What an Evaluation Actually Looks Like
Most psychiatric evaluations take about 45 minutes. Ours involves two clinicians who share one chart, multiple appointments, and 13 pages of notes — all reviewed and discussed together before we decide anything. Here's exactly what that means, and exactly what we'll explain when you call.
How our practice actually works
A doctor and a therapist who share one chart
Our therapist and Dr. Shapiro work as a single team and share one record. When you have a therapy session, the notes are in front of Dr. Shapiro before your next medication appointment — and the same the other way around. You don't have to repeat yourself, and nothing about your treatment falls between the cracks.
If something comes up in therapy, we don't wait
If you (or your child) tell our therapist during a session that a medication seems to be making things worse — more anxious, more moody, more hyper — she picks up the phone and calls Dr. Shapiro right then. We figure out the next step together, on the spot, instead of leaving you to manage on your own until the next appointment.
24-hour callbacks. Full evaluation done within 10 days.
Reaching a psychiatrist is sometimes harder than reaching your pediatrician. We understand that, so we've built around it. Our therapist gets back to you within 24 hours, and we aim to complete the entire evaluation within about ten days, working hard to make that happen as quickly as your schedule allows. We're a small practice on purpose — large practices often can't do this. We can.
Compare what you actually get
Typical psychiatry evaluation
≈ 30–45 min
- • One brief appointment with the psychiatrist
- • Symptom checklist, brief history
- • Often a same-day prescription
- • Limited collateral information from family or prior providers
- • Limited time for the patient to ask their own questions
Our evaluation
2 clinicians · multiple visits · 13 pages of notes
- Therapist meets with you (and your family if relevant) at length
- Therapist takes detailed written notes — about 13 pages
- Therapist and Dr. Shapiro discuss everything together
- Dr. Shapiro reviews the notes and writes his own on what matters most
- A full hour with Dr. Shapiro to review, discuss diagnoses, explore treatments, and decide together
If you're an adult
Step 1
1 hour with the therapist (Kari Gutzwiller, LPCC)
Kari Gutzwiller, LPCC — our licensed professional clinical counselor — meets with you for a full hour. She takes detailed written notes during the session — about 13 pages by the time you finish — capturing the kind of nuance and context a rushed appointment can never reach. Before this appointment, we send you rating scales to fill out so we have a structured baseline before you even walk in.
Step 2
Kari and Dr. Shapiro discuss everything together
Before Dr. Shapiro sees you, he and Kari sit down together. She tells him everything she learned. They go through the rating scales together. They discuss the picture as a team. You are not repeating your story to a second clinician who hasn't heard it.
Step 3
Dr. Shapiro reviews all 13 pages of notes
Dr. Shapiro reads through every page Kari wrote. He takes his own notes on the most important information. By the time he meets you, he already knows your story in real depth.
Step 4
1 hour with Dr. Shapiro
Dr. Shapiro starts by telling you what he learned from Kari — he reads the notes back to you so you can add anything that was missed and correct anything that wasn't quite right. Then he walks through the possible diagnoses and explains each one in plain language. He answers your questions — every one of them. He tells you there's more than one way in life to solve things, and walks through different possible treatments so you understand the choices. Then you decide together how to proceed. You leave with a real plan — and a backup plan, in case the first approach doesn't get you all the way there.
If your child or adolescent is the patient
For children and adolescents, the evaluation has three parts. The first two parts let parents and the child each have time to speak freely — separately — without worrying about the other person being in the room. The third part brings everyone together with Dr. Shapiro to make a plan.
Step 1
Part 1 — 1 hour: Kari meets with the parents
Kari sits with both parents for a full hour. This is your chance to speak openly about everything you're concerned about — without having to worry about hurting your child's feelings, and without having to be careful about what you say in front of them. The history, the worries, what's been tried, what school says, what home looks like. All of it.
Step 2
Part 2 — 1 hour: Kari meets with the child or teen
Separately, Kari spends an hour with the child or adolescent. This is their chance to speak freely about what's upsetting to them — including things about the parents — without anyone else in the room. The format meets the child where they are; older kids talk, younger ones use play and drawings. The point is to understand the child's experience in their own words, not just what the parents report.
Step 3
Rating scales come in from parents, child, and often teachers
Before the evaluation begins, we send rating scales to be filled out — by the parents, by the child if old enough, and often by teachers. Kari and Dr. Shapiro go through them together as part of the team review. Nothing relies on memory alone.
Step 4
Kari and Dr. Shapiro discuss everything together
Before the family sees Dr. Shapiro, he and Kari sit down. She tells him about both meetings — the parents and the child — in detail, and they go through the rating scales together. They discuss the picture as a team.
Step 5
Dr. Shapiro reviews all 13 pages of notes
Dr. Shapiro reads through Kari's notes from both sessions. He takes his own notes on what matters most. By the time he meets the family, he already knows their story.
Step 6
Part 3 — 1 hour with Dr. Shapiro: parents and child together
Dr. Shapiro tells the family what he learned from Kari, reads the notes back, and asks them to add anything missed or correct anything wrong. He walks through possible diagnoses and explains each in plain language. He answers every question. He explains there's more than one way in life to solve things, walks through the different treatments so everyone understands the choices, and then the family decides together how to proceed. You leave with a Plan A, a Plan B, and often a Plan C — so if Plan A doesn't work, you're not starting over. You already know what's next.
Why it's worth doing it this way
Most of the people who reach our office have been to other doctors. They've had brief evaluations, been put on medications quickly, and either didn't get better or didn't fully understand what was happening to them. The way we evaluate is the answer to that — two clinicians, real time, every important detail captured in writing, every question answered, every decision made together with you. The evaluation itself is the explanation. There is no shortcut to getting it right.
When you call us
Before we ever schedule an appointment, here is exactly what we'll walk you through on the phone — so you can decide whether our practice is the right fit for your situation.
We'll explain insurance honestly.
We are not an in-network provider. That doesn't mean you can't see us — it means you pay for the visit out of pocket up front, and as a courtesy we still submit your claims to your insurance company twice a month (the 1st and the 15th). Most out-of-network practices don't do that — they hand you a superbill and leave the paperwork to you. Because we are not a contracted provider, your insurance company is not legally allowed to share your reimbursement information with us. Once they process the claim, the amount they pay back to you will appear on your EOB (Explanation of Benefits). If you want to know exactly what to expect, the best step is to call your insurance company directly with our fee information and ask.
We'll explain the fees.
Most people understand by now that private psychiatric care is generally not covered by insurance the way it used to be. If you call around in our area, you'll find that our fees are very much in line with other private psychiatric practices.
It's a little like orthodontic care. Most insurance doesn't cover it well, and families decide it's worth allocating funds for because the outcome matters to them. Psychiatric care often works the same way — with one important difference. Whether a child gets braces at 14 or at 22 doesn't really change the result. But the longer mental health issues go untreated, the harder the road back, especially for children — what starts as a struggle with focus or mood often grows into struggles with self-esteem and how a child feels about themselves over time. That's why we treat it as something worth doing right, as soon as you can.
If our fees would add real stress, we'll say so.
We genuinely want what's best for you and your family. If our fees would add real financial stress on top of what's already happening, we'll tell you honestly and help you think about finding someone in network. We don't want to cut corners in your care just to make it affordable for you here — that's not in your interest. Tell us about everything going on, share whatever you'd like — it's your information, and you can absolutely take it with you to a different doctor if that's a better fit for your situation. There is no pressure to use our practice.
There's no pressure to decide on the spot.
We don't expect you to make a decision right then and there. We'll let you know that we now have your information, and that most people want to take it home and discuss with a spouse, partner, or family member before deciding. When you're ready, you simply call the office back at the main number — you don't have to go through intake again. Just say your name and that you'd like to move forward, and we'll send you the intake materials and have the therapist contact you within 24 hours.
How scheduling actually works.
After you schedule your appointment with the therapist, please call the office back at the main number to schedule your appointment with Dr. Shapiro. His schedule fills in 15-minute blocks, so the one-hour evaluation slots can take a little longer to find — but we'll always work hard to complete the full evaluation as quickly as your schedule allows, with the goal of finishing within about ten days.
Your privacy if you don't move forward.
If we don't hear back from you within a week of the call, we shred your information. Nothing sits around. If you decide later on that you'd like to become a patient, you may have to share some of the information again — that's the trade-off for not keeping records of people who haven't chosen us as their practice.
If it doesn't work elsewhere, call us back.
If you go to other doctors and treatment isn't working, please feel free to call us again. We always wish you the best, and the door stays open.
Talk to us first.
The best way to know if our practice is right for you is to call. We'll listen, answer your questions, and walk through what care here would actually look like for your situation — exactly the way it's described above.
If you're experiencing a psychiatric emergency, call 911 or go to your nearest emergency room.