Care with intention
A fuller picture.
A clearer beginning.
Understand your symptoms in the context of your life.
Understanding comes before a treatment recommendation.
An initial evaluation is a structured conversation about current concerns, psychiatric and medical history, medications, sleep, functioning, safety, and the goals you bring to care.
In person in Chehalis or by telehealth when appropriate.
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Your history provides context.
We explore when symptoms began, where they occur, how they affect daily life, and what has helped or created difficulty. Development, family history, relationships, substance use, and previous treatment can help distinguish among possible explanations.
A working understanding.
Screening tools, relevant records, physical-health information, and observations from others may contribute when appropriate. We discuss diagnostic possibilities, areas of uncertainty, and further information that could clarify the picture. Complex presentations may require more than one visit.
For children and adolescents.
Assessment includes developmental context, caregiver observations, and the young person’s perspective. School information may contribute with appropriate consent. Specialized developmental, learning, or neuropsychological testing is arranged through referral when needed.
School collaborationFrom evaluation to care.
We connect findings with your priorities, discuss suitable therapy and medication options, and agree on follow-up. A psychiatric evaluation is distinct from a full neuropsychological testing battery.
Individualized treatment planningQuestions the assessment helps answer.
Do symptoms follow an episodic or persistent pattern? Could a medical condition, sleep disorder, medication effect, or substance contribute? Are several conditions interacting? What risks and protective factors influence the level of care?
These questions guide the differential diagnosis: a considered comparison of plausible explanations. Findings may be refined as more information becomes available.
A closer look
What we look at together.
You may be coming with a diagnosis, several diagnoses, or a sense that something has changed. I consider the timeline: what your usual functioning looks like, when difficulties emerge, and whether changes in mood, energy, sleep, attention, or behavior travel together.
A careful history includes the benefit and burden of previous treatments. Medication names alone tell only part of that story. Dose, duration, side effects, consistency of use, and the circumstances around a change can help explain why an earlier approach did or did little.
The evaluation also considers safety, strengths, supports, work or school demands, and your own priorities. Relevant medical evaluation, records, screening measures, or collaboration with another clinician may help complete the picture. The goal is a reasoned formulation that connects the findings to useful next steps.
Context
Bring the concerns, history, and changes you want help understanding.
Clinical reasoning
Consider several explanations and the information that distinguishes them.
Next steps
Agree on priorities, suitable care, and what needs further clarification.
Before you begin.
Practical questions about psychiatric assessment.
What should I bring?
Bring your current medications and supplements, allergies, prior diagnoses, relevant test results, and the names of other clinicians involved in your care. A brief timeline of symptoms and treatment can be helpful. Send records through the secure portal or the practice’s confirmed records process.
Will I receive a diagnosis at the first visit?
Sometimes the pattern is clear early. Sometimes a working diagnosis needs more history, observation over time, or information from another clinician. I explain what the findings support, what remains uncertain, and how that uncertainty affects the plan.
Does an evaluation mean I will start medication?
Recommendations follow the assessment and a discussion of your preferences. The plan may involve psychotherapy, medication, changes in existing treatment, further medical assessment, coordination, or referral. A specific prescription is determined through clinical evaluation.
Can you evaluate attention or school concerns?
Attention is considered alongside development, sleep, anxiety, mood, learning, and daily functioning. For young people, caregiver and school observations may help with appropriate permission. Formal learning, autism, and neuropsychological testing require their own assessment process and may involve an outside specialist.
Let’s find a place to begin.
Tell me what you are looking for help with. We can clarify which kind of appointment fits.
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