Tagged: telehealth Oregon

Complex PTSD in adults: why the standard depression playbook often misses it

A lot of people arrive in my practice with a folder of failed antidepressant trials and a working theory that they are treatment-resistant. Sometimes that is exactly right. Often what is actually going on is that the…

Психиатрическая помощь и псилоцибиновые сессии в Орегоне на русском языке

Найти в Орегоне специалиста по психическому здоровью, который говорит по-русски, сложнее, чем кажется. Людей с таким сочетанием немного, и почти всегда выбор сводится к одному из двух: либо специалист, который вас…

How to tell your therapist about a psychedelic experience

People ask me this more than almost anything else, and usually in a lowered voice: should I tell my therapist, and what happens if I do. It is a fair question. The person asking has often spent years building a…

The preparation and the integration matter more than the session

The most common misunderstanding I meet about ketamine-assisted work is that the session is the treatment. People book expecting the appointment to do the work, the way an antibiotic does the work once you have…

Treatment-resistant depression: what to ask about by name

Treatment-resistant depression is a clinical term with a fairly unromantic definition: depression that has not responded adequately to at least two antidepressant trials, each at a reasonable dose for a reasonable…

You can integrate an experience you had years ago

A common assumption about integration is that it has a shelf life: that it belongs to the fortnight after an experience, and once that window closes the opportunity has gone. That is not how it works. A significant…

What actually happens in a first appointment with me

People are often braced for a first psychiatric appointment to be a triage exercise: a symptom checklist, fifteen minutes, and a prescription. That is a reasonable thing to expect, because it is what a lot of people…

What drives the cost of psilocybin services in Oregon

The first question most people ask about Oregon's psilocybin program is what it costs. The honest answer is that it varies more than almost anything else in mental health care, and the reasons are structural rather than…

Integration after ketamine: what to do with the week that follows

Most of what is written about ketamine covers the appointment. Far less covers the seven days after it, which is where people tend to decide, quietly and without noticing, whether anything is going to change. The…

Why I practice integrative psychiatry

I did not arrive at this way of working through a conference or a continuing education requirement. I arrived at it in my early forties, looking honestly at my own life and not being especially pleased with what I…

Ketamine or psilocybin in Oregon? Two legal paths, and who each one fits

Oregon is one of a small number of places where an adult can legally access both supervised ketamine care and a licensed psilocybin session. People ask me which one they should do. The honest answer is that they are not…

Telehealth in Oregon: Promise, Pitfalls, and the Path Forward