Integrated Psychiatry & Psychotherapy in New York City
Psychiatrist-led care that considers diagnosis, medication, psychotherapy, personality functioning, development, relationships, family context, and the treatment relationship as parts of one clinical picture. Integration may occur within one clinician’s work or through purposeful coordination among psychiatry, psychology, psychotherapy, and an existing care team.
In-person and clinically appropriate telehealth
One Coherent Formulation
Medication decisions make more sense when they are connected to the person, the symptoms, and the psychological work already underway.
Psychiatric symptoms do not exist separately from psychology, development, identity, relationships, coping, medical history, family context, or the treatment relationship. Yet care can become divided into brief medication visits, psychotherapy sessions, testing, family concerns, and outside recommendations that are not organized around the same explanation and integrated approach.
Integrated psychiatry and psychotherapy brings these parts together. For some patients, Dr. Sheppe may provide both psychiatric care and psychotherapy. For others, he may consult on diagnosis or medication while an existing therapist remains the primary psychotherapist. Dr. Spruch-Feiner’s assessment, psychological, and psychotherapy perspectives may also contribute to a coordinated plan.
The aim is not to combine services simply for convenience. It is to make sure that assessment, medication, psychotherapy, family participation, and care-team communication are responding to the same clinical priorities rather than operating as unrelated, siloed treatments.
Two providers. One integrated plan.
Alexander H. Sheppe, MD, FAPA, DFAACAP, and Aliza Spruch-Feiner, PhD, bring complementary psychiatric and psychological perspectives to evaluation, psychotherapy, personality formulation, medication questions, family context, risk, development, and coordinated treatment planning.
Alexander H. Sheppe, MD, FAPA, DFAACAP
Double board-certified child, adolescent, and adult psychiatrist whose work integrates complex clinical evaluation, psychodynamic psychotherapy, psychoanalysis, TFP, medication consultation, personality development, family systems, and coordinated care.
Aliza Spruch-Feiner, PhD
Clinical psychologist, experienced in integrated psychiatry-psychotherapy collaboration, providing psychological and personality assessment, psychodynamic formulation, and psychotherapy to complement psychiatric evaluation and medication management.
When Integrated Care May Be Helpful
Integration may be useful when assessment, medication, psychotherapy, family concerns, or outside recommendations are addressing different pieces of the presentation in a fragmented way. The appropriate model depends on the patient, existing treatment relationships, clinical needs, and provider availability.
Medication visits feel disconnected from psychotherapy
Symptoms, side effects, adherence, relationships, emotional patterns, stress, and treatment progress may be discussed in separate settings without enough communication to guide coherent decisions.
Psychotherapy needs psychiatric consultation
An existing therapist may need help with diagnosis, medication questions, safety, mood instability, attention, sleep, medical considerations, level of care, or a change in the clinical presentation.
Medication has helped only part of the problem
Symptoms may improve while identity, relationships, emotional regulation, avoidance, self-esteem, trauma, coping, family patterns, or recurring crises continue to interfere with functioning.
The diagnosis changes depending on who is asked
A psychiatrist, therapist, psychologist, family member, school, or program may each emphasize different symptoms without a shared understanding of what is primary, interacting, or still uncertain.
Personality or development affects treatment response
Identity, relationships, emotional regulation, coping, family roles, and the treatment relationship may shape symptoms, medication use, attendance, trust, and the ability to benefit from care.
Several providers are working without clear roles
Psychiatrists, psychologists, therapists, coaches, schools, colleges, hospitals, programs, and family members may be involved without a defined communication plan, treatment hierarchy, or shared clinical direction.
A treatment transition needs more continuity
Hospital discharge, residential treatment, college leave, transfer from youth to adult care, a new therapist, or medication changes may require clearer sequencing and communication across providers.
The patient needs more than brief symptom management
A fuller treatment may be needed when symptoms cannot be understood or addressed adequately without attention to root causes such as identity, relationships, development, family context, psychological meaning, and long-term patterns.
How Integrated Psychiatry and Psychotherapy Is Organized
Integration does not require one identical arrangement for every patient. Care may be provided by one clinician, divided between psychiatry and psychotherapy, coordinated within The Sheppe Group, or organized with outside clinicians who remain central to treatment.
Understand symptoms, treatment history, and psychological context.
The clinician considers diagnosis, risk, development, personality functioning, relationships, medical and medication history, family context, prior psychotherapy, strengths, and current daily functioning.
The formulation clarifies what medication may reasonably target, what psychotherapy needs to work through, whether family consultation is required, and what requires coordination.
Decide who will provide each part of care.
Dr. Sheppe may provide psychiatric care and psychotherapy within one treatment relationship when that model fits the patient’s clinical needs and treatment goals.
An existing therapist may remain primary while Dr. Sheppe provides psychiatric consultation, or Dr. Spruch-Feiner’s psychology-based assessment or psychotherapy may be coordinated with psychiatrist-led care.
Review progress across symptoms, relationships, and functioning.
Potential benefits, side effects, adherence, timing, diagnostic rationale, psychological meaning, and the patient’s lived experience are considered together rather than as isolated prescribing questions.
With appropriate authorization, clinicians may communicate about diagnosis, risk, medication, treatment goals, roles, progress, and transitions.
The treatment structure may change over time. A patient may begin with evaluation, add medication consultation, continue with an existing therapist, move into integrated treatment, or require a different specialist or level of care as the clinical picture becomes clearer or changes.
What Integrated Care May Include
Integrated care is not a package that automatically includes every service. Each component should have a clear role and should support the same formulation, priorities, and treatment goals.
Diagnosis and formulation
Assessment of symptoms, risk, development, personality functioning, relationships, medical factors, family history, prior treatment, medication response, strengths, and daily functioning.
Depth-oriented psychological treatment
Psychodynamic psychotherapy, psychoanalysis, TFP, personality-focused work, supportive treatment, or other approaches selected according to diagnosis, formulation, goals, and capacity.
Prescribing inside the full context
Review of potential benefits, risks, alternatives, prior response, side effects, adherence, medical considerations, psychological factors, and how medication fits with psychotherapy.
Assessment and formulation from clinical psychology
Psychological or personality assessment, psychotherapy, risk assessment, and deeper attention to identity, emotional regulation, relationships, trauma, development, and treatment fit.
Support, boundaries, and treatment participation
Clarification of family roles, communication, safety, privacy, caregiving, expectations, accommodation, adult responsibility, and how relatives can support care without taking it over.
Clear roles across clinicians and settings
Purposeful collaboration with therapists, psychiatrists, psychologists, coaches, schools, colleges, hospitals, programs, primary-care clinicians, and other supports when permission is in place.
Integrated care does not automatically mean medication, combined treatment with both practice providers, disclosure of psychotherapy content, or the replacement of an established therapist. Recommendations follow evaluation and depend on clinical need, consent, fit, availability, and the treatment plan.
Important Clinical Distinctions
Integration is valuable when it improves formulation, decisions, and continuity. More communication is not automatically better unless each person understands the purpose, boundaries, and responsibilities involved.
Integrated psychiatry is more than medication management
Medication may be one component, but the clinician also considers diagnosis, development, relationships, personality functioning, psychotherapy, risk, medical factors, family context, and the patient’s response to the treatment relationship.
Integration does not require one clinician for everything
One psychiatrist may provide both psychiatry and psychotherapy, but coordinated split treatment can also be effective when the psychiatrist and therapist have clear roles and share a clinically useful formulation.
Coordination is not unrestricted information sharing
Communication should have a defined purpose and respect privacy, authorization, safety, and the integrity of psychotherapy. Clinicians can coordinate important treatment decisions without routinely sharing every detail of private sessions.
Psychotherapy and medication answer different questions
Medication may reduce or stabilize certain symptoms. Psychotherapy may address emotional patterns, relationships, identity, coping, trauma, behavior, and psychological meaning. Integration helps each component support the broader treatment rather than expecting one to replace the other.
When treatment has become divided into separate conversations about medication, therapy, relationships, and daily functioning, integrated care can create a clearer understanding of how those pieces belong together.
Different Models of Integrated Care
The best arrangement depends on the patient’s needs, existing relationships, diagnosis, treatment intensity, privacy, provider roles, and whether continuity or a new clinical perspective is most important.
Psychiatry and psychotherapy within one treatment
Dr. Sheppe may provide both psychiatric care and psychotherapy when one integrated relationship offers the most coherent structure for diagnosis, medication, psychological work, and ongoing review.
A psychiatrist and therapist with defined roles
An existing therapist may remain primary while Dr. Sheppe provides evaluation, medication consultation, and psychiatric follow-up connected to the therapist’s broader understanding of the patient.
Psychiatry and clinical psychology in one shared direction
Dr. Spruch-Feiner’s assessment or psychotherapy perspective may complement Dr. Sheppe’s psychiatric work when psychology and psychiatry need to address different parts of the same clinical picture.
Coordination across several clinicians and settings
Families, therapists, psychiatrists, coaches, schools, colleges, hospitals, programs, and other professionals may need clearer roles, communication, sequencing, and one formulation that organizes treatment priorities.
What Integrated Care Is Designed to Support
No treatment model can guarantee symptom relief, medication response, or progress in psychotherapy. The aim is to improve clinical understanding, decision-making, continuity, and the fit between each treatment component and the patient’s actual needs.
One explanation guiding different parts of care
Diagnosis, medication, psychotherapy, personality functioning, development, relationships, risk, medical factors, and family context are understood as interacting parts of the same presentation.
A defined purpose for each clinician and service
Patients and providers understand who is responsible for psychotherapy, prescribing, assessment, crisis decisions, family communication, coordination, and review of progress.
Medication choices connected to the larger treatment
Potential benefits, side effects, adherence, timing, symptom patterns, psychological factors, relationships, functioning, and psychotherapy progress inform psychiatric decisions.
Fewer gaps during changes in symptoms or care
A shared plan can help organize transitions involving new providers, college, hospital discharge, residential treatment, medication changes, increased risk, or movement between levels of care.
Progress assessed across symptoms and daily life
Care can be reviewed through changes in emotional regulation, relationships, school or work, safety, identity, participation, self-care, medication response, and the capacity to use psychotherapy.
Related specialtiesand conditions
Specialties That May Be Part of an Integrated Plan
Personality Assessment & DevelopmentA fuller clinical picture
Transference-Focused PsychotherapyIdentity, emotion, and relationships
Adolescents & Emerging AdultsDevelopmental expertise
Family ConsultationRoles, communication, and support
School Avoidance & Failure to LaunchParticipation and independence
Conditions and Concerns That May Benefit From Coordinated Care
Integrated Psychiatry & Psychotherapy FAQs in New York City
These answers are general. The appropriate provider roles, treatment model, medication plan, psychotherapy structure, family involvement, coordination, and level of care depend on the individual patient, diagnosis, consent, safety, clinical need, and provider availability.
What does integrated psychiatry and psychotherapy mean?
Integrated psychiatry and psychotherapy means that symptoms, diagnosis, medication, personality functioning, development, relationships, family context, and the treatment relationship are considered as parts of one clinical picture. Integration may occur within one clinician’s work or through purposeful coordination among several providers.
Can one psychiatrist provide both medication care and psychotherapy?
Yes. Dr. Sheppe may provide both psychiatric care and psychotherapy when that treatment model fits the patient’s needs, diagnosis, frequency, goals, and available treatment structure. An evaluation is needed before determining whether one-clinician care is appropriate.
Can I keep my current therapist and see Dr. Sheppe for psychiatry?
Sometimes. Dr. Sheppe may provide psychiatric evaluation, medication consultation, or follow-up while an existing therapist remains the primary psychotherapist. Coordination depends on clinical need, appropriate authorization, and a clear understanding of each provider’s role.
Does integrated treatment always include medication?
No. Medication is one possible component. Some patients may primarily need psychiatric evaluation, psychotherapy, psychological assessment, family consultation, or care coordination. Medication recommendations follow the diagnosis, severity, prior response, evidence, medical considerations, and overall treatment plan.
How can Dr. Spruch-Feiner be involved in integrated care?
Dr. Spruch-Feiner may contribute psychological or personality assessment, psychodynamic psychotherapy, TFP, MBT-informed work, risk assessment, and formulation of identity, emotional regulation, relationships, trauma, development, and treatment fit. Her role may complement Dr. Sheppe’s psychiatric work when that structure is appropriate.
How is integrated care different from brief medication management?
Brief medication management may focus primarily on symptoms, response, side effects, and prescribing decisions. Integrated care places those questions inside a broader formulation that may include psychotherapy, personality functioning, development, relationships, family context, risk, medical factors, and daily functioning.
Will my psychiatrist and therapist discuss everything from my sessions?
No. Coordination should have a defined clinical purpose and should respect privacy and the integrity of psychotherapy. With appropriate authorization, clinicians may discuss diagnosis, risk, medication, treatment goals, progress, roles, and transitions without routinely sharing every detail of private sessions.
Can integrated care include family consultation?
Yes. Family consultation may be useful when relatives have important roles in safety, caregiving, treatment participation, housing, finances, school, work, or support. The appropriate participants and information-sharing framework depend on age, consent, authorization, safety, and the treatment plan.
Is integrated psychiatry appropriate for complex or treatment-resistant concerns?
It may be helpful when several diagnoses, partial treatment response, medication questions, personality or developmental factors, repeated crises, or multiple providers require one coherent formulation. A complex clinical evaluation may be recommended before the treatment structure is finalized.
Does consultation guarantee ongoing treatment at The Sheppe Group?
No. Consultation may lead to ongoing psychiatry, psychotherapy, integrated care, or coordinated treatment when clinically appropriate and mutually agreed upon. It may also support an existing team or lead to referral for another specialist, testing service, treatment program, or level of care.
Integrated Psychiatry and Psychotherapy in Midtown Manhattan
The Sheppe Group provides psychiatric evaluation, psychodynamic psychotherapy, psychoanalysis, TFP, medication consultation, psychological and personality assessment, family consultation, and coordinated treatment planning at 122 East 42nd Street, 32nd Floor in New York, NY 10168, near Grand Central. Care is available for adolescents, emerging adults, adults, and families depending on the presenting question and treatment fit.
122 East 42nd Street, 32nd Floor
New York, NY 10168
(646) 859-8585
Midtown Manhattan near Grand Central
Psychiatric evaluation, psychotherapy, medication consultation, psychology-based assessment, family consultation, and coordination with existing clinicians or care teams.
Telehealth for New York and Other Licensed States
Telehealth may be available for psychiatric evaluation, psychotherapy, medication follow-up, family consultation, and care coordination when remote treatment is clinically appropriate and permitted for the patient’s location. Suitability depends on privacy, consent, safety, diagnosis, complexity, and the treatment plan.