Optimal Behavioral Health


Call Us:  (541) 826-0899

Genetic Testing -- On-site DNA samples taken (via cheek swab) and sent to off-site facility (Genomind or Genesight) for genetic testing.

  • Why do genetic testing?
    • Genetic testing can help personalize your treatment by examining the ways specific genes influence your body's response to particular medications.  This can help us avoid medications which your body may not metabolize well and thus may not work well for you, and also find a medication which might optimally reduce your symptoms.
      • Cytochrome P450 system (2D6, 2C19, 2C9, 3A4, 2B6, 1A2) -- responsible for the metabolism (breakdown) of the majority of prescribed medications.  Individuals with Poor Metabolism (PM) or Intermediate Metabolism (IM) may be at risk for increased side effects from medications metabolized via this system.  Individuals with Ultrarapid Metabolism (UM) may not respond to "normal" doses of medications and may need higher doses which also increases risk for side effects.
      • Serotonin Transport Pump (SCL6A4) -- responsible for clearing and recycling the neurotransmitter, Serotonin (5HT), from the space (synapse) between neurons.  This pump is located in the presynaptic neuron.  Alterations in this gene are associated with increased risk for side effects with use of serotonergic medications like SSRIs and SNRIs.
      • Serotonin Receptor Type 2A (HRT2A) -- alterations in this gene may affect a patient's response to SSRIs and presence of G alleles may result in a poor response to these medications and increased risk for adverse drug reactions.
      • COMT -- gene that codes for the degradation (breakdown) of dopamine and norepinephrine in the pre-frontal cortex (PFC).  Dopamine and norepinephrine deficiencies are associated with problems with executive function (like the Chief Operating Office of the brain).
      • MTHFR -- variations in this gene may result in a decreased ability to convert dietary folic acid to methylfolate, the precursor (building block) for necessary neurotransmitters like serotonin, dopamine, and norepinephrine.
    • For those patients interested in genetic testing services, beginning in February 2016, Melanie will offer two 1/2 hour appointments on Thursdays for genetic testing review, interpretation, and recommendations.

In addition to clinical work, we also provide:  community trainings, staff/program development consultation, supervision, and training opportunities and support for students or new providers.

Assessment

·         Current symptoms

·         Symptom history

·         Past Developmental and Psychosocial History

·         Diagnostic clarification

·         Functional Impairments

·         Effectiveness of current medication regimen

·         Screening and Monitoring Tools

Psychoeducation

·         Diagnoses, symptoms, and course of illness

·         Early signs of relapse

·         Reasons for Treatment

·         Potential Benefits of Treatment

·         Potential Risks of Treatment

·         Alternative Treatments including non-medication treatments

·         Healthy coping skills

·         Preventative interventions

Safe Medication Management Practices

·         Evaluate effectiveness of current medication regimen

·         Assess and monitor for side effects

·         Assess opportunities to simplify medications

·         Optimize effective medications

·         Improve adherence through education

Therapy (Individual, Couples, Family, Group)

      ·         Cognitive Behavioral Therapy (CBT)

·         Dialectical Behavioral Therapy (DBT)

·         Motivational Interviewing (MI)

·         Psychoeducation (PE)

·         Focused-Family Treatment (FFT)

·         Interpersonal and Social Rhythm Therapy (IPSRT)

·         Anger Management

·         Collaborative Problem Solving (CPS)

·         Parent Training



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