I am a psychiatric nurse practitioner and I have spent fourteen years in private practice, mostly with adults, teenagers, and kids working through ADHD, anxiety, and depression. I treat medication as one tool among several rather than the whole plan. If you want a straight answer and a clear next step, we will get along.
Most of my visits do two things at once. We look at whether medication is helping, and we do real therapy work in the same hour, because a prescription is rarely the whole answer. I lean on cognitive behavioral therapy when a thought keeps presenting itself as a fact, acceptance and commitment therapy when the goal is to stop fighting something and start building around it, and motivational interviewing when you are genuinely of two minds about a change. My approach is strength-based, so I start from what is already working in your life rather than a list of what is broken. I will tell you what I think, and I will tell you when I am not sure.
The first visit runs about an hour. I will ask what brought you in now, what you have already tried, what your sleep and focus and mood actually look like week to week, and what you want to be different. If medication makes sense we will talk through the real tradeoffs, including side effects and what to do if the first thing does not work. If it does not make sense, I will say so. You should leave with a plan you could explain to someone else and a clear idea of what happens next.
