Please note
This page is written for clinicians and readers of the work. Reading it, or contacting me about it, does not create a therapist and client relationship, and nothing here is clinical advice for your situation or for anyone in your care.
For referring clinicians
Written for colleagues. What I take, what I decline, how the collaboration runs, and what comes back to you.
Psycholytic Services is a solo outpatient psychotherapy practice in Vero Beach, Florida, oriented toward trauma, complex trauma, and presentations where the nervous system has organized itself around conditions that no longer obtain. I work from a systems formulation, the framework I am developing is set out on the pages linked below, and deliver established modalities within it rather than in place of it.
I would rather decline a referral than absorb one badly. The section on exclusions further down is not defensive boilerplate; it is the part of this page most worth reading, because a poor placement costs your client months and returns them to you with an additional failure on the record.
A good referral.
- Treatment-resistant presentations
- Clients whose symptom picture has not moved across adequate trials of competently delivered treatment, where the question has shifted from which technique to what the presentation is organized around.
- Plateaued talk therapy
- People with good insight, a solid working alliance, and no further movement. Frequently the material has been thoroughly narrated and the physiology has not changed, which is a sequencing problem rather than a content problem.
- Clients seeking ketamine-assisted work
- Individuals already under the care of a prescribing medical provider, or actively pursuing that care, who want the psychotherapy component held by a trauma-oriented therapist rather than delivered ad hoc.
- Psychedelic integration therapy
- People processing an experience that has already occurred and who need somewhere rigorous to put it, rather than encouragement or a peer circle.
- Clinicians and healthcare professionals
- Therapists, physicians, nurses and first responders, for whom the usual difficulty is not stigma but the accurate suspicion that being a patient will be professionally awkward. That is handled directly here.
Who this is not for.
- Anyone needing more than outpatient psychotherapy
- If the clinically indicated level of care is partial hospitalization, residential, intensive outpatient, or inpatient, this practice is not it, and accepting the referral would delay the right placement.
- Acute risk
- Active suicidal intent with plan or means, recent serious attempt, or risk that requires monitoring between sessions. This is a solo outpatient practice with no crisis coverage and no after-hours service.
- Active detoxification
- Withdrawal management is a medical procedure. Where substance use is present and detox is indicated, that has to be arranged and completed under medical supervision before psychotherapy can be the primary intervention.
- Anyone outside Florida
- I am licensed by the Florida Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling, and I work only with clients physically located in Florida at the time of session.
If you are unsure which side of that line a client falls on, say so when you make contact and we will work it out before an intake is offered. I am content to spend a conversation establishing that someone should go elsewhere.
Ketamine-assisted work and scope.
This is the point on which referring prescribers most reasonably want clarity, so it is stated in full rather than summarized.
Scope of practice
For individuals receiving ketamine treatment from a qualified medical provider, I also offer ketamine-assisted psychotherapy in collaboration with the prescribing clinician. I do not prescribe or administer ketamine, and all medical decisions, including screening, dosing, and medication management, remain the responsibility of the treating medical provider.
In practice that means the medical relationship stays entirely with you. I hold preparation, the psychotherapeutic component, and integration; screening suitability, dosing decisions, route, monitoring, adverse-event management and any change to medication remain yours. Where a client has no prescriber, I do not arrange one as a matter of course, and I will not proceed with the psychotherapy component on the assumption that medical care will follow.
How the collaboration works.
With the client’s written authorization, I will speak with you. My default assumption when a referral arrives from a treating clinician is that you remain part of the picture, not that care has been handed over. If you are the prescribing provider, the psychiatric provider, or the primary therapist continuing other work, I would rather coordinate than run parallel and uninformed.
What you can expect back, again subject to authorization: confirmation that contact was made and whether an intake was offered; a formulation in plain clinical language rather than in the vocabulary of my own framework; a note on anything I think belongs with you rather than with me, including anything that looks medical; and notification if I conclude the level of care is wrong and the client needs stepping up.
What you should not expect: session content as a matter of routine, or a promise about trajectory. Therapy outcomes vary from person to person and no result is promised or guaranteed. If a client stalls here I will tell you that too, and I would rather return someone to you early than hold them for the sake of holding them.
How to reach me.
Use the practice contact page and mark the message as a clinician referral. Please do not include client-identifying clinical detail in that first message: the form is not a secure channel. Send enough to establish fit, presentation in general terms, level of care, what has already been tried, and whether a prescriber is involved, and we will move to a secure route before anything specific.
If you are the person this is about
If you arrived here as someone considering therapy rather than as a colleague making a referral, this page will read coldly, and that is because it was written for a different reader. Nothing on it describes how you would be spoken to.
You do not need a clinician to refer you. You can approach the practice directly, and the pages written for you say plainly what the work involves.