Facing your emotions, in adversity is formidable.
But learning that you can change your perspective
Alters your internal vision and empowers you on the way.
Facing your emotions, in adversity is formidable.
But learning that you can change your perspective
Alters your internal vision and empowers you on the way.
DRS seeks to address clients’ personal needs in an outpatient utilizing an in-depth holistic approach also empowering clients with psychoeducation. A conservative medication approach in tandem with therapy is usually taken. In addition, coordination with other providers is important so that there is continuity of care allowing for less duplication of similar medications, less medication interactions, therefore potentially less foreseeable adverse outcomes.
This is an outpatient service and is not equipped to handle emergencies / acute medical, psychiatric and substance issues. In acute issues seek higher care facilities. Clients are encouraged to also engage the care of PCP in maintenance care ongoing as well as recommended ancillary psychotherapeutic care.
Services Include:
DRS is able to offer treatment for substance use disorders in addition to other comorbid psychiatric disorders:
MAT (Medication-Assisted Treatment): Available for Opiate Use Disorders in the form of Buprenorphine, which will be discussed on an individual basis. This is because compliance must be consistent with state and federal legislation in effect at the time. This generally requires some lab work from the client, as well as identification when picking up medications and adherence to medication follow-up policies. However, the buprenorphine products available can be very effective at managing opiate use issues. With other opiates available, such as fentanyl, the induction can be more complicated, as would be discussed on an individual basis.
MAT for Alcohol Issues: Although there is no “ideal” treatment for alcohol use, there are some approved medications that can help with “cravings” for alcohol. It is important to recognize that “cravings” are complex and somewhat habitual, i.e., behavioral; therefore, there is no “magic bullet” treatment in medication form. However, medications such as Campral, Vivitrol (i.e., naltrexone), and some others can be used in conjunction with therapy, depending on the situation and other psychiatric medications. Sometimes a single medication can benefit both alcohol and opiate issues.
Other Illicit Substance Issues: Can be discussed on an individual basis, as literature and current treatment recommendations are subject to change.
This category of service can come as a referral from other providers such as primary care providers, other APNs, therapists or when clients self-refer due to concerns of many different potential issues. Some issues that have been expressed in my experience could include:
This category of service can come as a referral from other providers such as primary care providers, other APNs, therapists or when clients self-refer due to concerns of many different potential issues. Some issues that have been expressed in my experience could include:
Although we may think of telehealth as more common these days, it was not so common just several years ago. Dr. Deerfield provides these services when appropriate for clients, even with complex conditions. However, it is important to abide by the telehealth tenets that will be provided later in the policies section. Also, in-person visits are at times not only necessary but preferable, as they provide more helpful information.
Often, legal entities will engage in Psychiatric expert services. These services vary by venue and are usually time-limited. They often involve solving a particular concern or question. I have many years’ experience in providing these services.
A good way to look at a truly integrative efficient model that utilizes limited expert services and distributes them effectively is the “hub and spoke”. This model efficiently uses limited expert services by distributing them effectively. This approach can be effective if implemented properly. The “hub” represents the locus of expert resources in a rural area and the “spokes” are the satellites sites or points of entry where clients are screened and treated at some level of service. The integration of sites has supported research and grant applications by addressing specific needs, particularly in under-served areas where specialists are scarce and primary care is heavily utilized. As an addiction psychiatrist in such a rural area I was able to consult very effectively in multiple facilities even within the same week/day. These included : forensic (jails) for emergent issues or medication management, hospitals for complex psychiatric cases when there was not a psychiatrist on staff, ER settings for emergent needs in detoxes or medication questions, group homes for medications and guidance, MAT clinics for protocols and quality of care issues, therapist groups and PCP groups for guidance and cases, neurological centers for cases with mixed presentations, APN’s consultations , and policy protocols groups, as well as lecture/discussions to specified target audiences that would facilitate the increase in quality care in PCP or mid-level providers and perhaps decrease the need for psychiatric referrals This was an experience that truly illustrates how consulting can increase efficiency, and the quality of integrative care. It is a “team effort” that can pay off in improved client care despite less resources!
To read more about this topic please see “Comorbidities in Psychiatry: Prescribing Pearls” blog article
DRS has a broad array of ongoing collaboration opportunities for nurse APNs. I have been providing these for well over 15 years and enjoy teaching/mentoring. I am also available for PCPs and/or groups of physicians. I am available on short notice for “more emergent questions that may come up.” I am current and continuously following state regulations and this is important as they change from time to time.
Dr. Deerfield currently has some ongoing Medical Directorships that she attends to on a daily basis. Usually, she supervises the work of the APNs, provides ongoing training, addresses liability issues, facilitates state-of-the-art MAT treatment, and seeks to improve the client treatment experience while safeguarding against potential safety issues. Other duties include: Setting up toxicology screening and other protocols, as well as ,providing surveillance of toxicology reports and provide summary reports that integrate medical notes with toxicology to show relapse and progress with each client . She then presents the data at conference meetings or in bulk emails to staff. She is also involved in hiring APNs and giving feedback on performance. In addition, she provides peer reviewed articles that are pertinent to medical cases that arise and is also responsible for medical clearance of cases that are presented for admissions. Overall Dr. Deerfield works closely with administration to improve the overall quality of the clients experience and promote excellence in the facility.
DRS seeks to address clients’ personal needs in an outpatient utilizing an in-depth holistic approach also empowering clients with psychoeducation. A conservative medication approach in tandem with therapy is usually taken. In addition, coordination with other providers is important so that there is continuity of care allowing for less duplication of similar medications, less medication interactions, therefore potentially less foreseeable adverse outcomes.
This is an outpatient service and is not equipped to handle emergencies / acute medical, psychiatric and substance issues. In acute issues seek higher care facilities. Clients are encouraged to also engage the care of PCP in maintenance care ongoing as well as recommended ancillary psychotherapeutic care.
Services Include:
DRS is able to offer treatment for substance use disorders in addition to other comorbid psychiatric disorders:
MAT (Medication-Assisted Treatment): Available for Opiate Use Disorders in the form of Buprenorphine, which will be discussed on an individual basis. This is because compliance must be consistent with state and federal legislation in effect at the time. This generally requires some lab work from the client, as well as identification when picking up medications and adherence to medication follow-up policies. However, the buprenorphine products available can be very effective at managing opiate use issues. With other opiates available, such as fentanyl, the induction can be more complicated, as would be discussed on an individual basis.
MAT for Alcohol Issues: Although there is no “ideal” treatment for alcohol use, there are some approved medications that can help with “cravings” for alcohol. It is important to recognize that “cravings” are complex and somewhat habitual, i.e., behavioral; therefore, there is no “magic bullet” treatment in medication form. However, medications such as Campral, Vivitrol (i.e., naltrexone), and some others can be used in conjunction with therapy, depending on the situation and other psychiatric medications. Sometimes a single medication can benefit both alcohol and opiate issues.
Other Illicit Substance Issues: Can be discussed on an individual basis, as literature and current treatment recommendations are subject to change.
This category of service can come as a referral from other providers such as primary care providers, other APNs, therapists or when clients self-refer due to concerns of many different potential issues. Some issues that have been expressed in my experience could include:
Although we may think of telehealth as more common these days, it was not so common just several years ago. Dr. Deerfield provides these services when appropriate for clients, even with complex conditions. However, it is important to abide by the telehealth tenets that will be provided later in the policies section. Also, in-person visits are at times not only necessary but preferable, as they provide more helpful information.
Often, legal entities will engage in Psychiatric expert services. These services vary by venue and are usually time-limited. They often involve solving a particular concern or question. I have many years’ experience in providing these services.
A good way to look at a truly integrative efficient model that utilizes limited expert services and distributes them effectively is the “hub and spoke”. This model efficiently uses limited expert services by distributing them effectively. This approach can be effective if implemented properly. The “hub” represents the locus of expert resources in a rural area and the “spokes” are the satellites sites or points of entry where clients are screened and treated at some level of service. The integration of sites has supported research and grant applications by addressing specific needs, particularly in under-served areas where specialists are scarce and primary care is heavily utilized. As an addiction psychiatrist in such a rural area I was able to consult very effectively in multiple facilities even within the same week/day. These included : forensic (jails) for emergent issues or medication management, hospitals for complex psychiatric cases when there was not a psychiatrist on staff, ER settings for emergent needs in detoxes or medication questions, group homes for medications and guidance, MAT clinics for protocols and quality of care issues, therapist groups and PCP groups for guidance and cases, neurological centers for cases with mixed presentations, APN’s consultations , and policy protocols groups, as well as lecture/discussions to specified target audiences that would facilitate the increase in quality care in PCP or mid-level providers and perhaps decrease the need for psychiatric referrals This was an experience that truly illustrates how consulting can increase efficiency, and the quality of integrative care. It is a “team effort” that can pay off in improved client care despite less resources!
To read more about this topic please see “Comorbidities in Psychiatry: Prescribing Pearls” blog article
DRS has a broad array of ongoing collaboration opportunities for nurse APNs. I have been providing these for well over 15 years and enjoy teaching/mentoring. I am also available for PCPs and/or groups of physicians. I am available on short notice for “more emergent questions that may come up.” I am current and continuously following state regulations and this is important as they change from time to time.
Dr. Deerfield currently has some ongoing Medical Directorships that she attends to on a daily basis. Usually, she supervises the work of the APNs, provides ongoing training, addresses liability issues, facilitates state-of-the-art MAT treatment, and seeks to improve the client treatment experience while safeguarding against potential safety issues. Other duties include: Setting up toxicology screening and other protocols, as well as ,providing surveillance of toxicology reports and provide summary reports that integrate medical notes with toxicology to show relapse and progress with each client . She then presents the data at conference meetings or in bulk emails to staff. She is also involved in hiring APNs and giving feedback on performance. In addition, she provides peer reviewed articles that are pertinent to medical cases that arise and is also responsible for medical clearance of cases that are presented for admissions. Overall Dr. Deerfield works closely with administration to improve the overall quality of the clients experience and promote excellence in the facility.
