At the first appointment, Dr. Crandall conducts an initial evaluation, which includes a full history and mental status exam.
Patients should be prepared to answer questions about symptom characteristics and history, past psychiatric history, substance abuse, family, educational and social histories. Subsequent to the initial evaluation, patients followed for medications only will return to the office at some regular frequency to assess progress. Medication visits are normally scheduled in 20-minute intervals and are used to discuss response to medications, side effects and other relevant issues. Dr. Crandall also provides psychotherapy.
Dr. Crandall’s psychotherapeutic approach includes aspects of Freudian, interpersonal, somatic, and spiritual techniques. Depending on the patient’s belief system, psychiatric symptoms can be evaluated and explored through many viewpoints, such as psychological or spiritual crisis. Dr. Crandall’s approach attempts to recognize places where the patient is not tuned in to natural rhythms or intuition. She also uses concrete therapeutic techniques such as cognitive behavioral therapy (CBT), meditation, and relaxation exercises. However, she will focus primarily on the medical evaluation and treatment in the first sessions, as Western medicine is her training and expertise. The patient is encouraged to specify what approach they prefer the treatment to focus on. Dr. Crandall specializes in treatment of ADHD and anxiety disorders, as well as mood disorders.
Medication Philosophy –
Medications are very useful and clinically proven tools to ameliorate physical and psychological symptoms of mental illness. While they have multiple benefits, they can also cause uncomfortable or disruptive side effects that limit their usefulness. The focus of medication treatment is to maximize positive response while minimizing unwanted side effects. Dr. Crandall’s approach to prescribing medications is conservative, and she tries to reserve this option for instances in which the potential benefits outweigh the risks. Some symptoms are so severe and persistent that they interfere with attempts at healing, and can produce serious negative consequences for the patient and family if untreated.
Depending on the wishes of the patient, medications can be an integral part of a healing journey. Sometimes they are used on a long term basis and sometimes for brief periods of time, which will be determined by the course of treatment. For moderate to severe symptoms, a course of 6-12 months of medication treatment is a standard recommendation. Most commonly, medications are used to address the most prominent and disruptive symptoms, freeing up the patient to learn cognitive, behavioral and physical tools that will form the foundation for healing and staying symptom-free. Ideally, when a patient has mastered new coping skills and created a stronger, more stable emotional foundation, medications can be minimized or discontinued.
Buprenorphine Maintenance Treatment –
Buprenorphine is an partial opiate agonist approved by the FDA for treating opiate addiction (Vicodin, Oxycontin, Percocet, Heroin, etc.). Dr. Crandall received specialized training and certification to prescribe this highly effective tool in arresting opiate craving. There is a specific method to using Buprenorphine, which she will impart to those who could benefit.
Dr. Crandall works closely with other therapists and practitioners to coordinate care and reassess the most effective treatment for the patient. Her referral sources include craniosacral practitioners, body workers, life coaches, meditation teachers, and specialized therapists.