Dr. Fieve employs a MULTI-PHASE TREATMENT PROCESS that consists of the following procedures:

PHASE I
INITIAL EVALUATION/DIAGNOSIS

To provide a precise psychiatric diagnosis, a thorough patient evaluation and detailed family history are taken in order to identify patterns and symptoms of mood disorder and behavior.  A positive family history of Bipolar Illness, Clinical Depression, suicide, alcoholism, drug abuse, gambling, hospitalization or outstanding achievements add to the likelihood of a bipolar diagnosis.

In addition to the initial psychiatric evaluation a physical examination with EKG and blood chemistries is required.  This may be performed by the in-house M.D. also in Dr. Fieve’s office for the patient’s convenience.  If a physical exam was done with an outside physician the reports must be delivered to Dr. Fieve’s office before the first follow-up visit either by fax or by mail.

PHASE II
PSYCHOPHARMACOLOGY AND PSYCHOTHERAPY

Based on the findings of the initial evaluation Dr. Fieve initiates weekly psychopharmacological follow-up visits to adjust medications as necessary to achieve desired therapeutic results.  The weekly follow-up visits develop into bi-monthly and monthly visits to monitor medication levels, patient progress and possible side effects.  Medication levels are determined in the office by the M.D. through the use of specialized equipment in the very convenient in-office laboratory so that the blood level values are available when the patient sees Dr. Fieve or one of his associates.

Patients that do not live in the area and become stable may have follow-ups via telephone consultation or telemedicine.  These patients must have their blood levels taken at a lab in their area and faxed to Dr. Fieve’s office before their next scheduled appointments.

For patients who wish to discuss problem areas of their lives, Standard or Cognitive Psychotherapy is also available in the office by a PHD or CSW that works closely with Dr. Fieve and his associates.  A combination of talk therapy and medication are often necessary to achieve optimal results, although Psychotherapy is not a required treatment for approximately two thirds of our patients.

PHASE III
PROGRESS ASSESSMENT

In this phase of treatment the patient’s overall mood and behavioral responses are evaluated for signs of improvement.  Progress is recorded on specially designed progress forms and overall treatment is adjusted accordingly.  In the rare case of little or no improvement after 3 to 4 weeks Dr. Fieve re-evaluates the patient’s condition and implements an alternate treatment plan that may better suit them.