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MENTAL HEALTH TREATMENT

Most people diagnosed with mental illness can experience benefits and improvement of their symptoms by actively participating in treatment. Modalities of treatment are many and the services recommended will depend on many variables. An initial consultation is the goal standard to determine a diagnosis and treatment plan. Individuals will have the option of a second opinion prior to engaging in any particular form of treatment or if treatment approaches are not eliciting the desired results.

HOLISTIC MODEL
Provides the individual with the tools to a holistic approach for his or her health by addressing physiological, psychological, interpersonal and spiritual needs. The holistic approach supports the idea that body chemistry, spirituality, nutrition, and other factors can impact the brain and be a contributor to ones well being or illness.

PSYCHIATRIC EVALUATIONS
The purpose of a comprehensive psychiatric evaluation is to diagnose any number of emotional, behavioral, or developmental disorders using interview skills, laboratory data, neuropsychological testing, rating scales, neuroimaging studies, physical examination, clinical history and collateral information if necessary. An evaluation of an adult is made based on behaviors present and in relation to physical, genetic, environmental, social, cognitive (thinking), emotional, and educational components.

The purpose and conduct of a psychiatric evaluation depends on who requests the evaluation, why it is requested, and the expected future role of the psychiatrist in the patient’s care. The outcome may or may not lead to a specific psychiatric diagnosis. At times the evaluation will have administrative or legal purposes; at others the main goal is to establish an effective working relationship with the patient, at other times the emphasis is placed on obtaining information needed for immediate clinical recommendations and decisions.

On the basis of information obtained in the evaluation, a differential diagnosis is developed. The differential diagnosis comprises conditions (including personality disorders or personality traits) described in the DSM-V . Diagnostic and Statistical Manual of Mental Disorders.

The initial treatment plan addresses any specific diagnoses and psychiatric needs of the patient that have been identified during the evaluation. The initial treatment plan begins with the determination of the appropriate treatment setting and includes an explicit statement of the diagnostic, therapeutic, and rehabilitative goals for treatment that includes short-term and longer-term goals.

A comprehensive treatment plan addresses biological, psychological, and socio-cultural domains. The psychiatrist can select from a range of individual, group, and family therapies to create an integrated multimodal treatment that includes biological and socio-cultural interventions.

BIBLIOGRAPHIC SOURCE: American Psychiatric Association (APA). Practice guideline for the psychiatric evaluation of adults. 2nd ed. Washington (DC): American Psychiatric Association (APA); 2006 Jun. 62 p. (302 references) recommendations and decisions.

On the basis of information obtained in the evaluation, a differential diagnosis is developed. The differential diagnosis comprises conditions (including personality disorders or personality traits) described in the DSM-V . Diagnostic and Statistical Manual of Mental Disorders.

The initial treatment plan addresses any specific diagnoses and psychiatric needs of the patient that have been identified during the evaluation. The initial treatment plan begins with the determination of the appropriate treatment setting and includes an explicit statement of the diagnostic, therapeutic, and rehabilitative goals for treatment that includes short-term and longer-term goals.

A comprehensive treatment plan addresses biological, psychological, and socio-cultural domains. The psychiatrist can select from a range of individual, group, and family therapies to create an integrated multimodal treatment that includes biological and socio-cultural interventions.

BIBLIOGRAPHIC SOURCE: American Psychiatric Association (APA). Practice guideline for the psychiatric evaluation of adults. 2nd ed. Washington (DC): American Psychiatric Association (APA); 2006 Jun. 62 p. (302 references)

MEDICATION MANAGEMENT
Once a comprehensive diagnostic evaluation is conducted a comprehensive treatment plan is developed that at times includes a choice of medication(s). The psychiatric will offer the patient a clear explanation for any diagnosis and recommended treatment. This explanation may not be limited to medication recommendations but also psychosocial interventions.

The psychiatrist will identify those components of treatment the psychiatrist will provide, and those components that will be provided by other non-psychiatrist physicians or non-physician mental health providers. If it is necessary appropriate consent to communicate with other providers will be obtained.

The psychiatrist will exercise the highest professional standards in the choice of medications and the management of continuing treatment with medications. The patient will have the opportunity to ask questions related with the medications or any side effects, the physician will also discussed any relevant side effects and at times will provide information in writing related with the medication(s)..
The psychiatrist providing Medication Management will maintain written documentation of the diagnostic assessment; of the treatment plan; of periodic assessments of the patient's status and progress, etc.

The frequency of the follow ups for Medication Management will vary depending on the clinical needs of the patient and in each visit the psychiatrist determines if the current level of care is appropriate or additional interventions as family sessions, referrals to other specialists, individual therapy, group therapy, intensive outpatient treatment, hospitalization, etc. are needed.

INDIVIDUAL, MARITAL AND FAMILY COUNSELING
There are many different types of psychotherapy however communication between the client and the clinician is the basic tool for bringing change in a person’s feelings and behaviors. Psychotherapy is usually provided to an individual, family, or group of individuals in a trusting environment.

It is relevant for the person to know why it is recommended, what are the specific goals to be accomplished, how long it will last and how frequent the sessions will be. The individual should also be aware of the cost of the service.

There are many modalities of psychotherapy and clinicians will have different degree of expertise on the different modalities. The individual should discuss with his or her clinician the form of psychotherapy that will be the most effective for their condition and if they have the required level of expertise to provide it or if referral sources should be consider.

The most common forms of psychotherapy provided at the Horizon Behavioral Center are Cognitive-Behavioral, Existential, Rational Emotive Behavioral Therapy, Pastoral, Relapse Prevention, Eye Movement Desensitization and Reprocessing, EMDR, Solution Focus, Educational.

INTENSIVE OUTPATIENT PROGRAMS

Is a modality of treatment used primarily for mental and/or substance use disorders when other

modalities or services as individual or group therapy, psychopharmacological interventions and other

modalities are not sufficient for stabilization of the individual. It is also used a transitional treatment

immediately after discharge from an inpatient setting.


It is a level of care offered prior to the consideration of residential or partial day treatment. The program

typically offers 12 hours of group psychotherapy per week. The individual is capable of remaining engaged

most of the time in their daily affairs or work responsibilities. In addition to the group sessions other

interventions will take place as individual counseling, case management, etc.


IOP’s can be a very effective intervention with significant reductions in daily use of substances and/or

improvement of psychological symptoms associated with mental health disorders. Patients also have

reported significant functional improvements in all spheres when they were capable of completing

treatment successfully.


IOP FOR SUBSTANCE USE DISORDERS

- Comprehensive Biopsychosocial

- Evidenced based group psychotherapy

- Weekly Individual sessions

- Monthly treatment team meetings and Medical Director

- Family Interventions

- Motivational Incentives

- Introduction to approaches such as Yoga, Meditation, Acupuncture, Fitness, Massage therapy

and Equine therapy

- Optional approaches include but are not limited to: AA, NA, Smart Recovery, Faith Based Treatment

and Spiritual Counseling

- Length of program variable

- Aftercare services


IOP FOR SUBSTANCE USE DISORDERS AND MENTAL HEALTH

- Psychiatric Evaluations and management

- Comprehensive Biopsychosocial

- Evidenced based group psychotherapy

- Weekly Individual sessions with clinician

- Monthly treatment team meetings

- Family Interventions

- Medically assisted detoxification

- Motivational Incentives

- Introduction to approaches such as Yoga, Meditation, Acupuncture, Fitness, Massage therapy

and Equine therapy

- Optional approaches include but are not limited to: AA, NA, Smart Recovery, Faith Based Treatment

and Spiritual Counseling

- Length of program variable.

- Aftercare services.


DAY TREATMENT

Waiting for info.


OUTPATIENT DETOXIFICATION

This type of management is appropriate for patients with an alcohol or other drug addiction in mild to moderate degree of withdrawal with no significant comorbid medical conditions. The patient needs to have a stable living environment as well as support from family and friends for assistance, emotional support and to monitor their progress.

The psychiatrist will provide medical supervision and guidance and will use medications to assist with the medical withdrawal symptoms to ameliorate as much as possible suffering and discomfort.

At times depending on the amount of illicit drug use or alcohol use the psychiatrist will recommend inpatient, residential treatment or a sober structured setting as a halfway house or supervised living environment. The psychiatrist may also recommend individual or group psychotherapy. Co-occurring medical conditions or mental health conditions, if present, can be safely managed in an ambulatory setting.

The ambulatory detoxification phase may last from a week to few months depending on the patient degree of motivation as well as the severity of the addiction and the substance(s) involved. The patient may be seen weekly, biweekly or monthly.

Abstinent from all substances including alcohol will be required and strictly monitored and failure to comply with guidelines of the program will prompt the physician to discontinue outpatient treatment and recommend a higher level of care.

OPIOID USE DISORDERS
Suboxone Induction, Stabilization and Maintenance

A comprehensive substance abuse evaluation will be completed to determine if the patient is a candidate for outpatient treatment or is in need of a higher level of care as residential or inpatient detoxification. Many factors are taken in consideration prior to making this decision including prior or current medical complications, number and doses of substances of abuse, living environment, support system, etc.

Once the patient is consider to be a candidate for outpatient detoxification or induction for maintenance and all require information is available he or she will be scheduled to return to initiate the treatment, usually the next business day.

Induction

The goal of induction is to switch the individual from (heroin, methadone or a prescription painkiller) on to SUBOXONE. The first dose of suboxone should be given when the individual is experiencing mild-to-moderate opioid withdrawal symptoms. If SUBOXONE is taking before the individual is in withdrawal, the medication will make the individual feel worse because it can cause withdrawal symptoms.

The goal is to induce treatment smoothly and suppress withdrawal as completely and rapidly as possible. Failure to do so may cause the patient use opioids, alcohol, benzodiazepines or other medications to alleviate opioid withdrawal symptoms, or it may lead to early treatment dropout.

The first dose of suboxone usually provides some relief within 20 minutes, although the full effects take about an hour. Your doctor may suggest that you pass the time in the waiting area or by taking a short walk and returning to the office at a specific time. Depending on the extent to which the first SUBOXONE dose suppressed your symptoms, your doctor may decide to give you a second dose.

When you are ready to leave the office after your first induction visit:
Your doctor will make arrangements for you to have SUBOXONE to take home. Typically, your doctor will give you a prescription for the amount of SUBOXONE that you will need until your next appointment, along with any special instructions related to your care. Your doctor may also prescribe other medications to help control withdrawal symptoms.

During induction, daily appointments are not uncommon. This allows your doctor to adjust for your withdrawal symptoms and cravings. Induction can last anywhere from 2 to 7 days. Urine drug screening at every visit is also fairly standard during induction. Patients whose SUBOXONE dose may be too low often use other drugs to try to suppress the withdrawal symptoms and cravings; doctors look for this when evaluating whether a patient is at the right dose.

Stabilization

During stabilization, the SUBOXONE dose is "fine tuned" about once a week, as needed. The goal is to find a dose where the individual withdrawal symptoms and cravings are suppressed and he or she experiences minimal to no side effects. The individual and the doctor will discuss treatment options going forward, specifically, maintenance versus medically supervised withdrawal.

Maintenance

Once the dose is stabilized, the maintenance phase of treatment begins. During maintenance, the individual treatment compliance and progress will continue to be monitored.

Participation in some form of behavioral counseling is strongly recommended to maximize the likelihood of treatment success. At times your doctor will require or recommend that you participate in individual and group counseling simultaneously. Urine samples from time to time will be required.

Appointments are usually scheduled on a weekly basis, however, if treatment progress is good and goals are met, monthly visits may eventually be considered sufficient. The maintenance phase can last anywhere from weeks to years—depending on what the individual, the doctor, and, possibly, the therapist or counselor determine is best for your individual needs.

For additional information in regards to suboxone treatment:
visit www.suboxone.com/patients/suboxone

ALCOHOL, SEDATIVE HYPNOTIC AND BENZODIAZEPINES DETOXIFICATION
Abrupt discontinuation of alcohol or sedative hypnotics can lead to life threatening or fatal withdrawal symptoms. The course of these symptoms is extremely variable with some individuals experiencing mild symptoms of withdrawal to to others that may experience delirium or seizures.

The physician will examine the patient and review all relevant history including social factors as family support, living and transportation arrangements. Urine and blood samples may need to be ordered prior to reaching a recommendation for the appropriate level of care.

If the patient meets criteria for outpatient detoxification a protocol will be established and the patient will be treated with frequent reassessments to determine the need for hospitalization.

Before beginning any tapering regimen, the patient must be fully stabilized; that is, all signs and symptoms of withdrawal must be improved. Once the patient has been stabilized, oral benzodiazepines can be administered on a predetermined dosing schedule for several days, weeks or months and gradually tapered over time.

If there is objective evidence of other substances in the drug testing particularly opioids, the patient most likely will not be a candidate for outpatient detoxification.

RELAPSE PREVENTION

It is a cognitive and behavioral program that teaches the individuals with addiction how to anticipate and cope with the potential risk of relapse. Coping skills training is the cornerstone of relapse prevention as well as other interventions including aftercare, and medications that will decrease the likelihood of relapse.

From this perspective, relapse is not viewed merely as an indicator of treatment failure. Instead, potential and actual episodes are key targets for both proactive and reactive intervention strategies.

TELEPSYCHIATRY

Telemedicine has been variously defined. To paraphrase the National Library of Medicine definition of telemedicine as it applies to psychiatry, telepsychiatry is the use of electronic communication and information technologies to provide or support clinical psychiatric care at a distance. This definition includes many communication modalities such as live interactive 2-way audio-video communication. See and talk to a psychiatrist or therapist in real time via live, interactive videoconferencing on your computer.

A growing body of research data clearly demonstrates that psychiatric treatment provided with the use of telemedicine can be as effective as when delivered during traditional outpatient appointments.

If you are a patient highly motivated and computer literate you can benefit of videoconferencing to have access of psychiatric services from the privacy of your home, office or any other setting in which you have access to the internet and a telephone landline available.

If you have limitations as living in a rural area, can’t afford to take time off from work, don’t have transportation or for any other reason are unable to leave your home.

How is your privacy protected?

The electronic interactions used by your physician or therapist will be using a secure videoconferencing meeting room that complies with HIPAA requirements and are subject to the same state federal privacy and confidentiality policies.

You however had to ensure the privacy of your computer, internet connection and location where you engage in the video conferencing appointment.

Your physician or therapist must be licensed in the state where you reside. You may need to have your first evaluation with the psychiatrist face to face or may need to see your primary care physician prior to treatment with medications. The physicians will have some limitations in regards to prescriptions of certain narcotics. In addition all limitations related with the traditional psychiatric-patient relationship.

If you are in a state of crisis or your or the safety of others is compromised in any way you will be required to have face to face services until stabilization. We will be instrumental in providing you referral sources based on your needs. If you are actively suicidal, then call 911 or go to your nearest Emergency Department for an immediate evaluation.

We do not provide Disability or Workers compensation evaluations. In any of these cases contact your PCP or a local psychiatrist.

At this time we are only offering fee for services, we however will be able to provide you and invoice to submit to your insurance company for reimbursement if it is a cover service. The payment for the services is made at the time of scheduling and it is non-refundable. We guarantee to provide the service that you have scheduled and paid.

You will need a computer with a windows based operating system or a mac computer, a webcam and speakers/microphone. You will need to have an email address and be at a location at the time of services where there is a landline telephone service.

On Call Emergency Telepsychiatric Services.

A service provided to emergency room during non-working hours for psychiatric consultations. Patients will be seen within an hour of the initial contact and there has to be an existing contract with the hospital or setting prior to the availability of the services.

If you are a physician or therapist licensed in the State of Florida interested in providing telepsychiatric services feel free to contact us for additional information.

Providers will have the option of working from their office or private home office and will receive technical and administrative support.

A service provided to emergency room during non-working hours for psychiatric consultations. Patients will be seen within an hour of the initial contact and there has to be an existing contract with the hospital or setting prior to the availability of the services.

In addition scheduled psychiatric consultations are offered to patients as requested by their treating PCP or specialist.

Rural hospitals, prison systems and underserved areas can benefit from affordable and reliable care including Baker Act patients in a timely manner.

SPECIALIZED DRUG TESTING (HAIR, URINE, SALIVA)

The purpose of drug testing is to determine accurately the presence of drugs of abuse in urine, hair, saliva or blood. The price is affordable and it will depend on the drug testing panel required, the source of the sample and the purpose of the testing.

We offer a variety of drug testing including Instant Drug Screens using as samples urine or saliva. If necessary the specimen is sent for laboratory confirmation. In addition hair testing can also be collected on site.

A brief consultation could be provided to determine the most accurate and effective method for drug collection, many factors will be taking into consideration. All collections will require the consent of the patient or participant or the present and consent of the guardian if a minor.

Results are typically reported in 24 hours for negatives, 48-72 hours for positives. All presumptive positive results go through a confirmation process to ensure accurate results. Screening and confirmation testing are performed using different methodologies that require separate cut-off levels.

Hair Drug Testing

Hair Drug Testing provides significant advantages over traditional drug testing. The advantages include a wider window of detection (90 days), less invasive and easier collection, and virtual elimination of tampering with the test. The standard hair-5 panel includes cocaine, opiates, amphetamines (including ecstasy), PCP, and marihuana. Other opioids could be detected with an extended opioid panel.

Urine Drug Testing

The panel could include Amphetamines, Cocaine, Opiates, THC (Marijuana), Phencyclidine (PCP), Alcohol (Ethanol), Barbiturates, Benzodiazepines, Methadone, Propoxyphene, Steroids, Diuretics, GHB, etc.
In addition EtG could be detected in the urine as a recent indicator of ethanol for up to 80 hours after the ingestion.

Other

The panel could include Amphetamines, Cocaine, Opiates, THC (Marijuana), Phencyclidine (PCP), Alcohol (Ethanol), Barbiturates, Benzodiazepines, Methadone, Propoxyphene, Steroids, Diuretics, GHB, etc.
In addition EtG could be detected in the urine as a recent indicator of ethanol for up to 80 hours after the ingestion.

OFFICE SPACE FOR MENTAL HEALTH PROFESSIONALS


SERVICES

Once a year fee for the following services:


- Cost effective second office for small practices.

- Mailing and business address.

- Office space rental online on as needed basis

- High Speed Internet.

- One time fee for web upload page gaining access to our marketing channels.

- We facilitate networking.

- Additional customized services.

REGISTER

WELLNESS PROGRAMS

The individual with assistance of a mental health professional will discover the roots of their stress, determine the behaviors that triggers and enable stress to take hold, and discover effective tools to control stress and promote behavioral wellness.

The individual will reach a level of understanding about the sources and symptoms of stress that are unique to him or her and that there is no ultimate solution that eliminates all health risks at once. Each person will be engaged according to his or her unique pattern of health behaviors, stress sources, and symptoms, and creates solutions tailored to the individual.

Other aspects of mental health wellness will be incorporated in the treatment plan including nutrition, exercise, meditation, sources of inner peace, etc...
APPOINTMENTS 954-530-4526
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