMDR) I will refer the patient to a therapist who provides that service.

• Psychotherapy begins with once weekly 45-minute sessions.

• Depending on patient progress, we can increase or decrease the frequency of sessions.

*All services can be provided virtually or in-office.

When indicated, I may recommend starting a patient on a medication. Some patients see me for medication only, while others see me for both psychotherapy and medication management. I am judicious about starting a patient on medication. Informed consent from parents and patient is required. My medication management sessions include elements of psychotherapeutic principles, rather than being just brief check-in sessions. I incorporate parent feedback into my assessment of medication efficacy.

• Medication management follow-up sessions are up to 30 minutes; frequency of visits depends on clinical indication.

• For patients on a stable medication regimen (including patients on controlled substances such as stimulant medications), follow-up sessions can be spread out to once every 3 months.

*All services can be provided virtually or in-office.

The parents’ assessment of their teen’s symptoms and response to treatment is vital in adolescent psychiatry. I find that regular but brief (15 min.) phone call check-in’s with parents are usually sufficient for me to get a sense of patient’s progress. Outside of these scheduled phone calls, I maintain an open-door policy with all parents, encouraging them to update me with any new concerns that arise.

In complex cases, I may recommend a session with parents to discuss concerns that can’t be adequately addressed in a 15-minute phone call. For example, when safety concerns come up, a parent support session will most likely be indicated.

• Parent support sessions are up to 45 minutes in duration; frequency depends on clinical indication.

*All services can be provided virtually or in-office.

Although I do not provide weekly family therapy, dynamics between parents and teen may require a family therapy session to help facilitate healthy communication. For cases with complex family dynamics, I may recommend more frequent family therapy with another provider.

• Family therapy sessions are 45 minutes; frequency depends on clinical indication.

*All services can be provided virtually or in-office.

An integral aspect of the psychiatric evaluation and treatment of teens is the coordination of care. I collaborate with a patient’s individual therapist, school representatives, executive function coach, pediatrician, and other relevant parties to ensure that my understanding of the patient is as comprehensive as possible.

Patients occasionally require letters from their psychiatrist to support various needs, such as school or work accommodations, leave of absence requests, and support letters for medical/surgical transition for some transgender and nonbinary patients. I provide this service to patients who see me for psychotherapy or medication management.