frequently asked questions

How do I determine if I need psychotherapy?

Different people seek out therapy for different reasons. We all deal with problems in our lives everyday. We use our resources -

talk to our family and friends, religious leaders, teachers, mentors and bosses; read self-help books, join support groups; or

attempt to deal with our difficulties the best way we know how. For many people this alone is sufficient and the crisis is

averted. Sometimes, however, these efforts are not sufficient. Life throws unexpected curveballs our way that make it difficult

to maintain relationships, work, and otherwise function in the ways that we want. It is when our own efforts do not give us

relief that people need professional assistance. Sometimes people want help to get through a crisis in their lives. Some people

wish to be proactive during major life transitions even when not in crisis. Some people seek therapy soon after a traumatic

experience (end of a relationship, death of a loved one, recent illness, and loss of a job) or long after they have begun seeking

closure. Some people are inherently curious about their lives and want a deeper understanding of themselves, their desires and

motivations. Psychotherapy and, only when appropriate, medications can help to re-establish order so that you see your life in

an entirely different way that allows you greater mindfulness, such that you are making decisions about your life rather than

simply reacting to impulses.

What's the difference between a psychiatrist and other forms of counselor, therapist, etc.?

All of these mental health professionals talk to people and can help them solve their problems. The difference is their

education and training background. Psychiatrists are medical doctors that have the ability to prescribe medications in addition

to providing psychotherapy. A licensed clinical social worker trained in psychotherapy helps individuals and families deal with a

variety of mental health and daily living problems with an emphasis on client advocacy to improve overall psycho-social

functioning. A marriage and family therapist works with families, couples, individuals and groups with a ‘systemic’ emphasis on

interpersonal relationships for the purpose of achieving more adequate, satisfying, and productive lives and relationship

adjustments. At the Cairn Center, we take pride in our diverse training backgrounds that allow us to collaboratively provide

expertise for all your mental health needs under one roof.

How do I know if I need to see a psychiatrist or a therapist?

Psychiatrists have the training to prescribe medications. Some psychiatrists, like Dr. Jain, provide both psychotherapy and

medications. If you are already in therapy, your therapist may have suggested that you might benefit from medications. You

may want to discuss whether you need to see a psychiatrist with your therapist who has taken the time to get to know you well

and can give you good feedback on this question. You can alternatively discuss this with your family doctor and we strongly

recommend that you be honest, open and upfront with your internist/family doctor. You can also schedule a consultation at The

Cairn Center and we can do a thorough diagnostic assessment and recommend the best course of treatment for you. Consider us

as consultants giving you an expert opinion.

Why do I choose Dr. Jain as my psychiatrist?

We believe that Dr. Jain is one of the few psychiatrists in Las Vegas that can provide both medication management and

psychotherapy. She is the only member of the American Psychoanalytic Association in the state of Nevada. She is

psychoanalytically trained and has an extensive psychotherapy background in CBT and DBT as well. Her psychopharmacological

training was under the mentorship of some premier depression researchers. She also spent a year doing her research fellowship

and participating in psychopharmacological research at the Depression Research Clinic at UT Southwestern Medical Center in

Dallas.

Can't I just put my problems behind me, move on and hope for the best next time?

Learning from our problems helps us prepare for the next time. You may do that by self-introspection or talking with loved

ones. Being honest with yourself can tell you if you are successful. Running away or shoving your problems under the carpet in

hope for a different outcome can backfire. In fact, the more we deal with life in that manner the more difficult it usually

becomes to move on after each successive disappointment, frustration, or conflict. Each situation that is not dealt with

adequately accumulates over prior unresolved issues. A large pileup can cause an overflow in the form of symptoms like stress,

anxiety, depression, irritability, lack of focus, stomach upset, headaches, muscle tightness, and the like.

What about reading a book, joining a support group, going to church/temple, attending a parenting class or a seminar, etc.

to get the help I need?

It’s possible. We encourage people to be an active participant in their recovery and explore all options. The journey to feeling

better is determined by what you put into the treatment. That is, how far you go. Everyone’s path to better mental health is

different. And yes, many people try other avenues first before turning to therapy. But know that it does not have to be an

“either/or” decision.

What about medications?

Anxiety, fear, depression, mood swings, anger, impulsiveness and addiction can significantly complicate and alter one’s

experience of life and relationships. These and other conditions can, indeed, be treated with medications (though in some

instances the medications are only working on the symptoms, not the cause). However, research has proven that psychotherapy

can often reduce the need for prescription medications with these and other conditions. Our belief is that medications

prescribed appropriately can benefit a person tremendously, but that one should not assume that this is the only path of

treatment. Psychotherapy, which allows a person to not rely on the medication exclusively and can help get the maximum relief

and benefit without being over-medicated, should be considered.

Am I a failure if I go to a psychiatrist or a therapist (or am I a failure as a parent if I take my child)? Am I "weak" if I cannot

work my problems out by myself?

If you have diabetes, you see your family doctor. You go to your lawyer for legal counsel. And you have a mechanic fix your car.

Unfortunately, many people do not see going to a mental health professionals in the same light. They may feel that one should

just “pull yourself up by your bootstraps” and “stop whining and deal with it.” There is a sense of shame and they see it as a

deficiency in themselves. This is probably the result of a lack of information about the nature, causes, and complexities of

emotional problems, and what is required to deal with them effectively. Some people are comfortable seeing a life coach, but

are hesitant to see a psychiatrist/ therapist. A common myth is that psychiatrists only see severe mental illnesses and “I must

be really nuts if I need to see one.” Another belief especially regarding psychiatrists is that “they will fill me up with

unnecessary medications”. These myths unfortunately contribute to a mental health stigma and keep people from getting

timely assistance. We believe that it is wise (not weak) to seek professional counsel and get the direction and guidance you

need especially with Cairn Center professionals who take pride in their ethical practice and are known for their judicious

treatment recommendations. We believe in empowering you with tools and skills necessary to live your life effectively. The

Chinese axiom “ Give a man a fish, and you have fed him once. Teach him how to fish and you have fed him for a lifetime”

aptly illustrates our practice philosophy.

Will I “fall apart” if I start talking about upsetting thoughts and feelings?

For most people, the answer is no, at least not in terms of a "nervous breakdown" or crying uncontrollably. It is certainly

possible that you may cry or feel anxious or upset. But many people feel relief after letting their feelings out during a session.

Will you put me in a hospital against my will?

We recommend hospitalization only when we are deeply concerned about your safety and that of others or in the case of severe

mania and psychosis. We do not take this lightly and make this decision in conjunction with your family and loved ones only if

you are not in a position to make a decision. Otherwise, we have an extensive discussion with you that explore all the possible

options. We believe that involuntary hospitalization is only a last resort and in our practice we have only made a handful of

these recommendations. It is not often.

Will what I say in therapy sessions be kept private and confidential?

The details of your personal life discussed at Cairn Center have no chance of being divulged to an outside party without your

consent. Confidentiality is essential to creating an atmosphere of trust, and treatment cannot work without that trust. Were we

to practice under the traditional managed care model, your rights to confidentiality are basically waived. But because we are

not on any insurance panels, we are free from any and all third-party intrusions. If you choose to use traditional insurance to

get reimbursement for your sessions with us, we will be required to give a diagnosis in order for you to get reimbursed, based

on your benefits. This is the only time we would ever share any information about your treatment with an insurance provider

unless you requested otherwise. Further, we share pertinent information with your physician, therapist and family members

only when you are in agreement that this would facilitate your treatment.

However, there are circumstances under which exceptions do exist. The following is not a complete list of exceptions to

confidentiality, but it does contain a few of the more common ones: 1) you are a threat to harm yourself or someone else; 2)

child abuse or neglect is suspected; 3) your treatment records are requested by legal subpoena (Should we receive such a

subpoena for your records for legal reasons like a divorce, only the dates of your sessions and diagnosis will be available); or 4)

to collect payment for services rendered.

Are your services covered by my insurance plan?

As we are not members of any HMO/PPO insurance plans, Cairn Center treatment is fee-for-service only and payment is due at

time of your appointment. That does not mean that you may not be able to be reimbursed by your insurance company for your

Cairn Center visit. Many insurance policies provide ‘out of network benefits’ that reimburse our services to varying degrees. We

can help facilitate your efforts to claim traditional insurance benefits by providing you a receipt that you can then submit to

your insurance company.

What is a “concierge practice” and why don’t you take insurances?

There are several types of concierge practices, but all of them alike include direct payment by the patient to the physician for

the services provided. There are many benefits of this arrangement. One is that providers can spend more time with his/her

patients. Additionally, treatment decisions are made entirely by the provider and patient/client, not by insurance companies or

managed care organizations. For a full discussion of this topic and of why we feel that this model provides the best care for our

clients, please see my thoughts on managed care.

How do I get started?

Give us a call or send us an email. We will be back in touch as soon as we are able.

How soon can I get an appointment?

For first-time visitors and those in need of prompt attention, we will always do our utmost to make appointments available as

soon as possible. As a commitment to those we treat, we make ourselves personally available for emergencies should they

arise. We also make ourselves available for phone and web consultations should this prove necessary or more convenient.

What can I expect in the first session?

The first session offers a comprehensive psychiatric or psychological evaluation where our providers will seek to gain a clear

understanding of what issue(s) are bringing you into treatment. By the end of the session, we will provide you a psychiatric

diagnosis if applicable and/or our impressions of your psychological distress. We will discuss with you the treatment options

available, and together you can develop a plan about how to address the issues in terms of working towards solutions.

What is your cancellation policy?

As we only schedule one person per appointment time, you have effectively contracted for that time. As such, should you not

attend your session and not give us 48 hours notice (so that we can try to fit another patient into that time), you will be

charged for the full fee of the appointment that you had reserved, regardless of whether this appointment was used or not.

Frequent cancellations/rescheduling may incur a fee as well.