Psychiatric services with clear boundaries

Comprehensive psychiatric evaluation: The starting point for care at Foundry, reviewing current concerns, psychiatric history, medical history, medications, prior treatment response, sleep, substance use, family history, relationships, functioning, safety, and goals. Boundary: Evaluation does not promise a diagnosis, medication, or particular outcome.

Medication management: Ongoing psychiatric follow-up guided by evidence, safety, treatment response, tolerability, medical history, medication interactions, monitoring needs, and patient preference. Boundary: Refills are not automatic. Medication decisions, including controlled-substance decisions, require clinical appropriateness and standard safeguards.

Psychotherapy-informed care: Care may include supportive therapy, psychoeducation, motivational interviewing, coping strategies, behavioral activation, sleep and routine support, relapse-prevention awareness, and attention to patterns that affect functioning and relationships. Boundary: Some patients may also benefit from ongoing psychotherapy with a separate therapist.

Integrative treatment planning: Psychiatric treatment planning may include review of sleep, lifestyle, nutrition, supplement use, metabolic health, hormonal transition, pharmacogenomic testing, and complementary approaches when clinically relevant. Boundary: Adjunctive strategies are considered through a safety-focused psychiatric lens and are not substitutes for psychiatric evaluation or evidence-based treatment.

Pharmacogenomic testing: Pharmacogenomic testing may be considered when clinically appropriate, particularly when medication response, side effects, tolerability, metabolism, or interaction concerns are relevant. Boundary: Testing does not replace clinical judgment and does not guarantee medication choice, response, tolerability, safety, or insurance coverage.

Nutritional and supplement review: Foundry may review current supplement use or discuss evidence-informed nutritional and supplement considerations when clinically relevant to psychiatric care. Boundary: Recommendations consider safety, potential interactions, medical history, pregnancy status when relevant, and coordination with other clinicians.

Complementary approaches and referrals: When complementary approaches may be helpful, Foundry may discuss them as adjuncts to care or refer to appropriately trained clinicians. Boundary: Foundry does not provide acupuncture, yoga therapy, bodywork, or similar adjunctive services directly.

Care coordination: With patient consent, Foundry may coordinate with therapists, primary care clinicians, medical specialists, recovery supports, family members, schools, or other trusted providers when collaboration would improve safety or clarity. Boundary: Foundry will not assume coordination without appropriate consent or authorization.