Comprehensive Psychiatric Evaluation & Ongoing Treatment

COMPREHENSIVE PSYCHIATRIC EVALUATION & ONGOING TREATMENT

Good psychiatric treatment begins with understanding what we are treating.

CNY Psychiatry provides two related pathways of care: specialty psychiatric consultation for patients being evaluated for TMS, IV ketamine, or Spravato®, and insurance-based ongoing psychiatric care through our psychiatric clinicians.

COMPREHENSIVE PSYCHIATRIC EVALUATION

A psychiatric evaluation may include review of current symptoms, previous diagnoses, medication history, psychotherapy history, prior treatment response, medical conditions, sleep, substance use, family history, functional impairment, and the patient’s goals for treatment.

The purpose is not simply to assign a diagnosis.

It is to understand the clinical picture well enough to determine what treatment makes sense.

WHEN TREATMENT HASN’T WORKED

Repeated treatment failure deserves reconsideration.

Was the diagnosis correct? Were previous medication trials adequate? Was treatment limited by side effects? Has appropriate psychotherapy been tried? Are trauma, anxiety, obsessive symptoms, bipolarity, sleep disturbance, substance use, medical illness, or other factors complicating recovery?

Sometimes the next step is another medication.

Sometimes it is a different form of psychotherapy.

Sometimes it is TMS, Spravato, or IV ketamine.

And sometimes the most important intervention is reconsidering what we think we are treating.

SPECIALTY CONSULTATION FOR TMS, KETAMINE, OR SPRAVATO

Dr. Jason Stepkovitch provides insurance-based psychiatric consultations for patients with specific interest in TMS, IV ketamine, or Spravato.

The consultation is not simply a procedural screening visit. It is an opportunity to review with you the diagnosis, treatment history, symptoms, functioning, medical considerations, and available evidence and determine whether the requested treatment, or another approach, makes the most clinical sense. Patients do not need to transfer their ongoing psychiatric care to CNY Psychiatry to receive a specialty consultation or interventional treatment.

ONGOING PSYCHIATRIC CARE

Patients who need longitudinal psychiatric treatment may receive ongoing medication and psychiatric follow-up through CNY Psychiatry’s insurance-participating psychiatric nurse practitioners, according to availability and insurance participation.

Ongoing care includes medication treatment, monitoring of symptoms and functioning, assessment of side effects, diagnostic reconsideration when appropriate, and coordination with other clinicians.

CNY Psychiatry offers psychodynamically oriented Ketamine-Assisted Psychotherapy (KAP) in-house with Georgian Mustata, MD, while continuing to encourage evidence-based psychotherapy and collaboration with community therapists. Patients who already have a therapist do not need to transfer psychotherapy to our practice.

SHARED DECISION-MAKING

Treatment decisions should be made with patients, not simply for them.

We discuss the rationale for recommendations, expected benefits, limitations, risks, alternatives, regulatory status when relevant, and practical considerations such as time, transportation, insurance, and cost.

A patient should understand not only what we recommend, but why.

COORDINATED CARE

Psychiatric care does not need to occur in isolation.

With patient consent, we can coordinate with therapists, primary care clinicians, psychiatrists, psychiatric nurse practitioners, and other healthcare professionals involved in treatment.

Specialty treatment should strengthen a treatment team, not unnecessarily replace one.

GETTING STARTED

Some patients know exactly why they are contacting us. Others simply know that their current treatment is not working well enough.

Both are appropriate. You do not need to decide whether you need medication treatment, TMS, ketamine, or Spravato before contacting us.

Helping determine that is part of the evaluation.

Request a Psychiatric Consultation