FRequently Asked Questions

Psychiatry is a medical specialty focused on understanding, diagnosing, treating, and preventing mental health conditions that affect how people think, feel, and function in daily life. Psychiatrists are medical doctors with specialized training in mental health, allowing them to consider both biological and psychological factors that contribute to emotional distress and mental illness. Psychiatry takes a whole-person approach, recognizing that mental health is shaped by the psychology of the mind, brain chemistry, genetics, physical health, life experiences, relationships, and social context. Psychiatrists work with individuals experiencing concerns such as anxiety, depression, mood disorders, trauma-related difficulties, and periods of stress or life transition. A psychiatric assessment typically involves careful listening and thoughtful questions to develop a clear understanding of a person’s experiences and needs. Treatment may include psychotherapy, medication, or a combination of approaches tailored to the individual’s needs, goals and values. Psychiatry also supports insight, recovery, and overall well-being, helping people reduce their personal suffering and improve the quality of their life. 

The terms “therapy” and “psychotherapy” are closely related and often used interchangeably, but have distinct meanings. Psychotherapy refers specifically to a professional who has been rigorously trained in a school of thought or some particular theoretical approach to the human mind under the supervision of mental health professionals. Psychotherapy involves structured sessions aimed at understanding and addressing emotional, behavioral, and psychological difficulties, helping individuals to develop coping strategies, insight, and long-term improvements in mental health. The term psychotherapy typically connotes a type of clinician who is able to do deeper, more comprehensive work with the people they are seeing in their practice. Therapy is a broader term that often includes other forms of support, such as counseling, life coaching, or guidance, which may focus more on practical problem-solving or personal growth rather than in-depth psychological exploration. While all psychotherapy is a form of therapy, not all therapy is psychotherapy. Psychotherapy tends to be more structured, clinically oriented, and capable of deeper work that produces lasting change for the person, whereas therapy in general may be more flexible in approach, duration, and goals. 

A lot of psychiatrists provide psychotherapy for their patients, like Dr. Wasik does, so those psychiatrists who do so are able to prescribe medication to their patients. This allows patients to receive all of their treatment under a one roof, rather than having split treatment where the psychiatrist is seen on one side of town and the therapist on the other. If there is a split treatment, the therapist will work collaboratively with the psychiatrist, who can evaluate the need for medication and manage its use safely. This collaborative approach ensures that individuals receive both psychological support and, when appropriate, medical treatment. Psychotherapy and medication are often complementary: while medication can help manage symptoms, psychotherapy provides tools, insight, and strategies to address underlying psychological conflict, helps one cope with stress, and improve long-term mental health and quality of life. 

Item descriLike most therapies, psychoanalysis is rooted in conversation, but it is an altogether more intensive form of therapy that attempts to understand the unconscious mind. The guiding principle in any psychoanalytic session is to say what’s on your mind, whatever you are thinking and feeling in the moment of a session, whether it be about the past or present, while withholding nothing, and without ever censoring yourself. That, of course, is a pretty tall order for anyone, so certain things are held back, and inhibitions occur, which tend to be rather stereotyped, repetitive ways of handling desire and your emotions. Once we have these inhibitions in site we try to gently break them down so you can develop newer and more gratifying paths for what you want your life to be. It’s time consuming and takes some working through, so typically appointments are 4 times a week (with the patient on the couch), although we would usually begin by meeting 1 to 2 times per week, and then comfortably working our way up. Who can benefit from psychoanalysis? Most patients can benefit from psychoanalysis. It helps one understand the complicated and confusing parts of the self that are often behind repetitive self-destructive behavior and emotional states. Understanding the deeper parts of ourselves leads to less harmful behavioral patterns, a greater sense of contentment, and overall better choices in life. ption

I offer a no fee twenty minute consultation that can be done online, by phone, or in person. This enables you to get a feel for my practice, and also gives you a chance to see if I’m someone you would like to work with. During this prescreening I want to learn what your concerns are, what sort of help you are seeking, whether it be therapy, med management, not sure, and also whether you want to use insurance to cover your charges. If at the conclusion you are interested in talking further, we would schedule a 90 minute appointment in my office. 

The initial appointment is 90 minutes and is in-person in my office. After gathering some basic information on where you live and work, we would explore whether you had any prior contact with the mental health field, and then move on to the history of what has currently brought you in to see me. I would then need to explore if there has been any substance abuse history, would need to hear about your medical history, your current and past medications, family psychiatric history, and lastly your personal history (where did you grow up, any siblings, what was childhood like, etc.). At the conclusion, I would give you my perspective on what I just heard, what diagnoses I am entertaining, and what treatment I would recommend. I would surely be interested then on hearing what you have to say about what I had just said, and between the two of us we would arrive at a treatment plan for going forward. 

I practice what is called “psychodynamic psychotherapy”, where the governing principle in any session is to explore as fully as possible what is on your mind. Some parts of your life, past or present, may be harder to talk about than others, so it becomes important for you and I to join together to overcome these inhibitions, these obstacles that are preventing you from having a fuller engagement with me. By a careful process of working through together, which can take some time, we gently deconstruct these inhibitions, which enables you to more fully engage with others in your life and the world at large. 

If there is a decision is to go with therapy (also known as psychotherapy), appointments will be weekly at 45 - 50 minutes. I say 45 - 50 minutes because within that final five minute time frame I like to find a good moment to conclude rather than abruptly stopping. If the session gets out to 50 minutes without coming upon one of those moments, I’ll gently let you know it’s about time to stop. Therapy sessions occur once per week, which permits us to do insight-oriented work that enables you to change and grow psychologically, whereas meeting less than once per week, often referred to as supportive psychotherapy, in my experience, does not really foster psychological growth. A swimming metaphor here can sometimes help: supportive psychotherapy may help keep you afloat, to doggy paddle, whereas insight oriented psychotherapy enables you to swim. In addition, it is also possible to see me more than once per week — the more often we meet, the more work we get done. 

Yes, I do see patients for medication management only. In certain instances, that’s what some patients are seeking. That could be because they are in therapy with a practitioner that can’t prescribe medication, and their practitioner felt their patient needed the clinical support of psychiatric medications. In other instances, a patient comes to me on their own solely for medication management because they have been stable for a long period of time on those meds and say they are not in need of any further support. A lot of times that is true, but in certain instances I might disagree and suggest they consider adding on some therapy or consider a change in their medication regimen, or both. Each person’s situation is unique, so all the important factors of any individual’s situation has to be taken into consideration when I make or start treatment recommendations. But, in the end, I do have a good number of patients in my practice who are receiving medication management without therapy. 

Yes, I certainly do. In a lot of instances, patients who are interested in or need therapy do not need medication management. 

I see psychiatric medications as agents that can help patients control debilitating symptoms that are causing personal suffering, disrupting their lives, and corroding relationships with important others. In that respect, people can feel better but the medicines are not a long-term solution because their focus is symptom control and not long-term psychological change and growth. Therapy is more effective when it comes to creating long lasting, durable psychological change, and plenty of research has shown that a combination of medication and psychotherapy is often the best treatment for many, which puts medicines more in the helper role. In addition, because therapy can create significant psychological change, patients are often able to reduce the amount of medicine they are taking, or stop it all together. And, lastly, as noted above, there are plenty of patient who do not to want to take medicines, who prefer working through their problems by doing therapy alone, which in a lot of instances is completely acceptable. In all instances it is up to the patient to decide whether they want to take a medication that I might be recommending to help control their symptoms. 

If the decision for treatment is to go with med management only, I will most typically see you back in two weeks after your initial appointment for a 30 minute appointment to see how you are responding to the medication. If you are responding well to the medication, your next follow-up appointment will be in four weeks, followed by an appointment in six weeks, then eight, and then finally twelve weeks. Twelve weeks is the largest interval that I will permit between appointments if I am seeing you for medication management only. If your response to the medication doesn’t follow this progression, we will continue to meet every two to three weeks until you have a positive response. Once you do, we will then follow the 4 to 6 to 8 to 12 week progression that I just described. 

I am not in-network with any insurance company, but that doesn’t mean you can’t receive reimbursement for treatment with me. Generally speaking, there are two basic types of health insurance plans, the HMO and the PPO. With an HMO, you will not have coverage to see me, but you will have coverage with the PPO, POS, or a similar policy. To use one of these policies, you will first pay me in full directly, after which I will provide you with a receipt (called a superbill) that you can submit to your insurance company for reimbursement. The insurances most typically used by patients in my practice are Blue Cross/Blue Shield, Tufts Health (which now includes Harvard Pilgrim), Aetna, Cigna, and Optum (which includes UnitedHealthcare/ United Behavioral Health), although occasionally other policies are used. 

Yes, you will first pay me in full directly, after which I will provide you with a receipt (called a superbill) that you can submit to your insurance company for reimbursement. 

For patients who see me on weekly basis for regular therapy or psychoanalysis, cancellations within a 48 hour window of the scheduled appointment may incur a full fee payment for the session. My fee for these appointments, which is the standard 45 to 50 minute session, is $350, unless otherwise stated. In certain instances appointments can be rescheduled.

If you cancel outside the 48 hour window, we will make every effort to reschedule the appointment, as it is important to sustain, on average, the per week frequency of your therapy appointments.

If you are seeing me for medication management appointments, and you cancel within the 48 hour window of the scheduled appointment, the same applies, that is, you may incur a full fee payment for the session. The fee for the 30 minute session is $300, $250 for the 15 minute session. In certain instances these appointments too may be possible to reschedule.

Cancellations outside the 48 hour window for medication management appointments will need to be rescheduled ideally within the same week as the originally scheduled appointment, and, if that isn’t possible, then rescheduling should occur the following week as early as possible original to avoid running out of your medication.

All no-shows, unless there are mitigating circumstances, will incur a full fee for the particular appointment scheduled. 

All initial appointments are in person, as are all therapy appointments. However, certain situation may arise where we do a therapy appointment online, such as a snow storm, you have cold virus but are doing well enough to meet online, etc. Virtual online appointments for medication management patients are possible ninety days after the initial appointment if you are stable on your meds and you are not seeking major changes in your medication regimen. If you desire to do in-person for all of your appointments, I would certainly welcome that. 

The security of your sensitive information is of utmost importance to me, and I am bound by law to protect your confidentiality. There are exceptions to this confidentiality, where disclosure is mandatory. These include the following:

• If you are a threat to the safety of others, I will be required by law to take protective measures, including reporting the threat to the potential victim, notifying police, and seeking your hospitalization.

• If you are an imminent threat of harm to yourself, in most circumstances I am required to seek immediate hospitalization, and will likely seek the aid of family members or friends to ensure your safety.

• In situations where a dementing illness, epilepsy or other cognitive dysfunction prevents you from operating a motor vehicle in a safe manner, I will be required to report this to the RMV, take steps to revoke your driver’s license, and seek family support to prevent you from driving.

• If a mental illness prevents you from providing for your own basic needs such as food, water, shelter, I will be required to disclose information to seek hospitalization.

These situations rarely occur in an outpatient setting. If they do arise, I will do my best to discuss the situation with you before taking action. In rare circumstances, I may find it helpful to consult with other professionals who specialize in such situations (without disclosing your identity to them).