Pre-Surgical Behavioral Assessments
Bariatric Surgery: Almost all bariatric surgery programs in the U.S. request candidates to undergo a pre-surgical psychological screening to identify potential contraindications to surgery, such as substance abuse, poorly controlled depression or other major mental illness, as well as help identify potential postoperative challenges and facilitate behavioral changes that can enhance postoperative weight maintenance. Factors such as mood or anxiety disorders, depression, and eating disorders, need to be evaluated to screen individuals who will more than likely be successful post-surgery. The pre-surgical evaluation plays a vital role in identifying psychosocial issues that a patient may encounter postoperatively. It is also considered a unique opportunity to perform the psychoeducation of the patient about the changes resulting from the surgery, offer psychological support and prepare the candidate for behavioral modifications that must occur in the postoperative period.
Spinal Fusion/Laminectomy: Spine surgery can have a profound effect on a patient, surgeon, as well as third-party payers. Unfortunately, if a spine surgery fails, the patient continues to remain disabled, with perhaps even greater pain, increased medication dependence and more emotional difficulty than before the surgery. The many psychosocial risk factors that challenge spine surgery results can be assessed through psychometric testing and a detailed patient interview.
Spinal Cord Stimulators/Peripheral Nerve Stimulators/Intrathecal Pump/Intracept Procedure: Chronic pain patients who are seeking an SCS, PNS, an intrathecal pump or Intracept may have some level of pre-existing depression and anxiety, which may increase if the device becomes ineffective in reducing the patient’s pain level. A pre-surgical psychological evaluation is important in predicting the outcomes of this patient population. Due to the risks associated with implantation of these devices and their substantial costs, a good deal of emphasis has been placed on patient selection. Some of the risk factors that have been identified which correlate with greater risk for pain or poor outcomes include: pain chronicity, psychological distress, a history of abuse or trauma, poor social support and significant cognitive deficits. An evaluation is designed to help identify the right patient to achieve the maximum benefit from an implanted device. Patients can be more informed of their chances of success as well as the risks associated with the procedure.
Depression Screening: With depression rates increasing, the United States Preventive Services Task Force (USPSTF) has made strong recommendations for physicians to actively screen patients for depression at regular visits. Primary Care Physicians are the first line of defense when it comes to depression due to the fact that they usually see the patient first before referring them on to a specialist. However, most primary care physicians may not have the time to thoroughly evaluate a patient’s level of depression. Our service allows patients to be screened in a comfortable and convenient setting so as not to cause anxiousness or be a burden to the patient or doctor requesting the assessment. We can provide a comprehensive mental health report to complement a physician’s physical assessment to get a complete picture of the patient’s overall health.
Addiction Screening/Opiod Risk Assessment: Administering specific and targeted addiction screening is an important first step in improving identification of addictive disorders, which is imperative in this day and age due to the increasing number of people who are afraid to seek help or not being able to recognize their own addictions. By opening the way to early recognition of addictions, there is the potential to save millions of lives and healthcare dollars by facilitating identification and treatment of the problem before it becomes severe. Screening by itself has been shown to decrease the behavior. Many physicians fail to recognize addictions when seeing a patient for a routine physical. This can hinder the effectiveness of treatment. Our staff is trained in evaluating and recognizing addiction symptoms in an individual as well as suggesting a course of action for treatment. Our service provides an easy and convenient way for patients to be screened without feeling anxious or uncomfortable in a typical office setting. Our reports can be used as a preemptive screen for addictive tendencies prior to prescribing opioids, or as a regular tool to monitor a patient’s inclinations before becoming an issue.
Therapy Services
Cognitive Behavioral Therapy: Cognitive behavioral therapy (CBT) is a form of psychological treatment that has been demonstrated to be effective for a range of problems including depression, anxiety disorders, alcohol and drug use problems, marital problems, eating disorders, and other mental illness. Numerous research studies suggest that CBT leads to significant improvement in functioning and quality of life. In many studies, CBT has been demonstrated to be as effective as, or more effective than, other forms of psychological therapy or psychiatric medications. We provide CBT for chronic pain patients, weight loss patients (surgical and non-surgical) and patients who are seeking pre-approval for the Intracept procedure with Cigna and other insurances.
Chronic Pain Counseling: Patients gain ongoing support and tools for a better quality of life with chronic pain. The goal is to reduce the impact of that pain on a patient’s daily life. Some of the target areas we focus on are: psychoeducation, exercise, activity based pacing, pleasant activity scheduling, stress management, relaxation, cognitive restructuring, anger management and insomnia intervention.
Practices: Get InfoWeight Loss Counseling (surgical and non-surgical): Weight loss starts with a healthy mindset. The goal of this type of therapy is to supply the tools patients need to stay on track with their new lifestyle, teach them valuable ways to “flip the switch” that will help them form healthy relationships with both food and exercise and help them manage complex emotions such as fears, insecurities, trauma and stress.