At CFC we provide a Comprehensive and Integrated Practice,
A “CONCIERGE” PRACTICE, if you will: “Concierge” describes the kind of care that works to “cover all the bases,” and even “tries to find more bases previously unseen.” This type of care does not happen by accident. You have likely witnessed this type of quality of care in some general medical clinics or in the hospital. Everything fits. It’s comfortable. There is no wasted time. Staff and clinicians are friendly and caring. READ MORE
It requires an environment created on purpose and clinicians skilled enough to create and work within such an environment. Because all of these factors are in alignment at CFC, we are able to provide you with a seamless combination of therapist-psychiatrist services, and beyond: Our combined services also include behavior management training, cognitive behavioral, supportive, and interpersonal therapy, Social Security Disability application support, and ultimate general “Concierge” services. We are, in business-speak, better-faster-cheaper than most any other mental clinic you will encounter. This saves your money (more done in less sessions), your time (i.e. money), saves your insurance company and your company more money (keeping your premiums low). What could be better?! Below, we have listed some of the SPECIFICS of our COMPREHENSIVE MODEL of service.

1. Literally, this means that therapists can access the psychiatrist per phone or in person (when he/she is in the building) presence at any time. The therapist can request that the psychiatrist interrupt his/her own session to provide face-to-face time with the therapist and his/her patient. All of this presupposes that the therapist detected some evidence of the need to alter medication dose or type. Physician makes immediate decision, sometimes of course keeping things the same. Most often, the patient improves much more rapidly. Business jargon for this sort of thing is “JUST IN TIME” shipping and receiving.
2. Our therapists also focus upon providing the most research-supported therapies (Cognitive-behavioral, Interpersonal, etc.) as well as comprehensive evaluation of all problem areas (work, school, family, work, finances, medical) in order that these be addressed BEFORE they become life-eating monsters. A common example: A patient with severe Major Depression is declining in work ability because of the depression and is being prepped for firing by HR. The CFC therapist will have inquired about job/home issues on a regular basis, prepping the patient for the possible need for application for medical leave and disability benefits (most people resist such an idea, of course, so there is a lot of persuasive “prep time and education time” involved, such as helping the depressed patient understand the physical nature of depression, the no-fault research findings. Thus, by the time HR is moving the patient to launching pad, the patient is willing to ACCEPT the necessity of going on leave, and NOW, BEFORE HR has them out the door and their disability benefits have evaporated. This is merely one of many examples. Now, the RESEARCH-BASIS for all of this, for this all-around care, is all over the place. Sadly, most clinics don’t practice this way. 
3. CFC clinicians meet daily for a lunch/clinical review meeting (using only first names, of course, and sitting far away from other patrons) regarding difficult cases – Yes, daily. Well, not Saturday or Sunday. This is one of our most effective of transmitting knowledge from each to the other.

2. Exceptional Paperwork I – Outcome Measures – Torture by Any Other Name: At each visit, using our “Child/Adolescent” or “Adult” Update Forms, you’ve noticed that we request our patients to self-rate a 1-10 Likert Scale of sentinel psychiatric symptoms – i.e. the kinds of symptoms that direct treatment (depression, agitation, insomnia, etc.). We also request that patients provide a rating of percentage improvement overall (assuming improvement). We use these literature-based methods to rapidly direct treatment in the right direction – (or wrong), again, improving our ability to more accurately focus upon those issues causing the most suffering, and to what degree. Again, evaluation become better, faster, cheaper!

3. Exceptional Paperwork II – Child/Adolescent (40pp) and Adult (30pp) History Forms: We ask our patients to complete these whales prior to the first visit. Most of our patients, remarkably, go ahead and fill out these monsters, not even complaining! (We would complain, well, Dr. Lyles says he would, even though he wrote them). Of course, all CFC clinicians and staff are willing to apologize often and early about these horrendous forms. (We would note at this point how truly treacherous these forms can be. For example, if you already know that someone with Major Depression has virtually no energy, concentration, memory or motivation, think about how truly horrible it is to ask them to complete a 30 page, detailed, history form. Whoa! We just haven’t figured out any way around it, though. We’ll keep trying.

So, why the forms then? Well, these forms allow the “first-visit” clinician to consume a patient’s entire history in 5-10” before the session. Significantly, these forms are penned “by” the patient. This avoids all of the uncomfortable transcription errors (clinician writes and dictates) wherein the many elements of the patient’s history are wrong in the report. We assume you’ve witnessed the dismay, misdirected care, and anger attendant to these situations. Our History Forms were developed by combining all of the best items from similar forms from Duke, the University of Pittsburg and the University of Florida, all with strong Psychiatry Clinical and Research traditions.

4. Exceptional Paperwork III – Rating Scales: We ask that our patients complete certain rating scales in addition to the History Forms, before the first visit (and intermittently thereafter). These scales are edited into child, teen, and adult versions. The scales include: 1) Barkley ADHD scale (essentially the DSM IV items); 2) A DSMIV Major Depression Scale; 3) The Mood Disorder Questionnaire (for Bipolar); 4) The Sheehan Anxiety Rating Scale (Dr. Sheehan is the Scottish Anxiety Research Professor at the University of South Florida - Tampa), 5) The Hallowell and Ratey Teen and Adult Rating Scales, 6) the Home and School Reports (Barkley),  and we’re probably forgetting some.

5. Exceptional Paperwork IV – Aggressive search for prior records. We seek and find patient prior records as aggressively as possible. As you would likely agree, most people have too much to worry about to remember details of prior care – plus, as patients, they’re usually depressed, distracted, fatigued, and unmotivated. Sadly, it is hard to provide comprehensive, integrated, CONCIERGE CARE without this kind of information. Better faster cheaper. 

6. Special Testing: Given the above, we seldom find it necessary to order expensive “diagnostic psychological testing” (very expensive – often over $1,000.00) and mostly unhelpful – as you know). We also rarely order expensive tests such as EEG’s and MRI’s, for similar reasons. Of course, we DO order labs relevant to Lithium and Depakote management, and now intermittently for atypical antipsychotics.

7. Advocacy: We advocate aggressively for our patients, not only because it conserves their money, time, and resources, but also because it’s the right thing to do. Examples include:

1. Advocacy for child with LD/ADHD/ED, etc., in the school system, including training parents to self-advocate for their child. Sadly, though some schools are very supportive in helping a child with special needs, just as many are resistant and require the treatment team (parents, psychiatrist, therapist) to intervene aggressively.
2. Advocacy for teens within the juvenile justice system (sometimes to get more time, sometimes less). In such cases, parents are required to obtain research-based, behavior management training/therapy, which we provide.
3. Advocacy for those applying for Social Security Disability benefits: We see an awful lot of patients with Bipolar Disorder who, of course, have been managed poorly. Accordingly, the Kindling Effect has wrought havoc with their neurochemistry before they even alight upon our doorstep. While doing our best to heal, we also place several advance notices to Social Security and Employer Short-Term and Long-Term Disability. We aid the patient complete the voluminous disability-related paperwork (even worse than ours!). We do depositions. We testify at hearings. Why? Well, it is the right thing to do. But it is the right thing to do because it helps the patient get better faster, thus – saving money, resources, and time all around. Better faster cheaper.

8. Special Services:

1. Training in expert behavior management of children and adults (based upon research – supported work of Barkley and of Clark). Ken Horn, MSW, LCSW, provides this training.
2. Marital therapy with one therapist or often with both therapists.
3. Group Therapy, when indicated: Past groups have focused mostly on Mood Disorders or Bipolar Disorder, or Family Members, Women’s Issues, etc.

9. Research-Based: If we haven’t emphasized it enough, allow us to do so now. We seek research validation and support for EVERYTHING we do. We change practices whenever the research directs that we do so. Again, this means we are better, faster, and cheaper than our competition, most of whom haven’t read a research article in 10 years – sorry – it’s true. Modern psychiatric research is amazingly RELEVANT these days.

10. We Care: We do all of the things we do because, yes, we care. We are committed to providing the best possible service to any patient we are honored to care for. Incidentally, the best service, the most caring service, (unlike prior eras in mental health) is actually the least expensive service!