Dr. Ferstandig’s individual services are typically applied in four major areas:
1. Psychiatry and behavioral medicine
2. Addiction medicine
3. Biological, physiological and medication management of behavioral health and addiction medicine disorders
4. Expert opinions, reports and testimony
1. Initial Evaluation
Initial evaluations are designed to identify and clarify the central problem(s), assess the patient’s history (life, medical, psychiatric, drug, etc.). If the patient/couple/family decide that they wish to return for further treatment with Dr. Ferstandig to address their issues, a treatment plan is offered that incorporates the other relevant services listed below
The initial evaluation is the first step in a psychiatric evaluation, Suboxone® treatment evaluation, behavioral medicine evaluation and expert assessments. The charge is $400/hour, with most initial psychiatric evaluations lasting one hour unless it is professional evaluation, which lasts at least 2 hours. Addiction/Suboxone evaluations last 90 minutes. During this initial evaluation, Dr. Ferstandig tries to formulate an initial assessment of the patient’s physiological status as well as their behavioral status to help determine the causes of any problems that they might be experiencing and to start the process of finding the most effective and efficient path to restoring the patient to their best possible state.
2. Follow-up to Initial Evaluation
Follow-ups to initial evaluations serve several functions including evaluation of response to medications and/or treatment suggestions; and additional data collection. When the purpose of a follow-up is to evaluate the impact of a medication or dose change, Dr. Ferstandig is carefully evaluating one or both of the following: 1) target symptom change in response to the medication change(s); and/or 2) as an attempt to help clarify the central problem by evaluating the impact of medicine on the core problem(s) (this approach is based on the reverse engineering approach of using a known (medicine) to see how it impacts an unknown (the central problem) as a tool to rapidly establish the fundamental nature of the central problem). Follow-up sessions to the initial evaluation typically last 30 minutes and cost $250.
3. Medication Management
Medication management sessions are typically 15 minute sessions with Dr. Ferstandig. During these sessions he will review any changes in medication procedures, types and doses and try to assess the relationship between these changes and the patient’s symptoms. Medication management sessions can also be incorporated into any type of therapy session.
A simple medication management session costs $150 and lasts 15 minutes. When medication management occurs as part of a therapy session, there is no extra charge because it charged at the rate for the therapy session that it is part of.
4. Therapy Sessions
Sadly modern day psychiatry is associated with medication management with an individual and to a lesser degree engaging in therapy. Dr. Ferstandig believes that medication management alone is rarely the best solution except in long-term treatment cases where there is little to be gained using therapy sessions. Dr. Ferstandig tries to offer some therapy in all contacts with his patients.
5. Second Opinions and Medications Review
Although it would nice if mental health work was based solely on science, it is largely a matter of interpretation and opinions. The range of these opinions is quite broad in mental health because nowhere else in the overall arena of health is there such a wide range of individuals offering services with a low end of well intentioned people with little to no specific education to a high end of Board Certified Physicians (M.D.’s and D.O’s) or Physicians with multiple board certifications, such as Dr. Ferstandig.
Although technically different, second opinions and medication reviews overlap so much that Dr. Ferstandig lists them together. Second opinions are more fundamental with a reassessment of the patient’s total situation to insure that the proper diagnoses are assigned when possible AND the proper and optimal treatment plan is created and implemented. Medication reviews are necessary when for a wide range of reasons a patient may be taking the wrong medications, the wrong doses of medication and/or taking the medications using less than optimal techniques.
Dr. Ferstandig’s background in the sciences, physiology and pharmacology, plus the time he takes talking to all patients helps him choose the optimal medication for each need instead of the using the all too common and inferior technique of “using some other medication from the same category to see it if works better.”
6. Couples and Family Therapy
Perhaps the most difficult area of behavioral medicine to obtain treatment success is when treating a system of multiple people who have a common linkage of some sort. In these cases it is necessary to address the problems of each individual PLUS interactions between each of the individuals. Therefore it should not be surprising that any work in this area is very labor intensive, requiring numerous visits to properly address each individual and how they interact with the other people in the system being treated.
7. Intensive Personality and Behavior Modification
This service is the most labor intensive of all of the services offered by Dr. Ferstandig. It initially requires at least 5 hours of treatment per week and in some severe cases considerably more. While this service is extremely intense and demanding, the results are rapid and typically life changing, provided that the patient is in full compliance with the treatment program.
The service is the most complex, customized and creative of any service provided by Dr. Ferstandig. Essentially each step is custom designed, both from a physiological and behavioral standpoint, as the treatment progresses. This way, the patient has a constant highly knowledgeable and skilled companion in Dr. Ferstandig as they work to let go of past maladaptive beliefs and behaviors and start to incorporate new more effective and grounded beliefs and behaviors.
Another benefit of this approach is that Dr. Ferstandig can optimally manage the change process that is inherent in all personal growth and successful therapy. While this is a fundamental part of all of Dr. Ferstandig’s work, it is present in its most complete and sensitive form with this service.
8. Professional Reports
Dr. Ferstandig believes that professional reports need to achieve two things: 1) provide information about the patient and his life situation; and 2) promote a specific perspective to the person(s) reading the report. Through his 15 years as a consultant to Fortune 100 companies, a frequent keynote speaker at large and medium size meetings and as an educator in the Fordham Business School and Touro University Worldwide, Dr. Ferstandig has learned how to teach and persuade people to his point of view.
The combination of his excellent diagnostic and treatment skills with his ability to educate and persuade the individual reading the report of his position has had an extremely positive influence on judges, lawyers, insurance companies, etc. and helped his patients in many areas.
9. Expert Assessments and Testimony
The same skills that makes it possible for Dr. Ferstandig to write powerful and persuasive expert reports also makes him a highly refined and convincing expert when testifying and making expert assessments. These assessments and reports are made in a timely fashion and must be paid for in full in advance.
Expert testimony rates are higher than other services provided by Dr. Ferstandig because of the need for travel, unpredictability of required time which forces large blocks of time to be cancelled in the office. Expert testimony is done through contracts that address the limits and liabilities of the process and must be paid for in full prior to commencing the services.