Therapy is a process in which patients are guided by a trained mental health professional to identify and understand any thoughts, behaviors, and emotions they may be having that they want to change or process.

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Therapy can help you identify difficult to understand thoughts or feelings you may be having. Our providers are dedicated to creating treatment plans that speak to your unique, individual needs. The process of therapy helps patients work through traumatic events, grief, and loss, create boundaries with self or others, break down emotions, thoughts, and feelings, identify areas of strength and build self-esteem and worth. If you have any questions about how therapy can help you today, please call ___________.

These letters indicate the provider's level of education and degree and any certifications and qualifications they may have! M.D. - Doctor in Medicine M.S. - Master of Science MSW - Master of Social Work LCSW, LCSWA - Licensed Clinical Social Worker/Associate LCMHC, LCMHCA - Licensed Clinical Mental Health Counselor/Associate LCAS, LCASA - Licensed Clinical Addictions Specialist/Associate LMFT - Licensed Marriage and Family Therapist

Absolutely! Unless a client poses a danger to themselves or others, our provider suspects child or elder abuse, or our provider is legally mandated by a court order to pass along records, 100% of everything you say in the session will be confidential in accordance with the Health Insurance Portability and Accountability Act (HIPPA).

After scheduling an appointment the first session is an intake session lasting ______. After that, sessions are ________. We try our best to make sure all questions are addressed during the time of the session.

No! Therapy is your personal journey. At any time you can opt in or out of therapy. Therapy is your time to explore your thoughts and feelings. While we recommend that you remain in therapy if a provider feels it is the best course of treatment, you are free to no longer schedule sessions. We ask that pre-scheduled sessions you do not plan to attend are canceled within ________ hours of your scheduled appointment time. All missed appointments will incur a fee.

People go to therapy for an endless variety of reasons! Just a few of the reasons one might go to therapy are: Anxiety and Depression Grief and Loss Anger management Low self-esteem Relationship issues Career changes Navigating feelings about retirement New Parents Sexual abuse and Domestic violence Domestic Exploring of Mental Health Conditions Self-improvement Bullying Boundary setting PTSD

The first session is an intake session which looks a little different than most other sessions.

ADHD is a neurological disorder characterized by a consistent pattern of inattention and/or hyperactive impulsivity, which disrupts daily activities in at least two environments, such as school and home. It affects individuals of all genders, ages, and backgrounds. The symptoms described encompass the diverse range of manifestations linked with ADHD, though the specific symptoms vary across its three subtypes: Inattentive type Hyperactive or impulsive type Combined type Individuals exhibiting the inattentive subtype of ADHD encounter challenges in maintaining focus, completing assignments, and adhering to directives. They frequently experience distractions and lapses in memory, often characterized by daydreaming and recurrent misplacement of items like homework, mobile devices, and ongoing conversations. Professionals suggest that numerous children with this subtype of ADHD might remain undiagnosed due to their less disruptive behavior within educational settings (Willcutt, 2012). Individuals diagnosed with predominantly hyperactive-impulsive ADHD exhibit behaviors akin to being continuously energized, displaying limited impulse regulation. They demonstrate constant movement, restlessness, and verbal expression, often regardless of the appropriateness of the situation. Their actions tend toward impulsivity, impatience, and frequent interruption of others. Individuals diagnosed with combined-type ADHD manifest a blend of symptoms encompassing those described previously. A medical professional will identify patients with this subtype if they meet the criteria for both predominantly inattentive ADHD and predominantly hyperactive-impulsive ADHD, requiring the presence of at least six out of the nine symptoms outlined for each subtype.

The symptoms of ADHD can differ from person to person. You or your child might encounter all or only some of the symptoms mentioned below, as well as others outlined in the DSM-V. Short attention span, especially for non-preferred tasks. Hyperactivity, which may be physical, verbal, and/or emotional. Impulsivity, which may manifest as recklessness. Fidgeting or restlessness. Disorganization and difficulty prioritizing tasks. Poor time management and time blindness. Frequent mood swings and emotional dysregulation. Forgetfulness and poor working memory. Trouble multitasking and executive dysfunction. Inability to control anger or frustration. Trouble completing tasks and frequent procrastination. Distractibility. Difficulty awaiting turn.

ADHD Testing: Overview and Importance ADHD testing is a comprehensive process designed to accurately diagnose attention deficit hyperactivity disorder (ADHD) in individuals across various age groups. This evaluation is essential because ADHD is a multifaceted neurological condition that manifests differently in each person. Testing typically involves a combination of clinical interviews, behavioral assessments, and standardized questionnaires to gather a holistic view of the individual's symptoms and their impact on daily functioning. The primary goal of ADHD testing is not only to confirm the presence of ADHD but also to differentiate it from other conditions that may present with similar symptoms, such as anxiety, depression, or learning disabilities. Accurate diagnosis is crucial for developing an effective treatment plan tailored to the individual's specific needs (American Psychiatric Association, 2013). Components of ADHD Testing The ADHD testing process usually begins with a thorough clinical interview conducted by a healthcare professional, such as a psychologist, psychiatrist, or pediatrician. This interview involves a detailed exploration of the individual's developmental history, behavior, and academic or work performance. Input from parents, teachers, or significant others is often sought to provide additional perspectives on the individual's symptoms across different settings. Standardized behavior rating scales and questionnaires, such as the Conners' Rating Scales or the ADHD Rating Scale, are commonly used tools that help quantify the severity and frequency of ADHD symptoms. These tools enable clinicians to compare the individual's behavior to normative data, enhancing the accuracy of the diagnosis (DuPaul et al., 2016). Additionally, cognitive and neuropsychological assessments may be employed to evaluate executive functions, attention span, and working memory, which are often impaired in individuals with ADHD. Challenges and Considerations in ADHD Testing Despite the structured approach, ADHD testing faces several challenges that can complicate the diagnostic process. One major challenge is the variability in symptom presentation, which can lead to underdiagnosis or misdiagnosis, especially in populations that exhibit less disruptive behaviors, such as females or adults. Cultural and socioeconomic factors can also influence the perception and reporting of ADHD symptoms, potentially leading to disparities in diagnosis and treatment access. Furthermore, the overlap of ADHD symptoms with those of other psychological or developmental disorders necessitates a careful differential diagnosis to avoid inappropriate treatment. Clinicians must remain vigilant and consider the broader context of the individual's life, including stressors, environmental factors, and co-occurring conditions, to ensure a comprehensive and accurate diagnosis. Continued research and refinement of diagnostic criteria and assessment tools are essential to improving the reliability and validity of ADHD testing (Willcutt, 2012).

Testing Overview  This evaluation of ADHD is intended for individuals aged 4 through adults who present with academic and/or behavioral problems and symptoms of inattention, hyperactivity, or impulsivity. We will evaluate if symptoms of ADHD are present and to what extent they cause dysfunction.  For children, information will be obtained via a clinical evaluation which could include reports from parents or guardians, teachers, and other school and mental health clinicians involved in the child’s care.  We will also assess for other conditions that might coexist with ADHD (e.g. anxiety, depressive, oppositional defiant, and conduct disorders, among others). Based on our findings, we could recommend further neuropsychological testing.  Testing Personnel  At our facility, ADHD testing and interpretation are conducted by a team of highly qualified medical professionals, including board-certified doctors and Advanced Practice Providers (APPs). Utilizing the latest diagnostic tools and evidence-based protocols, our experts are committed to providing accurate and comprehensive assessments. Our multidisciplinary approach ensures that you receive a tailored treatment plan to effectively manage and improve symptoms of ADHD. Testing Fees and appointments Our fees vary depending on patients' insurance and out-of-pocket expenses. Our testing is composed of two appointments: Testing Appointment: This appointment is usually about 30 minutes and consists of a task-oriented computerized assessment of attention-related problems called Conners Continuous Performance Test 3rd Edition™ (Conners CPT 3™), or The Conners Kiddie Continuous Performance Test 2nd Edition™. Results are reviewed internally between the examiner and a member of our clinical staff.  Intake Appointment:  This appointment is a 30-minute to one-hour session for a clinical interview and assessments. Data collection surveys are due from families and teachers (for children) at this session. If the examinee is a minor, parents are responsible for ensuring that the teacher’s form is completed and provided to the examiner before this appointment. An explanation of the results will be provided in the clinical report. Complete fees are to be paid before the written report is provided.  It is encouraged that all parties, including the examinee, attend this appointment to review the diagnostic results and clinical recommendations.  The CPT-3 (Continuous Performance Test, Third Edition) is an essential component of our comprehensive ADHD evaluation process. Please note the following important information regarding the cost and billing of this part of the test: Cost of CPT-3 Testing: The fee for the CPT-3 test is $250.00. This is a one-time charge specifically for the administration and analysis of this CPT-3 test. Insurance Billing: This fee will not be billed to your insurance company. The CPT-3 test is a self-pay service, and you will be responsible for covering this cost out-of-pocket. Self-Pay Rate: The $250.00 fee is the only self-pay charge you will incur for our ADHD evaluation services. All other visits and services provided by your healthcare provider will be billed to your insurance, provided that your provider is in-network with your insurance plan. Disclaimer: The Intake appointment, and Follow-up appointment services may or may not be covered by medical insurance policies. The patient is responsible for understanding their insurance coverage and payment for services. Both visits will receive a good faith estimate which is not a guarantee of coverage nor reimbursement from the patient insurance.

ADHD treatment typically involves a combination of therapy and medication. For preschool-aged children and younger, the first recommended approach is to use behavioral strategies, including parent management training and school interventions. According to current guidelines, psychostimulants (amphetamines and methylphenidate) are the primary pharmacological treatments for managing ADHD (Pliszka, 2007). For preschool-aged patients with ADHD, amphetamines are the only FDA-approved medication, although guidelines suggest that methylphenidate, rather than amphetamines, may be helpful if behavioral interventions are insufficient. Other FDA-approved options for treating ADHD include alpha agonists (clonidine and guanfacine) and the selective norepinephrine reuptake inhibitor atomoxetine. There are newer FDA-approved medications for ADHD, such as Jornay (methylphenidate extended-release), taken at night to start the medication effect the next morning, Xelstrym (dextroamphetamine), an amphetamine patch, Qelbree (viloxazine), a non-stimulant, Adhansia (methylphenidate hydrochloride), Dyanavel (amphetamine extended-release oral suspension), Mydayis (mixed salts amphetamine product), and Cotempla (methylphenidate extended-release orally disintegrating tablets). Of note, these newer ADHD agents differ mainly from the older ones NOT in the actual medications delivered (methylphenidates and amphetamines), but in newer methods of delivery that may offer patients a wider variety of options for timing of medication ingestion, length of effect, as well as how “smoothly” the patient experiences the medication.

What is ADHD? https://www.psychiatry.org/patients-families/adhd/what-is-adhd DSM-V https://www.psychiatry.org/psychiatrists/practice/dsm ADHD medications parent guide https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/med_guides/ADHD_Medication_Guide-web.pdf What is ADHD? Video by the American Psychiatric Association https://www.youtube.com/watch?v=9TcNQkyxMj8&t=119s ADDitude website https://www.additudemag.com/

Attention deficit hyperactivity disorder or ADHD, affects around 8-10% of children and nearly 3-5% of adults in the United States (Centers for Disease Control and Prevention [CDC], 2020). It's a multifaceted neurological condition that interferes with the brain's executive functions. Individuals with ADHD struggle with regulating impulses, maintaining focus, and organizing tasks. Insights from neuroscience, brain imaging, and clinical studies highlight that ADHD should not be classified as a behavioral disorder, mental illness, or specific learning disability (Barkley, 2015). Instead, it's identified as a developmental deficit within the brain's self-regulation mechanisms. Both adults and children can receive diagnoses of ADHD. According to Danielson et al. (2018) and Simon et al. (2009), ADHD is frequently first noticed in school-aged children due to classroom disruptions or difficulties with schoolwork. It is more commonly diagnosed in boys than girls, as the symptoms often manifest differently. Boys typically exhibit hyperactivity and other externalizing behaviors, while girls are more likely to show inactivity (Hinshaw & Scheffler, 2014). However, this does not indicate that boys are more prone to having ADHD.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing. Barkley, R. A. (2015). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment. Guilford Publications. Centers for Disease Control and Prevention. (2020). Data and statistics about ADHD. Retrieved from https://www.cdc.gov/ncbddd/adhd/data.html Danielson, M. L., Bitsko, R. H., Ghandour, R. M., Holbrook, J. R., Kogan, M. D., & Blumberg, S. J. (2018). Prevalence of Parent-Reported ADHD Diagnosis and Associated Treatment Among U.S. Children and Adolescents, 2016. Journal of Clinical Child & Adolescent Psychology, 47(2), 199-212. https://doi.org/10.1080/15374416.2017.1417860 DuPaul, G. J., Reid, R., Anastopoulos, A. D., & Power, T. J. (2016). Assessing ADHD symptoms in children and adults: Development and validation of the ADHD Rating Scale-IV. Journal of Psychopathology and Behavioral Assessment, 38(1), 25-35. https://doi.org/10.1007/s10862-015-9518-7 Hinshaw, S. P., & Scheffler, R. M. (2014). The ADHD explosion: Myths, medication, money, and today's push for performance. Oxford University Press. Pliszka, S. R. (2007). Pharmacologic Treatment of Attention-Deficit/Hyperactivity Disorder: Efficacy, Safety and Mechanisms of Action. Neuropsychology Review, 17(1), 61-72. https://doi.org/10.1007/s11065-007-9037-9 Simon, V., Czobor, P., Bálint, S., Mészáros, Á., & Bitter, I. (2009). Prevalence and correlates of adult attention-deficit hyperactivity disorder: meta-analysis. The British Journal of Psychiatry, 194(3), 204-211. https://doi.org/10.1192/bjp.bp.107.048827 Willcutt, E. G. (2012). The prevalence of DSM-IV attention-deficit/hyperactivity disorder: a meta-analytic review. Neurotherapeutics, 9(3), 490-499. https://doi.org/10.1007/s13311-012-0135-8

Cost for each session can vary widely based on your insurance plan and specific mental health benefits. During your first call with our intake coordinator, they will ask for your insurance information so that our eligibility team can run your insurance information to estimate the cost of your session. Someone from our eligibility team will be in touch prior to your session to explain the cost of your session and collect payment. Self pay rates vary depending on the provider that you plan to see.

A psychiatrist is a medical doctor that can conduct a psychiatric evaluation, prescribe medication, and in some cases provide psychotherapy. Physician assistants and nurse practitioners are advanced practice clinicians that operate under the supervision of a psychiatrist. They too can conduct psychiatric evaluations, prescribe medication, and in some cases provide psychotherapy. Therapists can provide dedicated psychotherapy services. Psychologists can provide psychotherapy and conduct psychological evaluations. Please note that our resident psychologist is not offering psychological evaluations (neurophysiology's testing, psycho-educational testing, etc.) at this time.

Self pay rates are $250 for new patients seeking therapy. Follow up appointments vary depending on provider but the range is $165-250 per session. These prices only apply to non prescriber patients, our therapists. Two of our therapists are credential with Blue Cross Blue Shield and Medcost. We would have to verify your plan to provide an estimate for the cost of the visit. Please call our office for more information. Our health coach rates for self pay patients is $140 per session

The paperwork is available to you on the patient portal. You should have received an email from “Insync administrator” with your login credentials. Once you log onto the portal you can see the forms are available to be filled out under the “Forms/Documents” tab. If you are having difficulty navigating our patient portal, please go to our resources page and click the grey bar that says "Click Here for Assistance with Our Patient Portal."

The person signing the new patient forms must be 18 or older. If the patient is a minor, the new patient forms must be completed by a parent or guardian. If the patient is 18 or older, they will need to complete the forms. The scales are to be completed as instructed on each form. If the scale says “parent” it should be filled out by a parent, if a scale says “child” it should be filled out by the child. If the form for whatever reason doesn't specify, it is meant to be filled out by the patient.

We have four psychiatrists, three physician assistants, six nurse practitioners, four therapists, and one psychologist for a total of eighteen providers.

The guarantor form only needs to be filled out if someone other than the patient will be paying for their sessions that isn’t a legal parent/ guardian of a minor. If a spouse, company, friend, family member etc. is paying for sessions- the guarantor form needs to be filled out with the information of the person that will be paying. We can not accept payment from someone for sessions if the form is not signed with their information.

Our providers specialize in a variety of psychiatric and behavioral conditions. Please scroll down to view our "Providers that Specialize In:..." section further down on this page to see all the providers that specialize in each specific condition. Also, if you navigate to each specific provider's page, their areas of interest will be listed for your perusal. Another great way to determine which provider will be a good fit is to call an intake coordinator at 980-237-4766 ext.103. They will take you through our screening process to determine if we can provide the level of care you need and can make a recommendation as to which provider would be best suited to see you. Using our new assessment found on "Click here to get started" will expedite the new patient process.

In order to give our patients the care they deserve, our patients are asked to complete a brief assessment on this website. This tool is both informative for the patient and, it also allows us to determine if we need records from the patients, or if the patient requires a higher level of care then we can provide. Review the list of insurance that are out of our network and the plans from BCBS and UHC that we are not contracted with.

If you need to cancel or reschedule your session, please note that we require 48 hours notice. Failure to provide adequate notice may result in incurring a no-show/cancellation fee. Please also note that if we have not received the completed new patient forms and prepayment for your session by the deadline set by our intake coordinator, your session may be cancelled. Depending on when you schedule your appointment, we require everything to be received no later than one business day prior to your session or by the deadline set by the eligibility team once they have determined the cost of your session

The patient portal in general is not a very mobile friendly application and the forms specifically are not. We recommend using a desktop or laptop computer whenever accessing the patient portal. If you do not have access to a desktop or laptop computer, please call the office to request an emailed PDF copy of the paperwork or to discuss other options.

To finalize your appointment, you will need to complete all of the new patient paperwork on the patient portal and provide prepayment for your session. Someone from our team will be in touch regarding the cost of your session and collecting prepayment. Please note, your provider will not be able to see you unless the forms have been completed and payment has been received.

Please note that the insurance plans we take vary by provider. To be sure what specific plan your provider is in network with, our intake coordinators will need detailed information of your insurance information. Our team will verify your insurance and provide an estimate cost of the first visit once we complete our screening process. We try to update each provider’s page with the insurance plans they take but as we are actively in the process of getting credentialed with some carriers, their pages may not include all plans with which they are in-network. When in doubt, our intake coordinator will have the most up to date information.

The administration of Spravato at our clinic involves a structured procedure, under the supervision of a healthcare provider, ensuring patient safety is at the forefront. As a nasal spray, Spravato provides a non-invasive and relatively quick method of delivery. Patients can expect a thorough explanation and guidance throughout their treatment journey, ensuring transparency, comfort, and peace of mind.

Blue Cross and Blue Shield (including Blue Value, Blue Local, Blue Home, and the High Performing Networks HPN) United Healthcare Optum UMR Medcost/Carolina Behavioral Health Alliance Humana Cigna/Evernorth Aetna (including Aetna CVS) Medicare

Choose Pediatric and Family Behavioral Health (PFBH) for SPRAVATO® treatment because we offer specialized care for treatment-resistant depression in a supportive environment. PFBH is the only practice in the area providing after hour appointments, catering to working professionals who may have difficulty attending during standard hours. Plus, you can get all your mental health needs under one roof, including therapy, TMS, ADHD testing, and medication management. Our team is committed to delivering effective, evidence-based care with the flexibility you need to manage your mental health while balancing work and life.

Shanna Mago PMHNP-BC Laura Nazzaro PMHNP-BC Micah Bright PMHNP-BC Daima Morales PMHNP-BC Levy Wiseman-Floyd PA-C Jeffrey Woodard PA-C Diana Remenar PA-C

Spravato is a brand name for esketamine. Distinguished from traditional antidepressants, Spravato acts on the brain's glutamatergic system, providing a new pathway for addressing the distressing symptoms of TRD and MDD. Importantly, Spravato has been FDA-approved specifically for TRD and MDD with suicidality, underscoring its scientific backing and rigorous testing. This therapeutic innovation opens a new chapter in mental health care, particularly for those patients who have not responded favorably to conventional treatment options.