Practice

However, many people suffer from mood or anxiety symptoms, or other stress relating to their life circumstances, that don’t quite fall into the classic diagnostic labels. Though diagnoses can be useful in guiding appropriate treatment or predicting prognosis, most meaningful work in the psychiatric setting requires further attention toward the patient as a unique individual with unique circumstances and goals.

At Republic Psychiatry Southlake, we appreciate the therapeutic relationship and understand its tremendous importance in collaborating on a successful treatment process. We encourage patients to freely share thoughts and feelings in treatment, as it allows for better understanding by us, more engagement by the patient, and hopefully more trust in us. We also value discussion and education about psychiatric conditions as some of this information can often be unfamiliar to people due to societal stigma, public misinformation, and other factors.  As physicians, we aim to be collaborative and responsive to referring providers and other members of the treatment team as needed for the patient's care.

Many mental health conditions respond best to a combination of psychotherapy and medication, though there can be substantial variation from person to person. For conditions that may appropriately improve with medication, and for patients open to medication, benefits and risks of reasonable options are reviewed until the patient is comfortable proceeding with a therapeutic trial. Response to medication, side effects, and alternative options if needed are evaluated throughout treatment. Genetic testing for medications can be ordered upon request, though we would discuss the evidence base and limitations in interpreting results.

Dr. Patel and Dr. Ostadian were trained at a program that also strongly valued the importance of psychotherapy in the treatment of many psychiatric conditions. We can provide psychotherapy in some cases, or we can provide referrals for good therapists based on the patient’s symptoms, needs, and preferences. Therapy may help an individual further understand oneself (including with identifying underlying beliefs and thought patterns, clarifying and tolerating feelings, examining the role of development on adult identity, and noticing pertinent defenses), adopt a more empowering outlook, or reflect on day-to-day situations with more insight and clarity. Sometimes therapy can help someone better accept oneself and work through shame or unresolved pain, modify interpersonal patterns with important people in one’s life, actively engage in fundamental life dilemmas involving freedom and choices, or create a deeper sense of meaning and purpose. Relationships, family dynamics, family of origin issues, loss, identity, and stress are sometimes best addressed through therapy.  Psychotherapeutic principles are often important considerations even for patients receiving primarily medication management treatment.

We focus on working with patients who have an interest in treatment and are voluntarily seeking it, though it is not unusual for the patient to have ambivalence about change. We do require regular office or telemedicine visits for ongoing treatment and medication renewals if needed. We do not provide walk-in appointments. Due to our small and independent practice setup, there are a few higher acuity psychiatric conditions that we don’t specialize in and that we believe would be better served by a multidisciplinary or specialty clinic with more specialized resources/staffing and after-hours services – our office may review this with you when you call for a new patient appointment. Additionally, we do not provide legal services or assessments/reports for external parties. Regarding medication management, we tend to be more conservative with benzodiazepine and controlled substance prescriptions than some may prefer. We also tend to discourage long leaves of absence due to the potential impact on self-confidence and the risks of regression with the underlying condition, though this is certainly evaluated on a case-by-case basis. Please call our office if questions about services.