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6 Forest Avenue, Suite 205
Paramus, NJ 07652
T. 201-880-6767 F.201-880-9719
79 Hudson Street, Suite 203
Hoboken, NJ 07030
T. 201-222-8808 F.201-222-8803

FAQs for Dr. Gajera

Please e-mail any general clinical questions you may have that can be included in our FAQs. You may address questions directly to a specific physician.

About My Practice

Do you accept insurance?
Our office does accept Aetna. Please note that some Aetna clients have separate mental health coverage under a differing company.  Most patients are usually able to obtain partial or full reimbursement (more typically 50% to 80%) by submitting a receipt.  Please check with your managed care plan for specifics about your out-of-network benefits.
Do you always prescribe medication?
No.  After a consultation I often will advise on therapeutic approaches that may be more effective.  However, I am often referred patients that would benefit from combining medications with therapy.
Do you see adults?
Yes. I work with adults who may have depression, anxiety, bipolar disorder or stress related to work and career. I have finished training in general adult psychiatry and I have a special interest in working with young adults. I feel that my training in child and family development improves my understanding and perspective with adult patients. 
Do you provide psychotherapy?
I do see a limited number of patients in psychotherapy or in combined psychotherapy - psychopharmacology treatment.
Do you treat the "mentally ill"?
Please take a moment to complete the initial patient packet found in our policies and forms section. Any copies of prior evaluations, labwork or prescriptions are also be helpful.
Do you treat substance abuse?
I do not specialize in substance abuse treatment. Patients with severe issues with alcohol, opioids, or other illicit substances benefit from a more specialized mental health provider or a team approach provided by a specialized center.

About the Initial Consultation

Why do you need two or three sessions for an evaluation?
A more thorough examination allows me to discover more of a person's subtleties and nuances that are easily overlooked in a single-session evaluation.  The additional time is also needed to address other potential causes or contributors to the presenting problem, including consideration of medical issues and comorbid psychiatric conditions.  Many patients appreciate the extra time to address any concerns or reservations they may have as well as to better work together in forming educated treatment decisions.
What should I bring to a consultation?
 Any past evaluation or testing would be helpful, but not essential. Recent labwork and prescriptions.  For children and adolescents, copies of the Individualized Education Plan (IEP), recent report cards, and any school notes are also useful.
What does a consultation involve?
For adult evaluations, consultations are typically done in two sessions or one double-length session.  Rarely, very complex histories may require a third session.  During that time a comprehensive psychiatric exam includes discussing the current concerns as well as reviewing history, medical history, medications and screening for other potential difficulties or hidden causes and complications.  At the end of the consultation, findings are discussed and I work with patients to find an individualized plan for treatment.  This may include starting therapy (either with myself or recommending appropriate therapists).  Adolescent and child evaluations consultations typically span three sessions.  The first is with the parents, the second is with the adolescent or child alone, and the third is conducted as a family where the diagnostic impression and a personalized treatment plan are discussed.

About Treatment

How long will I be in treatment?
That is a very important question.  Obviously, treatment varies considerably with each individual.  I do recognize that issues such as limited time, money, and desire for progress are part of an effective treatment plan and encourage discussion of treatment timelines.
What is the frequency and duration of your sessions?
Sessions typically last 45 minutes.  Psychotherapy is conducted, at a minimum, on a weekly basis.  Medication only treatment is typically monthly. Starting and adjusting medication may require more frequent initial visits, but once on a stable dosage of a non-controlled substance for several months, medication visits can occur once every two months.  This model of service differs from other medication-focused psychiatric practices where your visit may be from 10-15 minutes.
Can I keep my own therapist?
Absolutely.  A good treatment relationship with the right therapist is invaluable.  I prefer to be able to freely communicate with your therapist in this type of collaborative treatment.
Do you provide psychotherapy? (repeated)
I do see a limited number of patients in psychotherapy or in combined psychotherapy - psychopharmacology treatment. 

About Medication

Do you always prescribe medication? (repeated)
No.  After a consultation I often will advise on therapeutic approaches that may be more effective.  However, I am often referred patients that would benefit from combining medications with therapy.
Are psychiatric medications addicting?
There is some addiction potential with certain classes of medications.  Other medications may require gradual taper when discontinuing to prevent withdrawl-like side effects (i.e. Serotonin Discontinuation Syndrome), but are not habit forming per se.
Do you prescribe medication "off-label"?
Yes, with the patient's or parent's clear understanding.  The Food & Drug Administration has a process where pharmaceutical companies can get approval for specific uses of a medication.  Many times, most often due to cost considerations, these companies may not pursue certain indications.  This is an issue particularly of concern with the pediatric population where most medication needs to be prescribed "off-label". 
I know someone who takes five psychiatric medications. Would I need to take several medications?
I tend to be conservative and parsimonious with medication and allow adequate time to see if a medication is effective before adding additional ones.  There are, however, some treatment refractory cases which do need several complementary and synergistic medications. Ideally this would be a rare occurance. 

About Child & Adolescent Psychiatry

What age range of patients do you work with?
Anywhere from infancy to adulthood.  With infants, the work is centered around the parent-child bond and often focuses on new parent adjustment. Younger children are usually seen when there is a behavioral concern such as with sleep, eating, anxiety or socialization (as in the Autistic Spectrum Disorders).
Do you work with autism?
In a limited fashion. Autistic patients benefit most from school-based or team approaches addressing several different needs including academic, behavioral, and social adjustment. The psychiatrist's role is usually limited and would consist of medication to help in more difficult cases of behavioral distrubance, impulsivity or irritability.

If you have further questions, please call the practice main office at 201-222-8808.

 

Dr. Bhavin Gajera