ADHD Coaching

ADHD coaching can be an important part of a comprehensive treatment program for individuals with ADHD. ADHD coaches educate clients regarding this disorder. They reframe negative beliefs, identify individual learning styles, and develop systems and strategies to overcome strategies. Individuals with ADHD struggle with time management, organization, impulsivity, and procrastination. Coaching offers individualized and action-oriented approaches to combat these issues. Coaches are focused on developing productive habits and systems that lead to more productive lives. Several of our RCBM therapists have expertise in ADHD coaching. 

Read more about ADHD coaching


ADHD Medication Management

Medications are useful for ADHD along with ADHD Coaching. The Rochester Center for Behavioral Medicine prescribes many different medications and will work with you to develop an appropriate medication treatment plan. RCBM has been involved in many clinical trials that have studied the different types of ADHD drugs (stimulants and non-stimulants) to treat ADHD symptoms. Many of the medications currently available for the treatment of ADHD have been tested through clinical trials at the Rochester Center for Behavioral Medicine.


CBT-I

Over 50% of adults report difficulty sleeping, half of which suffer with chronic sleep difficulty. We now know that medications are not the only solution to insomnia and that it is possible to successfully treat insomnia using cognitive-behavioral therapy (CBT). CBT has been endorsed by the National Institutes of Health as an effective method for treating insomnia. Research on CBT shows the following:

  • 75% of insomnia patients experience significantly improved sleep
  • The majority become normal sleepers
  • 85- 90% reduce or eliminate sleeping pills

CBT achieves these results because it is based on the idea that insomnia is treated effectively by addressing the underlying causes of insomnia-related thoughts and behaviors, which are learned and can be unlearned.

CBT-I COMPONENTS
Techniques taught in CBT-I include:

  • Changing sleep thoughts and behaviors
  • Lifestyle habits that improve sleep
  • Relaxation techniques

WHO WOULD BENEFIT

  • Individuals with problems falling asleep, waking during the night, or waking too early
  • Individuals who wish to avoid, reduce, or eliminate sleep medications

VISITS
CBT for insomnia includes:

  • Five individual treatment sessions over a six-week period (Sessions 1-3 once per week, skip a week, session 4, skip a week, session 5)

INSURANCE COVERAGE
CBT-I is billed as a psychotherapy visit

PARTICIPANT REPSONSIBILITIES

  • Weekly reading in book that participant purchases called “Say Goodnight to Insomnia”
  • Weekly reading of the session summary handout that accompanies the book
  • Daily writing of sleep information in “sleep diary” log
  • Daily writing of a negative and positive sleep thought on provided "thought log"
  • Practicing guided relaxation using MP3 audio provided via email
  • Practicing sleep modification behaviors and other habit changes as guided by the program



Cognitive Behavioral Therapy


The Rochester Center for Behavioral Medicine uses Cognitive Behavioral Therapy (CBT) for the treatment of anxiety and depressive disorders. This therapy combines behavioral exposure therapy along with cognitive restructuring to help enable the patient to confront avoidance, correct negative automatic thoughts, and return to optimal functioning.


CBT is particularly effective for the Anxiety Disorder spectrum, such as Panic Disorder, Post Traumatic Stress Disorder, Obsessive Compulsive Disorder, Social Anxiety Disorder, and Specific Phobias. The hallmark of CBT is the patient’s role in learning and practicing skills outside the session, to maximize the therapeutic benefit of this therapy. In mood disorders, the patient will learn coping skills to master tasks often thought too arduous for the depressed patient. The use of CBT with or without medication management is addressed, and the ultimate decision is made between the patient and the RCBM Professional.


Comprehensive Psychiatric Evaluation & Second Opinions


The Rochester Center for Behavioral Medicine offers independent psychiatric examinations. This can be helpful in challenging cases where a new diagnostic perspective is necessary.


Examinations are performed regularly by RCBM Medical Director, Joel L. Young, MD. Often other RCBM services such as psychological testing or the Dementia and Cognitive Evaluation Program are helpful in the diagnostic process. If treatment is needed, a myriad of services is available at RCBM such as Individual therapy, Marital and Conjoint therapy or Cognitive Behavioral Therapy. Please contact RCBM at 248-608-8800 to schedule an evaluation.


Dementia / Cognitive Evaluations


For some patients, it is important to assess cognitive functions such as memory, recall, alertness, and overall aptitude. This is formally done by neuropsychological and psychological testing.


This type of testing can be ordered following medical illness such as stroke or other brain-based diseases such as Parkinson's Disease or Multiple Sclerosis. Psychological testing is also ordered to evaluate dementia. Dementia is the diminution in cognition and memory. It is associated with the aging process. The most common type of dementia is of the Alzheimer's Type. These are important diagnoses to make early on. Some dementias are reversible if caught early. For other types, such as Alzheimer’s and vascular dementias, newer cognitive enhancing medications are available which can improve functioning and prolong quality of life.


Diagnostic Screening and Assessment Services

The Rochester Center for Behavioral Medicine is committed to an accurate diagnosis. We believe that before appropriate treatment can be implemented (medication, psychotherapy, nutrition therapy), it is imperative to identify the extent and severity of your respective mental health condition.


Diagnostic screening often plays a vital role in this process. We have developed RCBMetrics, a protocol designed to assist us in treating you. RCBMetrics uses a variety of standardized psychological and educational testing batteries. The screening process is conducted completely online, from the comfort of your own home. RCBMetrics uses secure, web-based platforms to administer the rating scales, online. 

RCBMetrics quantifies the extent of many conditions, including anxiety disorders, depression, ADHD and its various subtypes, substance use disorders, eating disorders, and personality disorders. For children and adolescents, neurocognitive functioning can also be assessed remotely as part of diagnostic screening. Other aspects of RCBMetrics can assess and offer guidance regarding career planning.


RCBMetrics is particularly useful for the assessment of comorbidities. Comorbidities occur in 25% to 45% of individuals with ADHD. Common ADHD comorbidities include anxiety disorders, depression, and learning disorders. Input from teachers and family is also included in your final report that is generated upon completion of RCBMetrics. 

RCBMetrics cannot rule out learning disorders or cognitive impairments. A referral for a full psychological evaluation by one of RCBM’s psychologists to address concerns about those conditions will be made if appropriate. RCBM offers diagnostic screening (behavioral rating scales) to screen for the presence of Autism Spectrum Disorder (ASD) symptoms. Often, screening for symptoms of ASD along with a clinical interview can be valuable information for treatment planning and goal setting. If the clinician believes that the screening results may be indicative of ASD, and a formal medical diagnosis is needed, a referral for a full ASD evaluation will be made. *Please note that we are unable to complete full ASD evaluations at this time.

Your RCBM clinician will meet with you to review your results and develop a comprehensive treatment plan, including medication management, psychotherapy, medical nutrition therapy, and/or coaching.

 

Diagnostic screening done outside of RCBM may be considered sufficient, provided that the testing has been done recently and includes assessment of the following conditions:

-Depression (including an assessment of suicidality)

-Bipolar Disorder

-Anxiety Disorders

-Fatigue

-Substance Use

-Eating Disorders

-AD/HD (Objective testing is required, including assessment of processing speed, psychomotor speed, executive function, complex attention and cognitive flexibility).

-Autism Spectrum Disorders

Read more frequently asked questions about Diagnostic Screening 


Screening Timeline


Diagnostic Screening and Assessment Services FAQs

The following information contains frequently asked questions regarding our diagnostic screening. If you have already been referred for Diagnostic Screening and Assessment Services, and have additional questions after carefully reviewing the FAQs below, please contact your Screening Team Psychometrician directly via their email address.

FAQs

About Diagnostic Screening

About Diagnostic Screening

All assessments are currently completed online from the comfort of the patient’s home, for all age groups. RCBM is NOT conducting in-office screening at this time.

Adults (18+)

Self-Report Data: Adult patients will complete two or three parts total. Part 1 contains 1 weblink; Part 2 contains 5-7 links.

Observer Data: Data is also collected from one other person in the Adult patient’s life who knows them well. This person is referred to as an “Observer” for screening purposes and is usually one’s partner, roommate, parent, or best friend. The “Observer” completes two short assessments based on their observations of you, the patient.

Children and Teens (ages 8-17) 

Self-Report Data: 

  • Children (ages 8-10) typically complete the screening in two parts (one email containing 3-4 links; and a second email, if applicable, containing 1 direct assessment).
  • Children (age 11) and Teens (ages 12-17) typically complete the screening in two or three parts. Part 1 contains 1 link; Part 2 contains 2-5 links; and Part 3 (if applicable to you), contains 1 direct assessment link.

Parent Data: We ask each parent to complete several assessments about their child’s behavior and functioning. Each parent will receive their own set of screening materials in 2 parts: Part 1 contains 1 link; Part 2 contains 2-3 links. Each parent should complete their set of assessments individually. 

Teacher Data: Your child's teacher will be asked to complete two to three rating scales about your child's behavior and functioning in their current academic setting. Please see the "Teacher Data Collection" FAQ's section for RCBM's teacher data collection requirements.

Young Children (ages 4-7)

Self-Report Data: No Self Report assessments are completed by children in this age group. 

Parent Data: We ask each parent to complete several assessments about their child’s behavior and functioning. Each parent will receive their own set of screening materials in 2 parts: Part 1 contains 1 link; Part 2 contains 2-3 links. Each parent should complete their set of assessments individually. 

Teacher Data: Your child’s teacher will be asked to complete two to three rating scales about your child’s behavior and functioning in their current academic setting. Please see the “Teacher Data Collection” FAQs section for RCBM’s teacher data collection requirements.

What is the Timeline for Diagnostic Screening?

·         Please review the timeline in this link

I do not have a computer. But I do have an iPad/tablet or iPhone, can I still complete the screening assessments?

● All of the assessment links can be completed on an iPad/tablet except for the CNS Vital Signs.  (i.e., Part 3 for some children and adolescents ages 8-17). The CNS Vital Signs assessment must be completed on a computer in order to run properly. Please do not use a cell phone to complete the diagnostic screening assessments. 


What is the Difference in a Comprehensive Psychological Evaluation & Diagnostic Screening?

What is the Difference in a Comprehensive Psychological Evaluation & Diagnostic Screening?

I am requesting an evaluation to determine if I have a specific learning disorder, an intellectual disorder, or autism spectrum disorder. Does Diagnostic Screening meet these requirements?

  • RCBM’s Diagnostic Screening is the first step toward a full psychological/psychoeducational evaluation. It provides some of the required documentation for Specific Learning Disabilities, Intellectual Disorder, and Autism Spectrum Disorder and it helps ensure that a full evaluation is necessary.
  • In other words, Diagnostic Screening can rule out these conditions, but it is insufficient to diagnose (or confirm) these conditions are present for you.
  • The results from your diagnostic screening will be reviewed at your results appointment by your licensed mental health clinician. If further evaluation is warranted for one of these conditions, the screening data will be used in conjunction with a full evaluation conducted by one of our licensed psychologists.
  • Additional assessments that are completed through the Comprehensive Evaluation process, may be necessary to meet the accommodation requirements set forth by the organization that you are requesting accommodations at, such as your college or university.
  • Psychological Evaluations are NOT billable to any insurance.


For more information on our Comprehensive Psychological Evaluation services and the role of Diagnostic Screening in this process, please visit the links below.

After reviewing the information above, please contact RCBMetrics’ Director Dr. Jill Fortain, PhD, LP (jfortain@rcbm.net) and Dr. Ashley Ceresnie, PhD, LP at (aceresnie@rcbm.net) for additional information and consultation services regarding Psychological Evaluations.

*Please note that we are unable to complete ASD evaluations at this time.


Billing and Payment

Billing and Payment

What does screening cost and does my insurance cover it?

Full payment is expected to be rendered upon completion of screening. The cost you are responsible for will be reflected on your monthly billing statement, or you can view your account balance by logging into the Patient Portal, shortly after screening is completed. It is the patient’s responsibility to contact the RCBM Billing Department prior to completing this screening contract at billing@rcbm.net to make payment plan arrangements, if desired or necessary. 

Insurance coverage of diagnostic screening (procedure codes 96138 and 96139) varies by plan. If it is covered, please note that you will be responsible for your deductible and one co-pay/coinsurance per unit (half hour) of screening. If it is not covered, you will be responsible for payment according to RCBM's Private Pay fee schedule.  

Ultimate payment responsibility rests with the patient.        


Is Diagnostic Screening billable to my insurance?

Diagnostic Screening at RCBM is a billable service to certain BCBS-PPO, BCBS-Federal, Aetna, Cigna, and Medicare Plus Blue plans only*.

  • *Please be aware of mental health carve outs: Some insurance policies have a “carve out” where mental health benefits are provided through a contract with a separate provider or insurance company. For example, some BCBS medical insurance plans have a carve out where all mental health claims are submitted and processed by Beacon Health Options. Our screening is NOT billable to Beacon Health Options and therefore patients with this carve out plan will be responsible for the Private Pay fee for Diagnostic Screening.
  • *BCBS PPO through Ascension typically does NOT cover the diagnostic screening provided by RCBM. The Billing Department will bill Ascension BCBS for the diagnostic screening, however please note that if the claim is denied, you will be responsible for the out-of-pocket cost of the screening.
  • *Note that ONLY Medicare through BCBS - the Medicare Plus Blue plan - is billable for screening. Screening cannot be billed to any other Medicare plans.


This is NOT a guarantee of benefits or payment. If your insurance company is billed and you have not met your deductible, you can expect to pay anywhere from $150.00-$400.00, depending on the services performed and the patient's age.

Private Pay Rates: If your insurance carrier is not listed above, RCBM is *not able to bill* your diagnostic screening to your insurance, and you will be responsible for the Comprehensive Diagnostic Screening Private Pay rate of $350.00 for individuals ages 8+; $250 for individuals ages 4-7.


The contract states Diagnostic Screening is not billable to my insurance, but I called my insurance company and they said that it is billable. So is it billable?

  • RCBM’s Diagnostic Screenings are conducted by trained psychometricians under the supervision of Joel L. Young, MD, Medical Director. RCBM’s psychometricians are responsible for scoring the data and compiling it into the patient’s diagnostic screening report. Some insurance companies only cover screening or assessment services completed by a licensed mental health clinician (e.g., LP, LLP, LMSW, LPC, etc.) and do not cover assessments completed by psychometricians.
  • If our website states that we are unable to bill your insurance, your insurance does not cover diagnostic screening completed by trained and supervised psychometricians.
  • If the 96138 and 96139 codes are a covered benefit on your insurance plan, but are not billable to your insurance by RCBM (because we are not “in-network” for screening/evaluation services specifically), you have the option of finding an in-network provider to perform the screening. *If you proceed with the Screening at RCBM, you are responsible for out-of-pocket payment of this service.*

·       *Note. All diagnostic interpretations are made by one of RCBM’s licensed clinicians.


Diagnostic Screening was once billable to my insurance but according to the contract, now it is not billable. Is this correct?

  • Diagnostic Screening billing codes and contracts may change. If our contract indicates that this code is not billable to your insurance, this is the most current information we have.


What if I cannot pay for screening and do not want to proceed due to the cost of Diagnostic Screening?

  • RCBM offers payment plans and options that suit your individual needs. Please contact our billing department at billing@rcbm.net to discuss payment plan options.
  • If you have contacted our billing department and do not want to proceed with screening, please contact your clinician regarding how this may impact your care and treatment planning. Please notify your assigned psychometrician via email so they may update your chart.

Observer Forms for Adults

Observer Forms for Adults

What are the Observer Forms? If I do not have anyone to complete the Observer Forms, can I still complete screening?

  • If you are an Adult and participating in diagnostic screening at RCBM, you will be asked to provide the name and email address for an “Observer” on the Screening Contract form.
  • Observer Data is collected from one person in an Adult patient’s life who knows them well. This person is referred to as an “Observer” and is usually a partner, roommate, parent, or close friend.
  • The “Observer” completes two short assessments about the Adult patient’s recent behavior and functioning.
  • It is very highly recommended that all Adults completing Screening provide the name and email address for an “Observer."”. This allows your clinician to look for patterns across reporters (you and the observer) in the screening data and can aid in obtaining an accurate diagnosis.
  • Please let your psychometrician know if you did not provide an Observer’s contact information on the Screening Contract, but would like to do so now. 

Teacher Data Collection for Children & Teens

Teacher Data Collection for Children & Teens

Why is teacher data so important for Diagnostic Screening?

We strongly encourage you to provide the contact information for one teacher on the screening contract. Your child spends several hours every day at school surrounded by peers and responding to a variety of task demands and unique situations not often encountered at home or in the community: Teachers provide valuable observations of your child’s daily behavior and functioning at school. 

At RCBM, we highly value teacher input for many reasons. Most notably, the teacher’s school-based data plays an important role in ensuring your child is accurately diagnosed and that appropriate treatments are recommended. In fact, the diagnostic criteria for some conditions actually requires that symptoms be present in multiple settings, such as both home and school. 

*Note: For some conditions, RCBM providers may require that teacher data be obtained as part of the screening process for some conditions/cases: The results may be delayed if not completed in a timely manner and/or some treatment options may be limited without teacher data. 

Where do I provide the contact information for my child’s teacher?

On the Screening Contract. Specifically, you will be asked to provide the name and email address of ONE teacher who knows your child well and ideally teaches a core/academic subject, such as math, language arts, or science. ‘

By providing the teacher's name and contact information on the screening contract, you are providing consent for us to contact them via email and ask them to complete a couple rating scales about your child

Who is responsible for making sure my child’s teacher completes their screening materials?

We send multiple reminders via email to your child’s teacher prompting them to complete the rating scales. However, Ultimately it is your responsibility to inform your child's teacher that 1) they will be receiving these rating scales via email from us and 2) that they have about 2 weeks to complete them online. Please notify your child’s teacher right after you complete the screening contract. 

Your child's results session may be delayed if the teacher rating scales are not completed within the two week timeframe.

My child is in middle school or high school and has many teachers. Do all of their teachers need to complete a separate Teacher Report form?

  • No. Please choose only 1 teacher that knows your child well and ideally, teaches a core/academic subject (i.e., math, language arts, science) to complete the assessments. You will be asked to provide this information on the Screening Contract form so we can email the teacher the materials directly. Please let your psychometrician know if you did not provide the name and email address for one of your child’s teachers, but would like to do so now. 
  • It is very highly recommended that we obtain Teacher Report data for your child. This allows your clinician to look for patterns across reporters (your child, you, the child’s other parent, and a teacher) and across settings (home, school, community) in the screening data and aids in obtaining an accurate diagnosis. 

Screening Contract & Assessment Materials

Screening Contract & Assessment Materials

I did not receive the Screening Contract and my clinician said that I would receive it shortly after my appointment. When can I expect this email to arrive?

  • Screening Contracts are sent to patients within 10 business days after the clinician refers a patient for diagnostic screening. 
  • If it has been more than 10 business days, please search your email for “ RCBM Screening Contract”  (don’t forget to check your spam/junk folder too!).
  • If you cannot find it, please contact RCBMetrics - our Psychological Screening and Evaluation department - at screeningteam@rcbm.net or TEXT 248-609-4483 with your name/patient's name or contact your clinician at their email address, to notify us that you have not received the Screening Contract yet and we will send/resend it to you the following business day.

I submitted the Screening Contract. When will I receive my Assessments?

  • You can expect to receive your diagnostic screening materials via email within 24 hours after we receive your signed Screening Contract form. The email will have “ RCBM Screening Materials - Part 1'' in the subject line. 
  • If it has been more than 1 business day, please search your email for RCBM Screening Materials”  (don’t forget to check your spam/junk folder too!).
  • If you cannot find it, please contact RCBMetrics - our Psychological Screening and Evaluation department - at screeningteam@rcbm.net, or contact your clinician at their email address, to notify us that you have not received the Screening Contract yet and we will send/resend it to you the following business day.

I  completed Part 1 of my screening assessments but have not received Part 2 or 3

  • Please search your email for “RCBM Screening Materials - Part 2” or “RCBM Screening Materials - Part 3” (don’t forget to check your spam/junk folder too!).
  • If you still cannot find it, please contact the psychometrician who sent you the Part 1 materials directly so they can troubleshoot with you. 

The Assessment link(s) I was sent is not working. What should I do?

  • First, please make sure you are completing the assessments in Google Chrome, as they work best on this web browser. Check that the web browser window is fully expanded so you can view all the screen contents.
  • If the assessment continues to report errors, please clear your browser history and cookies and then re-try the links.
  • If the problem persists, please contact your psychometrician at their email address and they will troubleshoot the issue promptly.

Scheduling a Results session and Obtaining the Screening Report.

How soon after I complete screening will I be contacted to schedule my Results appointment?

  • After you complete all of the assessments, you will receive a phone call from the RCBM front office to schedule your results appointment.
  • You will receive this phone call within 5 business days from the date you submitted your final assessments (excluding holidays).
  • If you believe you have completed all of the assessment links and have not received a call to schedule your results appointment after 5 business days, please 1) Review the original email sent to you by your psychometrician and double-check that you have completed all the assessment links and then 2) Contact your Psychometrician via email to confirm all assessments have been completed.

When will I receive a copy of my Diagnostic Screening Report?

  • You will be emailed a copy of your report after your results session with your RCBM clinician. If you do not receive a copy of your report via email after your session, please email your psychometrician.
  • Please note that you must meet with an RCBM clinician to review your results before we can provide you the report.

Screening Timeline

Screening Timeline

​  Scheduling a Results session and Obtaining the Screening Report.

​  Scheduling a Results session and Obtaining the Screening Report.

How soon after I complete screening will I be contacted to schedule my Results appointment?

  • After you complete all of the assessments, you will receive a phone call from the RCBM front office to schedule your results appointment. 
  • You will receive this phone call within 5 business days from the date you submitted your final assessments (excluding holidays).
  • If you believe you have completed all of the assessment links and have not received a call to schedule your results appointment after 5 business days, please 1) Review the original email sent to you by your psychometrician and double-check that you have completed all the assessment links and then 2) Contact your Psychometrician via email to confirm all assessments have been completed.

When will I receive a copy of my Diagnostic Screening Report?

  • You will be emailed a copy of your report after your results session with your RCBM clinician. If you do not receive a copy of your report via email after your session, please email your psychometrician.
  • Please note that you must meet with an RCBM clinician to review your results before we can provide you the report.

Other Items & Non-Screening Related Issues

Other Items & Non-Screening Related Issues

I need to refill my prescription or I have a question about my prescriptions.

  • If you have questions regarding prescriptions and prescription refills, please contact your clinician directly at their email or email our Prescription Coordinator at prescriptions@rcbm.net
  • For Prescription Refills, please complete your refill request by clicking on the following link: https://www.rcbm.net/behavioral-medicine/prescription-refills/
  • What is the difference in a Comprehensive Psychological Evaluation & Diagnostic Screening?

I am requesting an evaluation to confirm or rule-out a specific learning disorder, an intellectual disorder, or autism spectrum disorder. Does this meet those requirements?

  • In most cases, RCBM’s Diagnostic Screening provides a portion of the required documentation and it is the first step towards completing the full psychological/psychoeducational evaluation.
  • The results from your diagnostic screening will be reviewed at your results appointment by your licensed mental health clinician and are typically used in conjunction with a full evaluation for these conditions.
  • Additional assessments that are completed through the Comprehensive Evaluation process, may be necessary to meet the accommodation requirements set forth by the organization that you are requesting accommodations at, such as your college or university.
  • Please contact RCBMetrics’ Director Dr. Jill Fortain, PhD, LP (jfortain@rcbm.net) and Dr. Ashley Ceresnie, PhD, LP at (aceresnie@rcbm.net) for additional information and consultation services regarding Psychological Evaluations.

For more information on our Comprehensive Psychological Evaluation services and the role of Diagnostic Screening in this process, please visit the links below.

●      https://www.rcbm.net/behavioral-medicine/services-detail-practitioners/Academic-and-Cognitive-Evaluations/

●      https://www.rcbm.net/behavioral-medicine/services-detail-practitioners/autism-spectrum-disorder-evaluation-program/

Find Programs and Services

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Grief/Loss/Coping with Illness Issues


Sudden loss of a loved one from a heart attack, stroke, homicide, suicide or accident, often presents many issues for those left behind. People who experience loss from divorce, chronic or terminal illness face a different type of grieving. There are also differences in how adults, children, men and women experience grief and loss.


RCBM clinicians are well-trained in helping individuals through the grieving process, whether grieving the loss of a loved one or coping with their own terminal illness. Some of the therapeutic interventions used at RCBM include techniques in relaxation, cognitive restructuring, stress management, goal setting, learning new coping skills, improving communication skills with loved ones as well as with medical personnel, and referral to community support groups. Each case is looked at individually and the type of loss is taken into consideration when a treatment plan is created. RCBM also offers the services of our Psychiatrist and Nurse Practitioners who can evaluate patients who may need medication as an adjunct to their therapy.


Grief/Loss/Coping with Illness Issues Professionals

C. Lynn Florek, MA, LLP, LPC
Grief/Loss/Coping with Illness Issues

C. Lynn Florek, MA, LLP, LPC

Ms. Florek is a graduate of Oakland University. She is licensed as a masters level psychologist and a licensed professional counselor. Her primary…
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Individual Therapy


Individual psychotherapy is an approach in which all therapists at Rochester Center are highly trained. Individuals receive assistance in addressing issues related to self, family, school and work. Clients who chose to participate in individual therapy work together with their therapist to gain insight and increase coping skills in order to improve general mental health.


At the Rochester Center for Behavioral Medicine (RCBM) therapists work closely with the Psychiatrists, Physician Assistants, Nurse Practitioners, and if your case involves our Registered Dietitian, in a therapeutic team approach. This provides a broader viewpoint of existing mental health issues. When deemed necessary by the mental health professionals at RCBM, psychiatric evaluations, medication management, and medical nutrition therapy, along with family or marital counseling may be recommended. 


The professionals at RCBM also encourage clients to take an active role in participating in their therapy. Therapists may also provide psychoeducation through the use of videos, bibliotherapy, and opportunities to attend seminars pertaining to individual mental health issues. Please view our  Professionals page to view the backgrounds and related interests of a particular therapist at RCBM.


Marital & Conjoint Therapy


RCBM offers marital and conjoint therapy sessions. Professionals at RCBM first carefully evaluate each member of the couple to ensure that no other condition is interfering with the marital or familial relationship. From there, individuals are brought together to begin conjoint therapy. Important steps in therapy include: reducing blaming and negativity within the couple or family; creating common goals toward which individuals can work (both and independently and together); and developing and implementing plans in order to accomplish these goals.


The therapist may help the couple or family with communication skills, coping techniques, patterns of interaction and any other important areas of stress. Further, therapists will help the individuals to generalize the skills they have learned in therapy so they are able to apply these techniques to any future difficulties that may arise. RCBM therapists are highly flexible and willing to adjust the process of therapy in order to best meet the needs of each couple and family. Confidentiality is a priority at RCBM, and the therapists work hard to ensure the privacy of everyone involved. If you are interested in becoming involved in marital or family therapy, please contact us at (248) 608-8800 to schedule an appointment.


Medical Nutrition Therapy


Medical Nutrition Therapy Services 

At RCBM, the nutrition therapy process includes a food and behaviors assessment, health and treatment history, interface with treatment providers, along with meal and treatment planning. A thorough assessment paves the way for a successful nutrition counseling experience. Review of food intake and behaviors, evaluating the meal plan, evaluation of laboratory work, and further information are provided at follow up appointments.


Medical Nutrition Therapy Services are available for, but not limited to: 

-Eating Disorders (Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, Other Specified Feeding and Eating Disorders - OSFED, Avoidant Intake Restrictive Disorder - ARFID)

-Polycystic Ovarian Syndrome (PCOS)

-Cardiovascular Disease and risk factors (Hypertension, Dyslipidemia, Diabetes Mellitus) 

-Gastrointestinal Disorders

-As an adjunct to depression, chronic-fatigue, fibromyalgia and ADHD management

-Picky eating in children

-Food, nutrient and medication interactions

Beverly Price, CEDRD-S, MA discusses the process of Medical Nutrition Therapy (MNT) and how current and prospective patients can access this service to work with our registered dietitians.


Medical Nutrition Therapy Professionals

Beverly Price, RDN, MA, CEDS-S, E200-RYT, C-IAYT
Medical Nutrition Therapy

Beverly Price, RDN, MA, CEDS-S, E200-RYT, C-IAYT

Beverly Price is a registered dietitian nutritionist who graduated with a Bachelor of Science degree in Dietetics and Human Nutrition from Michigan…
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Chelsea Carpentier, RDN
Medical Nutrition Therapy

Chelsea Carpentier, RDN

Chelsea Carpentier is a registered dietitian with a passion for helping individuals heal their relationship with food. Chelsea earned her…
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Ekaterina Malikov, RDN, MPH
Medical Nutrition Therapy

Ekaterina Malikov, RDN, MPH

Ekaterina (Katya) Malikov is a registered dietitian who earned her Master of Public Health in Nutritional Sciences from the University of Michigan…
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Jessica Grzybowski, RDN
Medical Nutrition Therapy

Jessica Grzybowski, RDN

Jessica Grzybowski is a registered dietitian nutritionist who graduated with a Bachelor of Science degree in Nutrition and Dietetics from Andrews…
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Medication Management

Many of the treatment plans developed at the Rochester Center for Behavioral Medicine include neuropsychiatric medication. When we prescribe these medications, we try to give you a full account of the potential benefits and some of the common side effects associated with these medications. Every RCBM prescriber (MD, PA or Nurse Practitioner) will be able to explain the medication management process to their patients. Typically, before medication is prescribed, the patient will undergo diagnostic screening to better understand the presenting issues. This will help your appointed prescriber to customize your treatment plan with the appropriate medication management solution. Each prescriber we have has an area of expertise. By clicking on their biography, you will be able to see the niche area of treatment for each prescribing clinician at RCBM.


Obsessive-Compulsive Disorder


Obsessive Compulsive Disorder (OCD) is an anxiety disorder that involves both obsessions (thoughts, images, or impulses that occur over and over again) and compulsions (acts that a person repeatedly performs in an attempt to make the obsession go away). The brain seems to get “stuck” on a thought or urge that they cannot move past. Individuals with OCD often have the sense that if that “obsession” continues without them taking part in any compulsions, the anxiety will become intolerable.


Cognitive Behavioral Therapy (CBT) is an empirically-validated therapeutic intervention that is often used to help individuals with OCD to manage their symptoms. CBT is a concrete, proactive and goal-oriented therapeutic style. With the help of our trained therapists, individuals with OCD can learn to control and even alleviate their obsessions and compulsions. Individuals will also learn coping strategies such as relaxation exercises and ways to challenge distorted thinking in an effort to reduce anxiety. Psychotropic medications may also be a part of the treatment plan for the individual with Obsessive-Compulsive Disorder.


Opiate Addiction


Non-medical use of opiates is dramatically increasing the United States (U.S.). Opiates include prescription drugs such as Vicodin and Oxycontin, as well as street drugs such as heroin. The misuse of and addiction to opioids—including prescription, pain relievers, heroin and synthetic opioids such as fentanyl—is a serious national crisis. Abuse of and dependence on opiates interfere significantly with work, relationships, and education.


At RCBM, we offer a collaborative approach to treating opiate-related struggles. Individuals with opiate addiction or dependence are evaluated and treated for other psychiatric problems which may be contributing to their opiate use. Suboxone is a medication used to aid in the cessation of opiate use while controlling withdrawal symptoms. Suboxone may be prescribed as a part of the treatment plan. Individuals on Suboxone are required to take part in counseling. Outside resources such as Narcotics Anonymous are also provided for additional support.


Overview of RCBM Services


The Rochester Center for Behavioral Medicine offers an array of mental health and substance abuse services in our comprehensive outpatient setting. Our practitioners work collaboratively within their expertise, through medication management, psychotherapy, and nutrition therapy, in order to deliver the highest quality care.


Parenting Techniques


It is not uncommon for RCBM clinicians to be faced with overwhelmed parents, many of whom have attempted to implement a variety of parenting techniques but have not found success. These failed attempts can lead to feelings of hopelessness and helplessness for these parents, which often exacerbate the problematic dynamics in the household.


The key elements include consistency and remaining calm, both of which can be difficult during stressful parenting situations. Our therapists at RCBM take into consideration the age of the child, the presenting concerns, and the family dynamics in order to tailor a treatment plan. Often, therapists will use a combination of techniques to meet their needs. These may include education about special considerations for their child along with exploration and practicing of parenting techniques. Sessions with the child alone, the caregivers alone, and the family together are all integral parts of the treatment plan.


Post-Traumatic Stress Disorder Treatment

Post-Traumatic Stress Disorder (PTSD) is an anxiety disorder which occurs after an individual has personally experienced or witnessed a dangerous and life-threatening event. Individuals who are at risk for developing PTSD include but are not limited to soldiers who have been in combat, survivors or witnesses of violent crimes (including rape, kidnapping, robbery), individuals who have lived through a natural disaster, and survivors of accidents or grave illness.

Eye Movement Desensitization and Reprocessing, (EMDR), is a treatment modality that has been helpful to people, who are suffering from the effects of trauma. After encountering a traumatic event, such as an auto accident, domestic abuse, violence, or perinatal loss, fragmented memories may intrude into daily life. This can result in feelings of helplessness or low self-esteem. Sometimes individuals turn to alcohol or substance abuse, in an effort to decrease the intrusive memories.

When experiencing trauma, the individual is flooded with strong emotions and, consequently, the brain cannot process, organize, and store the information in the usual way. EMDR allows the traumatic event to be fully processed so the individual is freed from re-experiencing the event in everyday life. This may result in a better quality of life and sense of hope and well being.

Judy Redmond, LPC, LLP, CAADC specializes in and discusses EMDR, a highly effective and efficient treatment for trauma and a broad array of other mental health challenges.

These events can cause lasting psychological symptoms, including the following from the National Institute for Mental Health

1) Re-experiencing symptoms: 

- Flashbacks—reliving the trauma over and over, including physical symptoms such as:

- Racing heart or sweating

- Bad dreams

- Frightening thoughts

2) Avoidance symptoms: 

- Staying away from places, events, or objects that are reminders of the experience 

- Feeling emotionally numb Feeling strong guilt, depression, or worry 

- Losing interest in activities that were enjoyable in the past 

- Having trouble remembering the dangerous event

Events that remind a person of the traumatic event can trigger avoidance symptoms. These symptoms may cause a person to change his or her personal routine. For example, after a bad car accident, a person who usually drives may avoid driving or riding in a car.

3) Hyperarousal symptoms: 

- Easily startled

- Feeling tense or “on edge”

- Difficulty sleeping, and/or having angry outbursts

Hyperarousal symptoms may make it hard to do daily tasks, such as sleeping, eating, or concentrating. 

At the Rochester Center for Behavioral Medicine, PTSD is treated with a combination of cognitive-behavioral therapy and when necessary, medications. This effective approach can help individuals with PTSD identify situations that trigger their “fight or flight” response. Using the cognitive-behavioral techniques of flooding and systematic desensitization, the therapist and patient can work together to safely reintroduce situations that have become too anxiety-provoking for the patient. Over time, irritability, flashbacks, and nightmares subside, the patient is able to return to their pre-trauma functionality, and long-term success is highly achievable.


RCBM Substance Abuse & Addiction Program


substance abuse addiction Our Substance Abuse Dependency Program has been established to help the care of individuals struggling with addiction and the abuse of opiates, benzodiazepines, and alcohol. We are dedicated to helping those patients who have exhausted all options of treatment and are seeking help to recovery. RCBM offers a unique approach to work with these individuals because we understand that addiction is a disease and with the right tools and support, we can help patients find solutions. Our primary goals for treatment include:

  • 1. Tapering off to Opiate-free by the end of treatment
  • 2. Minimizing the use of benzodiazepines


Joel Young, MD and Aliya Pasik, PA-C oversee the Substance Abuse Dependency Program initiative at RCBM. Our team has a specialized background in the treatment and care of those suffering from addiction and abuse. RCBM is very dedicated to treating substance abuse disorders and mental illness and feels that giving someone the gift of sobriety is one of the greatest gifts you can give a person struggling with chronic addiction. Establishing a trusting relationship with patients is our priority at RCBM. Establishing a personalized treatment plan involves four steps.


  • 1.  The first step in the Substance Abuse Dependency Program is to make an appointment with one of the members of our team. At that first appointment, the patient will explain the details of the substance abuse and addiction that brings them to RCBM seeking help.

  • 2.  At the second step, the patient will be scheduled for a psychological evaluation and screening. This will provide a better indication of the presenting issues along with any historical information.

  • 3.  The third step involves results from the psychological screening and analysis of the data in order to develop a personalized treatment plan. Depending on the type of substance abuse, specific medications will be prescribed for treatment, which may include:

    • 1. Campral™ -- to help control cravings
    • 2. Vivitrol™ -- a new injectable medication with 30 days of coverage
    • 3. Antabuse™ -- a powerful deterrent to drinking
    • 4. Suboxone™--a medication for the treatment of opioid dependence

  • recovery addiction treatmet4.  The fourth and final step includes referral and coordination of care with one of our certified advanced alcohol and drug counselors who will also be involved in the patient's care. Dr. Young and Aliya will also determine an appropriate schedule for medication management and will consult with the patient’s primary care physician (PCP) regarding the treatment plan. 

  • Prior to every visit, we will run a MAPS (Michigan Automated Prescription System) to make sure patients are not receiving opiates or benzodiazepines from another provider. The safety of our patients is of utmost importance.


Our comprehensive program will give patients the structure and support they need to find a treatment option that is customized to their addiction. Take control of the addiction. Do not wait for the legal system to take control of it. 



Aliya Pasik, PA-C

Program Director of Addiction Medicine                                                                                                                                                                                                


School Advocacy


The Rochester Center for Behavioral Medicine works with children, parents, and schools to provide a comprehensive and integrated treatment program. Children and teenagers spend the majority of their day in the school setting, and their relationships and behaviors in the school setting are often critical pieces of the diagnostic and treatment puzzle. Your child’s therapist or doctor will contact the school to ensure that treatment plans and goals are aligned and well-coordinated.


Navigating the educational system to advocate for your child can be overwhelming. RCBM can assist your family in getting answers to the follow types of questions: How do I know if my child is eligible for an Individualized Education Plan (IEP) or a 504 Plan for my child? When and how do I suggest this to my child’s school? What type of accommodations will teachers make without an official plan? Clinicians at the Rochester Center for Behavioral Medicine are well-versed in these issues and can help your family work through this process.


Sexual Health and LGBTQ Services


The Rochester Center for Behavioral Medicine believes that sexual health and identity are vital to overall mental well-

Woman intimacy cell phone young adultbeing. We strive to provide caring, affirming, and confidential services in an all-inclusive space that is supportive and free from bias. We have a dedicated multidisciplinary staff that is skilled in providing sexual health and LGBTQ services to individuals, couples, and families of all backgrounds and ages.



Sexual Health and LGBTQ Treatment Services:


Intimate Relationship Issues & Sexual Dysfunctions

Assisting individuals and couples who are struggling with problems related to sexuality, sexual orientation, sexual intimacy, or sexual behaviors. Additionally, addressing sexual dysfunction related to medication side effects, aging, physical illness, or stress.


Gender Identity

Using a nonjudgmental environment where we can provide education, support, and guidance to individuals and their loved ones about the nature of gender identity and gender dysphoria, along with how to work towards self-acceptance. Potential risks/benefits related to various treatment options are also presented.


Psychosexual Disorders

Providing evaluation and treatment to individuals with a variety of psychosexual disorders (paraphilias, distressing sexual behaviors), and sex-themed Obsessive Compulsive Disorder, in a caring and objective manner.


Sexual Trauma

Providing supportive services to survivors of sexual trauma and abuse, including counseling and psychiatric medication, to address possible anxiety, depression, intrusive thoughts, and nightmares.



Kendra Niemi, MSN, RN, PMHNP-BC  

Program Director of Sexual Health & LGBTQ Services


Sleep Disorders


Over 50% of adults report difficulty sleeping, half of which suffer with chronic sleep difficulty. We now know that medications are not the only solution to insomnia and that it is possible to successfully treat insomnia using cognitive-behavioral therapy (CBT). CBT has been endorsed by the National Institutes of Health as an effective method for treating insomnia. Research on CBT shows the following:


* 75% of insomnia patients experience significantly improved sleep

* The majority become normal sleepers

* 85- 90% reduce or eliminate sleeping pills


CBT achieves these results because it is based on the idea that insomnia is treated effectively by addressing the underlying causes of insomnia-related thoughts and behaviors, which are learned and can be unlearned.


CBT COMPONENTS

Techniques taught in CBT include:

* changing sleep thoughts and behaviors

* lifestyle habits that improve sleep

* relaxation techniques


WHO WOULD BENEFIT

* individuals with problems falling asleep or waking during the night

* individuals who wish to reduce or eliminate sleep medications


VISITS

CBT for insomnia includes:

* an initial individual assessment

* five individual treatment sessions over a six week period


INSURANCE COVERAGE

CBT is covered by most insurance companies but coverage cannot be guaranteed.


LINK

Studies have shown over 75% of adults with ADHD have difficulty with sleep. Tuck Sleep has created a guide to help combat this issue. Their guide includes a comprehensive overview of ADHD, how it affects sleep, expert sleep management information for people with ADHD and much more.


Social Phobia

Social Phobia, also known as Social Anxiety Disorder, is characterized by marked and persistent fear of situations in which one must perform or interact socially with or in front of others. A person with social phobia fears situations where they are exposed to new situations or people. They, therefore, worry about behaving in a way that they might be judged by others as foolish, unacceptable, inappropriate, or inadequate.

When a socially phobic individual is exposed to these situations, they feel anxious, both physiologically and emotionally. This disorder causes a negative impact on the individual’s social, academic and/or occupational functioning. Treatment for social phobia focuses on helping the patient to explore and identify possible triggers to their social anxiety, how this anxiety manifests itself, and develop coping skills and tools to help overcome their phobias. Furthermore, treatment interventions for social phobia may include individual, family, and group therapy. Cognitive-behavioral therapeutic techniques are often utilized, along with relaxation techniques and psychotropic treatment if appropriate.


Spravato Program

The Rochester Center for Behavioral Medicine is pleased to offer SPRAVATO® (esketamine), manufactured by Janssen pharmaceuticals that is used adjunctively with anti-depressant medications for treatment-resistant depression. Our medical director, Dr. Joel Young, was a primary investigator during the SPRAVATO® clinical trial. 

This page presents extensive information regarding SPRAVATO® and our state of the art SPRAVATO® Treatment Program at RCBM. In our frequently asked questions (FAQs) below, you will learn about SPRAVATO®, who can and cannot use SPRAVATO®, what to expect throughout the treatment process, and insurance coverage, along with the effectiveness of SPRAVATO®. 

Referral forms are located below the FAQs.

FAQs

About SPRAVATO®

About SPRAVATO®

Major Depressive Disorder (MDD) is one of the most common mental health disorders in the United States. For many people, treatments such as psychotherapy, medication management and lifestyle changes may help relieve symptoms. However, other individuals may have Treatment Resistant Depression (TRD) and continue to experience symptoms such as persistent feelings of sadness, sleep disturbances, low energy and thoughts of death or suicide, despite trying multiple treatments.

Taken along with an oral antidepressant, SPRAVATO® ® is the first nasal spray medication specifically for adults with treatment-resistant depression.

Taken along with an oral antidepressant, SPRAVATO® ® is the first nasal spray medication that treats depressive symptoms in adults with major depressive disorder with suicidal thoughts or actions.

SPRAVATO® ® was approved by the U.S. Food & Drug Administration on March 5, 2019 and is only available to patients at certified treatment centers in the United States, such as Rochester Center for Behavioral Medicine (RCBM).

SPRAVATO® ® is a prescription medication, used along with an antidepressant taken by mouth, for TRD in adults.

This treatment is approved for adults ages 18 and older.


Distribution and Administration of SPRAVATO®

Distribution and Administration of SPRAVATO®

SPRAVATO® ® is available only through a restricted distribution program called the SPRAVATO® ® REMS (Risk Evaluation and Mitigation Strategy). A REMS program is in place to ensure the safety of all patients who are treated with SPRAVATO® ®. The Rochester Center for Behavioral Medicine’s SPRAVATO® Program operates underneath the REMS program for service implementation at our office.

‍The goals of the REMS are to mitigate the risks of serious adverse outcomes resulting from sedation and dissociation caused by SPRAVATO® ® administration, and abuse and misuse of SPRAVATO® ®, by: ensuring SPRAVATO® ® is only dispensed and administered to patients in medically supervised healthcare settings that monitor these patients, ensuring pharmacies and healthcare settings that dispense SPRAVATO® ® are REMS certified, ensuring patients are informed about serious adverse outcomes from dissociation and sedation and the need for monitoring, and enrolling all patients who receive treatment in an outpatient healthcare setting in a REMS registry to further characterize the risks and support safe use.


What is the Difference Between Ketamine and Esketamine (SPRAVATO®)?

What is the Difference Between Ketamine and Esketamine (SPRAVATO®)?

While SPRAVATO® and Ketamine are chemically related, SPRAVATO® is not the same as IV Ketamine. Only SPRAVATO® has undergone extensive controlled clinical trials that informed the FDA approval of the medicine for use in adults with treatment resistant depression and to treat depressive symptoms in adults with major depressive disorder with acute suicidal ideation or behavior.

Esketamine is made from a drug called ketamine, an anesthetic that has also been used for many years to treat depression. Because Esketamine is more potent, it can be used at a lower dose and has fewer side effects. Esketamine has earned FDA approval specifically for use as a nasal spray for those with treatment-resistant depression. Because it is approved by the FDA, it’s more likely that insurance companies will cover the treatment.

For more information on Ketamine, please review:

Ketamine for Treatment-Resistant Depression and Related Conditions: A Review of a Novel and Needed Treatment Option by Benjamin Young, MD


Who Cannot use SPRAVATO®?

Who Cannot use SPRAVATO®?

You cannot use SPRAVATO® if you…

-Have a Blood Vessel Disease

-Have an abnormal connection between your blood vessels (arteriovenous malformation)

-Have a history of bleeding in the brain (intracerebral hemorrhage)

-Are allergic to Esketamine, Ketamine

-Are Lactating, Pregnant, or planning to become pregnant

-Active substance use disorder

-HIV

Please note: Because SPRAVATO® dosing requires a patient's nose and mouth to be exposed, it is an RCBM requirement that all individuals enrolled in our SPRAVATO® program be fully vaccinated against COVID-19, including required boosters.

Precautions:  If you are interested in SPRAVATO® , talk to your health care provider if you have the following medical conditions…

  • Hypertension (High blood pressure)
  • History of Stroke or Heart Attack
  • Heart Valve Disease
  • History of Brain Injury
  • Liver Disease
  • History of Psychosis
  • History of Seizures
  • History of Substance abuse
  • On MAO inhibitors

Does my Insurance Cover SPRAVATO®?

Does my Insurance Cover SPRAVATO®?

  • Insurance coverage varies based on individual health plan. We encourage you to check your insurance benefits for SPRAVATO® coverage, including co pays and deductible, along with whether SPRAVATO® falls under your medical or pharmacy benefits. The RCBM SPRAVATO® Program does not participate with TriCare, UMR, Blue Care Network, Humana and United Healthcare, along with Medicaid. If you have one of these health plans, please visit SPRAVATO®.com to find a SPRAVATO® center that does take your insurance.
  • All insurances require pre-authorization and continued authorization for SPRAVATO® treatment, while each insurance company has different criteria for authorization of SPRAVATO®. This includes a history of inadequate response to several different classes of anti-depressant medications with a trial of a minimum of 8 - 12 weeks each along with augmentation strategies.
  • Your healthcare provider must refer you for SPRAVATO® treatment and document medical necessity of SPRAVATO® based on required criteria.
  • If you have a commercial health plan, SPRAVATO with me is available to help you navigate access and affordability. 

SPRAVATO® Referral Timeline

SPRAVATO® Referral Timeline

The following is a timeline of what you should expect from referral through the course of treatment:

Spravato Referral Timeline


How Effective is Treatment

How Effective is Treatment

In clinical studies, patients who achieved stable remission with SPRAVATO®, augmented with an antidepressant, showed a 51% decrease in risk of relapse. In addition, there was a 70% risk reduction for depressive symptoms among those who achieved a stable response compared to an antidepressant alone.

For individuals with TRD

In clinical studies, improvement of depressive symptoms was demonstrated at four weeks by SPRAVATO® ® plus an oral antidepressant, compared with placebo nasal spray plus an oral antidepressant. Not all patients will respond to SPRAVATO® ®.

For individuals with MDSI

In clinical studies, those who took SPRAVATO® ® and an oral antidepressant experienced a greater reduction of depressive symptoms at 24 hours compared to those who took a placebo plus an oral antidepressant. Further reductions were seen consistently through four weeks (25 days) of treatment, so it is important to follow the treatment plan that you and your healthcare provider have made. Not all patients will respond to SPRAVATO®



Please read our Full Information SPRAVATO® Pamphlet before submitting a patient interest or Healthcare provider referral form. 

Patients must have an active diagnosis of either Treatment Resistant Depression (TRD) or Major Depression with Acute Suicidal Ideation (MDSI) in order to be eligible for treatment with SPRAVATO®.

Spravato Patient Guide

For more information on SPRAVATO®

In addition, watch this video that highlights additional common questions for those interested in Spravato treatment.


Please note important requirements for treatment in our program prior to completing the interest form or referral forms:

  • Patients must have an active diagnosis of either Treatment Resistant Depression (TRD) or Major Depression with Acute Suicidal Ideation (MDSI) in order to be eligible for treatment with Spravato.
  • Business hours are between 9:00 am – 5:00 pm, with last treatment appointment scheduled at 3:00 pm. 
  • Appointments are at least two hours in length and require a twice per week regimen for the first four weeks, followed by once per week for one month. Continued dosing based on response to treatment.
  • Patients must have a driver to and from each appointment and are not allowed to resume driving until the next morning.

For patients who have been seen by an RCBM provider within the past 6 months, please DO NOT complete the forms below. Please discuss your interest with your RCBM provider at your next appointment. Thank you!


Telemedicine

We are pleased to offer HIPAA-secure video sessions for medication management, psychotherapy, and medical nutrition therapy. We intend to provide telehealth services as a permanent offering.

To keep our patients and staff safe, RCBM transitioned to telehealth during COVID-19. Our patients have expressed high levels of satisfaction with their telehealth experience and there is a body of evidence supporting this modality for children, adolescents and adults. 

RCBM uses the HIPAA secure platform called Zoom, which is now integrated into our Electronic Medical Record system, allowing for ease of scheduling and appointment reminders.  Be sure to check your e-mail in advance of your scheduled appointment for your Zoom link and other logistical details.  Benefits of telemedicine include: ease, convenience, privacy, and access, along with increased choice and options. This service fits into your lifestyle, rather than the other way around. Most major insurance plans now have coverage for telehealth. Please check with your plan to confirm that you have this benefit.

The COVID pandemic has demanded innovation and flexibility from all of us. Since the start of the pandemic, RCBM has used telehealth to support the mental health needs of patients throughout Michigan. We found that we could safely meet and serve Michiganders from Monroe to Marquette. Regulations may change once the Public Health Emergency is lifted. RCBM will fulfill all regulatory obligations. We are committed to telehealth and will work to make these changes permanent.

Our patients are so very pleased with telehealth services!

"Great professionals here! It's so nice to talk with someone from the comfort of your own home. We trust them with our entire family."“I was skeptical about telehealth at first, as therapy sessions are so personal. Within a few moments of speaking with my therapist, I forgot that we were on Zoom.”

“I used to have to take 2 hours out of my day to drive to my appointment, wait in the waiting room, have my appointment, and then go back to work. I can now have my session and be back to work within an hour. Telehealth has been a huge convenience for me!”

“Honestly I felt so comfortable and welcomed, also nice to feel validated as well as talking about what/how I should do differently. Very nice Tele-visit and I feel very motivated to become better.”


Trichotillomania


Trichotillomania is a disorder characterized by the pulling of hair for non-cosmetic purposes, which can often result in significant hair loss. Hair is typically pulled from eyebrows, eyelashes, scalp, beard and pubic area, though hair from other parts of the body may also be pulled.


Individuals with Trichotillomania may also play with, bite, nibble or chew the hair. If ingested, this may cause a serious condition in need of medical attention. It is not uncommon for people with this disorder to engage in other damaging behaviors such as nail-biting or skin-picking. It appears that significant emotional experiences or feelings can trigger hair pulling. Anxiety, depression, stress, anger, and tension may increase the urge to pull. However, hair pulling may also occur when the individual is inactive and subdued; while reading, watching television, doing homework or even lying in bed. 


At RCBM, we fully evaluate individuals suffering from Trichotillomania to assess the disorder and determine if any conditions result from or contribute to the pulling of hair. In addition, we assess the impact on social functioning, academic environment, and family relationships. Often, we work with the family utilizing a cognitive-behavioral approach. This consists of developing a treatment plan focusing on triggers associated with the pulling, thoughts and feelings, along with the situations where pulling occurs. We meet with the patient and family regularly to determine progress and discuss the factors contributing to the pulling/picking behaviors. It is not uncommon for clinicians to ask patients with Trichotillomania to complete activities outside of the therapy session, such as journal writing, progress calendars, worksheets, and creating barriers such as wearing band-aids/gloves or hats/scarves.


Women’s Mental Health and Wellness


Research consistently shows that women suffer from mental illness at a higher rate than do men. This is likely due to a combination of the unique stresses women face, such as the pressure to conform to an unrealistic beauty standard or to be a perfect mother, along with factors such as hormonal shifts.


We work with women of all ages to combat mental illness and manage challenging mental health symptoms. We understand that mental health concerns—whether they be relationship issues or serious depression—rarely derive from a single cause. Instead, we treat the whole woman, looking at the complex interplay of biology, life history, environment, nutrition, and much more. We partner with you to find solutions, both medical and lifestyle-based, that fit into your life and are congruent with your values.


Infertility and Pregnancy Loss

Though both men and women often aspire to be parents, women are taught from an early age that motherhood is a special, and perhaps mandatory. For this reason, infertility can directly affect a woman's self-esteem and overall mental health. Moreover, the complex biological changes associated with treating infertility can wreak havoc on a woman's hormones, making an already difficult time even more stressful.


Women who struggle with pregnancy loss are often hesitant to seek help. There is still the stigma associated with miscarriage, and well-meaning loved ones may inadvertently say hurtful statements. Your partner might not feel as connected to the baby like you, and the sudden hormonal shift associated with a pregnancy loss can compound these challenges. We work with women to navigate the pain associated with infertility and pregnancy loss, to talk to their partners about their pain, to regain a sense of identity after pregnancy loss, and to move forward with confidence regardless of the outcome of fertility treatments.


Food and Eating Issues

Eating disorders are a serious mental health condition. The cause of eating disorders is multifactorial with women making up 75% of those diagnosed with eating disorders. Eating disorders include, but are not limited to, anorexia nervosa, bulimia nervosa, binge eating disorder, and other specified eating disorders. We have a comprehensive and skilled eating disorders team that can treat these issues.

Outside of eating disorders, some women have trouble achieving their usual weight post partum or struggle with obesity. For those patients who have underlying risk factors and do not have an active or history of an eating disorder, we can work with you to achieve a healthy weight without the use of diets or "gimmicks."


Trauma and Abuse

Trauma is a common experience among women. As many as one in four women have been raped, while one in three has experienced violence by an intimate. This type of interpersonal trauma can have far-reaching effects on your self-esteem, relationships, and sense of safety. Women who have experienced trauma may develop symptoms of post-traumatic stress disorder (PTSD), or adopt unhealthy coping mechanisms, such as alcohol use or refusing to leave the house.


We work with you to help you understand how your trauma has affected your life and sense of self. We never push you to talk about something you are not ready to address. Instead, we move slowly and deliberately, helping you feel safe to discuss the pain you have faced.


Prenatal and Postpartum Depression

Pregnancy is a life-altering event that spurs a whirlwind of changes in your body—weight gain, unusual medical symptoms such as swelling and high blood pressure, along with a sense that your body is no longer fully your own. It's no wonder that so many women experience depression either during or immediately after pregnancy.


Although not the sole culprit, hormonal shifts play a significant role in pregnancy-related mental health issues. Women are more vulnerable to pregnancy-related mental illness if they feel unsupported, have a history of trauma, struggle with financial issues, experience health problems during or after pregnancy, or do not receive adequate assistance to tend to their own health.


We work with you to tease apart the various causes of your depression. We don't dismiss you as just another case of hormones gone awry. Instead, we'll craft a comprehensive plan to help you get back to being yourself, so you can enjoy motherhood and find a sense of meaning in bonding with your baby.


Transitioning Into Motherhood

There is perhaps no more profound life change than the transition to motherhood. Suddenly you are responsible for caring for a small person. Many women find that the burdens of motherhood fall primarily to them, based on generations of gender norms. Additionally, women without partners may feel completely alone. From navigating breastfeeding to coping with the stress of a screaming infant, while managing the mixed emotions of transitioning back to work -  to rediscovering who you are separate from your identity as a parent - we can help you make a smooth transition to motherhood.


Relationship Issues

From an early age, women are taught to prize their relationships. Relationships make us human, enrich our lives, and offer support through the challenges of life. Too often, though, relationships themselves become the source of life's worst challenges. Infidelity, divorce, breakups, abuse, and relationship conflicts can overwhelm even the strongest women, leaving them wondering how to cope.


We will work with you and your partner to get your relationship back on track. Even if your relationship is ending or your partner is unwilling to seek counseling, we can help. Therapy sessions can offer clarity, a renewed sense of hope, and a deeper faith in your ability to resolve the problems in your relationship—or to move onto a more positive relationship.