FAQs

Psychiatric evaluations consist of two 60-minute appointments, allowing a thorough evaluation.

In the first appointment, the clinician will get a detailed understanding of the difficulties that led you to seek help for your child. We will also ask that you and your child fill out clinical questionnaires, yielding standardized data about the symptoms of concern. The data provide both an objective lens on any diagnosis under consideration and a baseline against which future progress can be measured.

In the second appointment, after some additional follow-up questions, the clinician will discuss relevant diagnoses with you (and, if appropriate, with your child). The clinician can share information about why diagnoses develop, what happens over time with and without treatment, what parents can do to help, and, of course, the range of treatment options available.

Any medicine that is recommended will be prescribed at the lowest dose and for the shortest period of time possible. Medicine would only be continued if it is both useful and causes zero side effects.

Psychiatric evaluations consist of two 60-minute appointments, allowing a thorough evaluation.

In the first appointment, the clinician will get a detailed understanding of the difficulties that led you to seek help. We will also ask that you fill out clinical questionnaires, yielding standardized data about the symptoms of concern. The data provide both an objective lens on any diagnosis under consideration and a baseline against which future progress can be measured.

In the second appointment, after some additional follow-up questions, the clinician will discuss relevant diagnoses with you. The clinician can share information about why diagnoses develop, what happens over time with and without treatment and, of course, the range of treatment options available.

Any medicine that is recommended will be prescribed at the lowest dose and for the shortest period of time possible. Medicine would only be continued if it is both useful and causes zero side effects.

A psychotherapy evaluation involves one 30-45 minute meeting. The clinician will ask questions to get a basic understanding of the challenges that led you to seek help. The clinician will also ask about relevant background information, including what worked or didn't work in previous experiences in therapy. Then, the clinician will offer a working hypothesis for what is going on. Following the evaluation, the clinician will recommend an individualized plan of treatment, as well as put you in touch with the Stratus therapist whose skill set and style best match your needs.

At Stratus, we expect treatment to work clearly and in a specific time frame. Progress can be recognized in five key ways:

1. Feeling better, often accompanied by greater self-esteem

2. Acting healthier: new achievements at school, at work, or in relationships

3. Looking better: for a child, observations of parents and teachers; for an adult, observations of friends, family and co-workers, seeing a noticeable difference in the person's reactions or behaviors

4. Quantitative improvement: standardized outcome measurements show reduced symptoms, more sleep, healthier coping and more satisfying quality of life over time

5. Resilience: reduced vulnerability when stress inevitably re-emerges

Of these, resilience is probably the most important. We believe that if treatment helps people feel better, but leaves them just as vulnerable to the next setback, it hasn't really helped enough.

The best number of medications for anyone to take, especially a child, is zero. We recommend medication only if absolutely necessary, and only as one component of an array of therapeutic interventions. Please know that we prescribe conservatively, following evidence-based guidelines, using the smallest dose for the shortest length of time possible. Participating in psychotherapy is usually the way to reduce or eliminate reliance on medication over time.

People can be understandably wary of a psychiatric diagnosis. Diagnoses, however, are not labels. They do not define people, nor should they. No teenager needs an illness as their identity (I AM depressed) when illness is actually an obstacle to building their sense of self. We do need accurate diagnoses to tell us what caused the suffering that brought people to our office. Knowing the cause, in turn, tells us which treatments will work safely, over which amount of time.

Mental health providers should recommend treatments that target a diagnosis, rather than the symptoms it produces, in the same way that cardiologists prescribe medicine for high blood pressure rather than for chest pain, or surgeons perform surgery for a torn ligament rather than for knee pain. Treatment in the absence of diagnosis is highly prone to error, creates unnecessary discouragement when poorly chosen treatments fail, and exposes patients to risk without clear likelihood of benefit.

Our clinicians have expertise treating nearly all psychiatric illnesses, including:

• Anxiety

• Attention-deficit hyperactivity disorder (ADHD)

• Autism spectrum disorders (ASD)

• Body dysmorphic disorder

• Body-focused repetitive behaviors (e.g., hair-pulling)

• Depression

• Disruptive mood dysregulation disorder (DMDD)

• Eating Disorders

• Gender dysphoria

• Insomnia

• Obsessive-compulsive disorder

• Oppositional defiant disorder

• Parenting and family difficulties, including those stemming from high-conflict divorce

• Personality Disorders

• Post-partum depression and other perinatal mental health disorders

• Pre-menstrual dysphoric disorder

• Problematic social media or video game use

• Schizophrenia and other psychotic disorders

• School avoidance/refusal

• Selective mutism

• Self-harm

• Substance use disorders

• Trauma- and stress-related disorders

At Stratus, we pride ourselves on offering evidence-based treatments. Our clinicians are trained in several of these, and are held accountable by regular outcome tracking. Some of the research-supported therapies our clinicians offer include:

• Acceptance and Commitment Therapy (ACT)

• Cognitive Behavior Therapy/Unified Protocol (CBT/UP)

• Dialectical Behavior Therapy (DBT)

• Exposure and Response Prevention (ERP)

• Habit Reversal Training (HRT)

• Mentalization-Based Therapy (MBT)

• Parent-Child Interaction Therapy (PCIT)

The sole exception to this principle is our decision, beginning in 2024, to offer ketamine-assisted psychotherapy (KAP). KAP is a novel and promising approach to treatment-resistant psychiatric illness. Though KAP is unproven, researchers are actively and rigorously researching how best to use ketamine as a psychiatric treatment. At Stratus, we offer KAP only when established treatments have failed. We follow protocols adapted from leaders in the field such as the California Institute for Integral Studies (CIIS) and the Multidisciplinary Association for Psychedelic Studies (MAPS), while also taking newly published studies into account. For more information, talk to your clinician or see our dedicated KAP FAQ section.

We do not. The American Academy of Child and Adolescent Psychiatry (the national organization representing child psychiatrists) published a policy statement in 2020 explaining why they recommend against such testing. The American Psychiatric Association published a similar conclusion in 2018. While we eagerly await the day when such testing can make trial-and-error prescribing obsolete, existing tests simply do not provide scientific and clinically useful information.

Yes, gladly. Many psychotherapy treatments are scientifically proven to be equally effective when delivered via telehealth, even for children. Psychiatric services can also be offered via telehealth.

The American Academy of Pediatrics in 2025 published thoughtful guidelines regarding screen time limits.

Maybe the simplest way to think about how much screen time to allow is to reverse the question, thinking about how much of other activities you want to see in your child's life. After counting school, sleep, family time, play with other children (arts, sports, free play, etc.), time to read, and for older children homework, often there isn't that much time left for any child to spend on a screen doing anything.

When parents worry about restricting access to social media or video games because their children are also socializing, we remind them that there are other ways to socialize that they can insist on for their children. Of course we cannot control what other children or their parents do, but families with similar values and goals will often be grateful that your child is moving their social interactions offline.