What is the first step?
If you are interested in our services, please call Dr. Wachtel’s assistant at 212-348-0175, extension 16. She will answer your questions about the practice and schedule an initial consultation. Prior to this appointment, you may forward any previous testing reports, school records, or medical material for review. You can fax these items to our New York City office at (212) 426-0784, or to our White Plains office at (914) 686-0933. If you are unable to fax materials ahead of time, please bring them with you to your first appointment.We recommend that you download the Patient Background Forms from our website and bring the completed forms to your appointment. If you are unable to complete these forms ahead of time, please arrive to your first appointment 15 minutes in advance in order to fill out the necessary paperwork.
During the first meeting, a family history will be obtained, followed by a discussion of the behavior and observations which initially led you to Familyhealth Associates. At this time, diagnostic neuropsychological testing may be discussed.
What is executive functioning and how can I improve it?
EF is difficult to define, but can best be understood as a set of cognitive (thought-related) processes involved in self-directed behavior. We can observe our EF system at work when we make decisions, confront novel situations, solve problems, and plan our day. This system is so much a part of our lives that we only really notice it when it isn’t working properly.
Along with issues of inattention and impulsivity, deficits in EF are often considered a hallmark of ADHD. We may observe these deficits in the form of procrastination, tardiness, time management, task-planning difficulty, organizational issues, and forgetfulness. While medication can vastly improve academic performance, attention, retention, and behavioral issues, it often fails to influence these very important daily issues. When these issues aren’t resolved, they can impede school and work performance and create conflict at home.
Over the past 3 decades, researchers have discovered that EF deficits can improve through instruction and practice. The evidence supporting interventions for organizational difficulties is compelling, as it has enabled countless children, adolescents, and adults to achieve and maintain specific goals related to EF. In addition to providing psychopharmacological and therapeutic interventions to reduce ADHD symptoms and improve overall functioning, FamilyHealth Associates is proud of offer a customized EF program as part of our commitment to integrated and collaborative care. Collaborating with other FamilyHealth Associates clinicians, a dedicated therapist will work with family members and teachers in the office, home, at school, online, and over the phone to provide continuous support. We feel that our EF program is an important element in the comprehensive treatment of ADHD and in improving the overall wellbeing of our patients.
What is a diagnostic neuropsychological evaluation?
Diagnostic evaluations are administered by psychologists using a set of standardized tests. These tests provide an in-depth assessment of cognitive and behavioral functions, intelligence, attention, memory, learning skills, perceptual/motor abilities and personality. When scored and interpreted, these tests provide critical information allowing us to diagnose disorders and recommend appropriate treatment options.
Evaluations are scheduled in accordance with the patient’s attention span and ability to remain on task. These assessments are usually administered during two sessions with approximately four hours allotted for each; additional meetings may be scheduled if needed to complete the process at no additional cost. Most adults and older adolescents are able to complete the process in one full day, if requested.
The evaluator will discuss these options with you before beginning the evaluation, as well as directions for lunch, breaks, and any other concerns you may have.
During the reporting conference, the results of the evaluation will be explained and discussed in depth. Recommendations for compensatory strategies may be indicated, and/or referrals for pharmacology, psychotherapy, and/or educational assistance. You will have the opportunity to ask any questions or voice any concerns.
What if we recommend prescription
Our psychiatrists specialize in the management of all psychotropic drugs. Before the physician prescribes stimulant medications, the patient will be asked to schedule cardiac testing. This is a precaution to rule out any cardiac abnormalities which may be exacerbated by certain medications.
Patients who are prescribed medication at our offices are closely monitored and required to adhere to a strict supervision policy. The patient may be asked to keep a log with a list of positive or negative side effects, rebounding, and the general efficacy of the medication. In the case of a child, parents and teachers will be asked to assist us in determining the effectiveness of the medication.
For more information on prescriptions, please visit our Prescription Policies and Reminders page.
What if we recommend psychotherapy?
If individual behavior modification is recommended, treatment may be arranged with one of our professionals who are specifically trained to work with issues of attention, mood, behavior, and other disorders.
How do I prepare my child for his/her appointment?
We suggest that you discuss the fact that you have noticed that he/she is having difficulties at school, problems with friends or just feeling sad. Explain that he/she will be meeting with some people who are specialists in helping children learn, have fun, and feel better. You may want to assure younger children that, unlike a visit to the pediatrician, there will be no physical exams or needles.
When working with children, our goal is to assist parents in their role as therapeutic agents and advocates. Thus, parents’ full cooperation and support is engaged. We offer several services to parents and children.
At your request, and when indicated, a Familyhealth clinician will arrange to visit your child’s school for observation of the child in an academic setting, or for a meeting with faculty or staff. Please note, however, that although we encourage school involvement, we do not release written information or have verbal contact with any school personnel without your written authorization.
If educational remediation is prescribed, we will maintain an active dialogue with the educational therapist of your choice. Additionally, if we feel it would benefit your child, we are available to consult with any other professionals.
In our treatment of adolescents, where boundaries are critical, we insure that the therapeutic alliance is protected. Familyhealth therapists are experienced in working with issues unique to the adolescent.
What is the office’s cancellation policy?
Appointments are reserved for you or your child. We do not “double book”. Therefore, if you need to cancel an appointment, we require at least 24 hours’ notice prior to your scheduled time. If we do not receive 24 hour advance notice of cancellation, you will be charged for the time allotted at the regular rate. This applies to in person and/or phone appointments.
Is the staff available by e-mail or over the phone?
We recognize that a brief email or phone conversation with a clinician is part of the ongoing treatment process. However, we believe they are not adequate replacements for face to face contact. We encourage you to discuss any issues in person at the office.
Calls lasting 15 minutes or longer are charged at the in-office rate. Please note that insurance companies do not reimburse for telephone calls.
What if we have an emergency?
In the event of a medical emergency, call 911 or go to your nearest emergency room. You may speak to one of our psychiatrists by calling the main office number and dialing extension 40. Instructions will be given on how to call the physician on call.
Are my records confidential?
Familyhealth Associates is HIPPA compliant. Medical information is not released without prior written authorization of the patient. If the patient is under 18 years old, we require written authorization of a parent. If the child’s parents are legally separated or divorced, we require the consent of the custodial parent. This policy extends to oral conversations with school personnel, physicians or any other professionals involved in the patient’s care.
In addition, please note that when insurance companies or legal entities request your medical information, we are compelled to release ALL INFORMATION IN YOUR FILE. Legally, we cannot withhold specific material. Alternatively, we may inform them that you have not given (or have withdrawn) consent. If you have any questions or concerns in this regard, you may contact Dr. Catie Stern, who is the staff HIPPA Officer, at extension 80.
Does Familyhealth Associates
participate in any insurance plans?
Familyhealth Associates is committed to providing the best and most advanced care to our patients. For this reason, we do not participate in any health management organizations (HMOs), and payment is due at the time of service in the form of cash, check or major credit card. For ongoing treatment, you may complete an authorization form to permit us to automatically charge your credit card after each session.
Our receptionist will provide you with a paid insurance receipt containing all the necessary information to submit to your insurance carrier for reimbursement. Furthermore, our administrative staff will assist you in obtaining reimbursement by providing you with supportive documents as requested. It is important to note that we will always remain within the parameters of all ethical requirements.
*Note on Testing: It has been our experience that certain insurance companies require pre-approval for any type of testing. If you or your child is scheduled for an evaluation, it is recommended that you contact your insurance company in advance.
What if treatment is terminated?
We strongly believe that the use of all medications requires careful monitoring by a physician. For this reason, pharmacological patients who have not been seen in this office by a physician for a period of six months or more are not considered patients of this practice. We will not be responsible for any patient who has not been seen in the office within the past six months.
If the relationship is terminated for this or any other reason, we remain available on an interim basis to handle any emergency situations until a new physician is engaged. At your request, we will provide you with a list of alternative physicians, clinics, and hospitals.
Upon receipt of appropriate written authorizations, we will forward your records to the another health care provider.