New Patient Suitability Criteria

We try to help a wide variety of people – but because of legal restrictions, our business model, and limitations on my own expertise, we’re not suitable for everyone. Appropriate patients will:

0. Be a transfer patient from Dr. Siskind’s previous practice. I am working on transferring my current patients over before I take on any new patients I haven’t worked with before. This process will take a few months. If I haven’t worked with you before or specifically given you permission to ignore this requirement, please wait until then.

1. Be age 18 or older. I’m not licensed as a child psychiatrist and I don’t see children.

2. Be a resident of the State of California. I’m not licensed to see people from other states. If you’re in some sort of complicated college-related or digital-nomad-type situation, I’ll see you if you have a residence in California and consider it your “home base”, but expect to encounter various problems. In particular, I may not be able to prescribe you medication (especially controlled medication) in other states.

3. Be able to use telepsychiatry. You’ll need to have a good Internet connection, be able to reliably use video conferencing, and be willing to put some effort into the appointment – please don’t try to see me through your cell phone while you’re driving your car or jogging. Although I’ll try to have the appointment by phone if there is an unexpected snafu in the videoconference, this should be a last resort and you should generally try to make videoconferences work.

4. Be a suitable patient for telepsychiatry. I prefer not to see extremely high-risk patients through telepsychiatry. If you’re frequently psychotic or acutely suicidal, I would prefer you attend in-person visits with a psychiatrist in your area who has close relationships with local psychiatric hospitals and care networks.

5. Understand that telepsychiatry may involve some extra steps. The state of California has traditionally required that patients get seen by an in-person doctor before receiving controlled substances. That means that if I (as your telepsychiatrist) want to prescribe you a controlled substance like Adderall or Klonopin, I can’t do this until you get examined by an in-person doctor (probably your primary care doctor if you have one) and have them sign a form saying you seem healthy enough to take the medication safely. This surprises and angers a lot of patients who chose telepsychiatry hoping to avoid the difficulty and expense of seeing an in-person doctor, so be prepared for it. As of my writing this, the government has waived this requirement because of the COVID-19 emergency, but it could come back into force at any time.

6. Have no personal connection to me. If you’re my family member, friend, or otherwise socially connected to me, it would be a conflict of interest for me to be your psychiatrist. If you’ve read things I’ve written online, that doesn’t in itself necessarily disqualify you, but keep in mind I won’t be interested in talking about these during sessions and will want to focus exclusively on your mental health. If you’re involved in the same organizations or communities I am, this might be a conflict of interest – please email me with your specific situation before signing up.

7. Have no strong personal connection to an existing patient. If you were referred to me by a family member or close friend who sees me, this presents a potential conflict of interest. I prefer not to see two people in a relationship that could potentially turn adversarial (eg husband-wife, employee-boss, etc) if there’s any chance I might be asked to help either party navigate it. If you were referred by a friend of a friend or something, that’s probably fine. If you have any questions about this, please email me with your specific situation before signing up.

8. Understand that this is not a therapy practice. Most of my training is in biological psychiatry, not therapy. Biological psychiatry doesn’t always mean medication – it could also mean dietary advice, circadian rhythm hacking, or environmental changes – but medication is often involved. If you would prefer care that focuses on talking about relationships, emotions, and your direction in life, you probably won’t find Lorien Psychiatry too helpful – especially since the twenty minute appointments we offer aren’t long enough to discuss those things in depth anyway. This doesn’t mean I don’t care about what’s going on in your life or that we won’t talk about it. It just means it won’t always be the focus of treatment, and that I may not be able to offer deep insights about it that will produce lasting change on their own. Many people get treatment with a biological psychiatrist and a psychotherapist simultaneously, this often works well, and I would be happy to be the biological psychiatry half of this kind of team. I’ll try to eventually have some resources up that will help you find the right therapist.

9. Understand that this isn’t a neuropsychological testing practice. Neuropsychologists diagnose people scientifically and officially, after spending many hours testing them. Their diagnoses can be used for legal issues like criminal cases, suitability-for-work evaluations, and educational accommodations. I only diagnose people for treatment purposes. Please don’t come to me for help getting an official diagnosis of something (or an official diagnosis of not having something) to use in legal proceedings. If in the course of normal treatment you need me to officially sign my name to things like disability documentation, that’s fine, but this practice is not for people who primarily need a legal certification service.

By signing your name below, you acknowledge that you have read and understand these issues, and that if I later learn you fall into one of these categories, we may have to discontinue treatment.