What is a psychiatrist?

A psychiatrist is a medical doctor (physician) who has completed at least four years of medical school, a medical or surgical internship year, and at least three years of residency training in psychiatry. Psychiatrists are experts in diagnosing mental illness, and in formulating treatment plans that may involve medication management, psychotherapy, and/or coordination with other specialists to treat mental illness.

What is a psychotherapist?

A psychotherapist is someone who performs psychotherapy, which is also known as “talk therapy.” Psychiatrists, psychologists, social workers, and licensed professional counselors all have varying training in psychotherapy and can classify themselves as psychotherapists.

How do I know if I need a psychiatrist or a psychotherapist?

Generally, if you are certain you want to be prescribed a medication, you should see a psychiatrist. If you are certain that you’d like to do only psychotherapy (talk therapy), you should see a psychotherapist. If you aren’t sure whether you’d benefit from both or either, you can start with one, and obtain a referral to see the other if needed. Further, if you call our office and briefly discuss what concerns you’d like to have treated, our staff may be able to guide you on this decision.

Will health insurance cover my treatment?

If you have a health benefits policy, especially a PPO, it will usually provide some mental health coverage. However, you, not your insurance company, are responsible for full payment of the session fees. We will not bill your insurance directly. If you plan to use your insurance benefits, we will provide you with a standard receipt and form (a Superbill) that can be submitted to your insurance company. Many PPO plans do provide some reimbursement for mental health provided by an out of network provider, so you may get a substantial portion of our fees back from your insurance company, depending on your specific plan. We recommend you contact your insurance provider to inquire about your out-of-network benefits if insurance reimbursement is an important issue. Please see our Out of Network Insurance Guide for more details.

Do telemedicine visits get reimbursed the same as in-person visits with my doctor?

Telehealth services (two way real-time interactive audio and video) continue to have coverage and payment parity with in-person care for NC Medicaid, Medicare, and NC Health Choice. They continue to cover and reimburse all telehealth interactions at a rate that is equal to in-person care as long as they meet the standard of care and are conducted over a secure HIPAA-compliant technology with live audio and video capabilities.

In North Carolina we have not yet passed a telehealth parity law, so private pay insurance are currently not required to provide equal coverage. This may change in the near future as 29 US states have already passed laws requiring parity. The majority of insurances still offer coverage, but it does depend on insurer and policy. This would be the first time I am hearing that an insurance may no longer cover telehealth services, but it is a possibility as insurance practices evolve now that the NC state-of-emergency is no longer in effect.

Is it inevitable that I will end up on medications?

Dr. Frische's primary goal is to help you feel well again. It is impossible to feel well if you are receiving a treatment you are not comfortable with. If medication is recommended, but the idea of taking psychiatric medicine is unappealing to you after we discuss the risks, benefits, and alternatives of doing so, then we will do all we can to help you without the use of medicine.

From the initial visit and onward, Dr. Frische will offer treatment options that do not involve medicine, including recommendations relating to exercise, diet, sleep, psychotherapy, and more. If your psychiatric symptoms are severe enough, she may recommend the use of a medicine, but will happily work on a treatment plan that involves non-medicinal treatments if that’s your choice.

If I'm prescribed medication, will I be on it forever?

Our goal at Frische Psychiatry is to help you feel well and stay well. For some individuals (especially those who have had multiple psychiatric episodes, psychiatric hospitalizations or suicide attempts), this may involve taking medicines indefinitely. For others, this may involve only using medicine for a brief period of time (6-12 months), before slowly reducing and ultimately discontinuing a medicine. From the moment a medicine is considered, to every office visit thereafter, you will always know the proposed timeline and evidence-based justification for any medicine we start, modify, or discontinue.

If you decide to start a medicine, the duration of treatment depends on multiple factors, including quality of your social support, whether you have a therapist, severity of your illness, time spent on medication, and duration of time without psychiatric symptoms. If you are uncomfortable with the idea of taking a medicine for the length of time we recommend, our clinic will work with you and help develop treatment strategies to increase the likelihood of a good outcome while reducing or discontinuing the medicine(s) of your choice.

How long will we work together?

How long we may work together varies widely, largely based off of the severity of your symptoms, level of distress, and your interest and motivation in making changes in your life. Medications and therapy can be tremendously helpful in feeling well, but the changes you implement in your life outside of your appointments with a psychiatrist are what have the largest impact on you reaching your goals in a fast and sustainable way. Clients seeking mental health services will often work with a psychiatrist for months to years, or until they are stable enough to transition to their primary care provider.

How do I join a telehealth session through the patient portal?