PATIENT INFORMATION

Questions
& Answers

Questions & Answers

Find the information you need about our services

Patient Information

Frequently asked questions

Frequently
asked
questions

Below are the answers to the most common questions we receive. We do our best to make sure you have the information necessary to understand how we can meet the needs of you or your child. If we missed something, please let us know.

General
What is ADHD?

ADHD is a treatable medical disorder characterized by the core symptoms of hyperactivity, inattention, and impulsivity that are experienced repeatedly and in a way that is severe enough to have an impact at home, at school, and in social situations. The specialists at KEGE Center can accurately diagnose ADHD in children and ADHD in adults with a recommendation for appropriate treatment options.

What is the age range of the patients you treat?

We typically see children as young as 6 years old and adults up to 60 years old.

What is the cost of working with you?

The cost of your treatment truly depends on your unique needs. Our standard fees are $350 for the initial psychiatric evaluation and $150 for follow-up medication management.

All KEGE Center providers have advanced and specialized training in psychiatry beyond their graduate work. Our session rates are comparable with other masters and doctoral level specialists in Arizona.

Can I still use my insurance for medication?

Yes. It is important to note that the cost of medications, both brand name and generics, varies greatly depending on insurance coverage and pharmacies. To avoid medication that is too expensive, discuss medication costs with your provider.

If cost is a concern or you will be paying out of pocket for your medication, a free prescription discount card, like GoodRx, can save you up to 80% off the retail price. Even for patients who have health insurance, GoodRx can still help you find prices that are lower than a typical co-pay.

How often will we meet?

The initial psychiatric evaluation is a single appointment lasting 90-minutes. On rare occasions, and in patients with complex psychiatric histories beyond ADHD, a second appointment is needed to complete an accurate diagnosis. If you think this rare situation may apply to you, please contact us to determine if it will be a good fit to work together.

Follow-up medication management appointments last 20 minutes and occur about every 2-3 months for stable patients or sooner if medication changes are needed. With the shortgage of certain stimulants, the Drug Enforcement Agency is requiring more frequent appointments for controlled substances, like stimlants (Adderall, Vyvanse, Focalin, Ritalin, etc.).

Do you offer in person appointments?

All appointments are completed in person in our Gilbert, AZ offices or online via our secure, encrypted video platform. Our clients love the convenience and flexibility of in office visits or being able to connect from work or from their own home where they feel most comfortable.

Online video visits allow you to avoid traffic and parking and are less of a time commitment than if you had to schedule a time to get to and from an office or take child out of school. They’re also more discreet.

Telehealth (video visits) has been thoroughly researched and all the studies show it is just as effective as in-person therapy. We would never practice in a way that is not effective and backed by research as we are very committed to providing the highest level of service to our clients.

Are online telehealth video visits just as good as in person?

Yes! Telehealth video visits are just as effective as meeting in person. All the nuances of facial expressions and body language can be seen through video just as they can in person. Many of our clients have commented that they prefer online visits because they do not have to allocate additional time to travel to and from an office, deal with traffic, parking, etc. and they feel more comfortable in their home or office.

Benefits of Teleheath Video Visits

Here are a few of the research-based benefits of telehealth services:

  • Increased access. Approximately 123 million Americans live in an area with limited access to healthcare. Telehealth can play an important role in these communities by increasing accessibility.
  • Reduced costs for clients. Telehealth saves money when compared with traditional approaches to providing care. For clients, this often means lower transportation costs, less time missed from work, and less money spent on child care expenses. These are some of the “hidden costs” of therapy beyond the session fee that many do not factor into the cost of their therapy services.
  • Same-level of client care. No client outcome difference was found between telehealth appointments and face-to-face office visits across multiple studies.
  • Better client experience. Telehealth eliminates the wasted time traveling and sitting in the waiting room. You get to have your visit in your own space where you are already comfortable which often leads to clients opening up faster given their increased comfort.
  • All major psychiatry, psychology, and social work associations have endorsed telemental health services. As the industry continues to progress and become more widely used by clients and practitioners, online psychiatry is on course to become as mainstream as face-to-face psychiatry. The use of online psychiatry has been validated by the US Federal government and most states, as illustrated by the billions of dollars dedicated to setting up and delivering telemental health services and the installment of the federal and regional offices advancing telehealth.
  • http://www.telehealth.va.gov/, http://www.hrsa.gov/ruralhealth/about/telehealth/.
What qualifies you as an ADHD specialist?

This is a great question because there are a lot of people in the marketplace today branding themselves as able to treat ADHD with very little formal training or experience in psychiatry. It is important to know what qualifies someone to be working as an ADHD provider so you can make an informed decision as a consumer.

All of our psychiatric providers are board-certified psychiatric/mental health nurse practitioners with a masters or doctorate degree having undergone extensive supervised experience with clients before getting licensed. They all passed rigorous licensing exams and are regulated by a board that ensures they maintain the highest ethical standards and continuing education.

All of our providers are specialists with extensive experience evaluating and treating ADHD symptoms, alongside symptoms of commonly co-occurring conditions like anxiety and depression, mood disorders, and oppositional defiant disorder They are equipped to accurately diagnose and address all of these conditions.

Many clients first seek help from their primary care doctor (PCP) or pediatrician. These providers often have limited time to complete a thorough assessment of the complexity of comorbid symptoms present in 70% of the ADHD cases presenting in this setting. It is also important to consider whether a PCP has sufficient experience and training to accurately diagnose psychiatric disorders.

If so, which disorder is treated first? Not approaching treatment correctly can make symptoms worse and result in lost time, excessive cost, and medication trial and error.

Our providers spend more than a few minutes diagnosing. They spend 90 minutes completing a thorough evaluation to ensure an accurate diagnosis and successful treatment plan.

While many pediatricians and primary care doctors are wonderful, it’s important to do your due diligence and hire an ADHD specialist. In reality, it’s important that you do your due diligence no matter who you are hiring!

Do your providers ever run late on your appointments?

We try to adhere to the schedule to respect your time. We do not double book, i.e. schedule 2 patients for the same time slot. Your scheduled time is only for you. There are the rare occurrences when the patient scheduled ahead of you is “having a bad day.” So, please understand, if we are running late, it is most often for this reason. If you are ever having a bad day, we will give you the time you need.

ADHD in Children
When can ADHD be diagnosed?

Most cases of ADHD are diagnosed when the child is 7 or 8 years old, but ADHD symptoms and impairment can be apparent as early as ages 3 to 5, when the child is in preschool or kindergarten. Girls are often identified later than boys. Bright children may not be diagnosed until later as they may compensate for their difficulties until school work and life demands get more challenging.

For children not treated early, their level of functioning declines when starting junior high and again in high school. They have difficulty with social distractions, time management the transitions between classes, and more demanding courses. This can be overwhelming and irritability, anxiety, and depression start to appear. We call these co-occurring conditions developing secondary to ADHD. With proper treatment, these clients regain focus and a sense of mental control, and as a result, the depression and anxiety quickly resolve.

Will my child grow out of ADHD?

For some children, ADHD may go away as they get older. For others, it may not. If your child’s ADHD does not go away, some ADHD symptoms may become more manageable or less noticeable.

As ADHD may persist from childhood into adolescence, symptoms of hyperactivity in children, such as talking excessively, butting into conversations, or running excessively tend to lesson as they mature and learn socially acceptable behaviors. In teens, untreated ADHD symptoms may present as an inner sense of restlessness, anxiety, and even depression.

How do I know if my child has ADHD and not something else?

A comprehensive psychiatric evaluation is required to ensure an accurate diagnosis by considering the presence of other co-occurring conditions that can exist with ADHD. Some frequent co-occurring conditions with ADHD present as defiance, lying, stealing, learning difficulties, anxiety, hopelessness, low self-esteem, depression, mood dysregulation, and excessive/extreme temper tantrums. The research has shown that for a child with ADHD, two-thirds have at least one other mental health disorder in their lifetimes.

What treatment options are available?

ADHD treatment depends on the child’s age and may include medication, parent training, behavioral therapy, coaching, and educational supports (IEP or 504 plan). Stimulant medication is first line treatment for ADHD, but the decision to start any medication will be thoroughly discussed and agreed upon by the provider, the parents, and the child. It’s important to weigh the risk and benefits of any medication.

Medications are not a cure for ADHD, but they may be able to help control the hyperactive/impulsive and inattentive symptoms of ADHD. Medication may not be right for everyone with ADHD, but it can play a vital role in the total treatment plan along with coaching and other therapies. Learn more about medication management and therapy.

Are there alternative treatments available?

Parents often hear reports of “miracle cures” for ADHD on television, in magazines, or in advertisements. Most of these treatments have not been shown by research to be ineffective for ADHD, some are expensive, and some may even be harmful.

Some of the more prevalent, yet unproven, treatments for ADHD are special diets, herbal supplements, homeopathic treatments, vision therapy, chiropractic adjustments, metronome training, auditory stimulation, applied kinesiology (realigning bones in the skull), brain wave training, and neurobiofeedback.

While parents remain optimistic in the efficacy of alternative, non-medication treatments, rigorous scientific research does not support that these alternatives are effective at managing ADHD symptoms. Research has shown that children with ADHD benefit from a health diet of fruits, vegetables, and low-fat proteins, as well as daily activity outdoors. 

Other Disorders in Children
What other disorders can co-occur with ADHD?

Diagnosing and treating ADHD with comorbid disorders is more difficult and requires a specialist with the experience necessary to identify and treat these other conditions. Some frequent co-occurring disorders with ADHD are insomnia, Oppositional defiant disorder (ODD), Disruptive mood dysregulation disorder (DMDD), Conduct disorder (CD), language and learning disorders, anxiety disorders, and depressive disorders.

How are these other disorders diagnosed?

Your child’s behavior may be caused by ADHD, another condition, or a co-occurring disorder. A thorough evaluation by a specialist considers all potential co-existing disorders to achieve an accurate diagnosis or diagnoses. This is essential to choosing the right treatments, including the choice of medication that will benefit your child the most.

What about sleep?

Difficulty falling asleep, staying asleep, or waking up too early commonly co-occur with ADHD and affect nearly 3 out of 4 children and teens and up to 4 out of 5 adults with ADHD. Children with ADHD who are deficient in sleep have increased hyperactivity and impulsivity, decreased attention span, irritability, and even aggression. For children currently taking ADHD medication, several factors may be involved. It could be the formulation (long-acting v. short-acting), dose amount, or the time of day the medicine is taken. Other factors involved include bedtime routine, use of electronics near bedtime, naps, caffeine, other medications, or the presence of another psychiatric or medical disorder.

The goal is to improve the sleep, which will improve the ADHD, which will improve the sleep. Sleep is assessed by your provider at the initial evaluation and at all follow up visits. Each individual is different, so your specific circumstances are considered in treatment.

How are these other disorders treated?

Treating ADHD and co-occurring disorders depends on the child’s age and comorbid condition. Treatment may include medication, parent training, behavioral therapy, coaching, and educational supports (IEP or 504 plan). Every additional disorder with ADHD adds to the complexity of the treatment. For instance, Oppositional defiant disorder has no FDA approved medication for treating it, but a mood stabilizer may be indicated if the anger and aggression are at a level where the safety of the child or others is a concern. While stimulant medication is first line treatment for ADHD, for a child with a co-occurring mood disorder, it may make the temper tantrums and irritability worse. When treating multiple disorders, the order in which they are treated and the choice of medication used requires the expertise of a specialist.

The providers at KEGE Center for ADHD will advise you when medication is indicated and the symptoms it intends to target. The decision to start medication will be thoroughly discussed and agreed upon by the provider, the parents, and the child. It’s important to weigh the risk and benefits of any medication.

Medications are not a cure, but they may be able to help control your child’s symptoms. Children are better able to learn and participate in therapy when their symptoms are stable.

Can you treat these other disorders at KEGE Center?

Yes. Our providers are specialists in treating ADHD and all of the co-occurring psychiatric disorders associated with it.

ADHD in Adults
When can ADHD in adults be diagnosed?

ADHD in adults can be diagnosed at any age. Most individuals seek help when their daily functioning declines enough to cause problems at work, school, social situations, or relationships. The presenting symptoms may be caused by ADHD, another condition, or a co-occurring disorder. A thorough evaluation by a specialist considers all potential co-existing disorders to achieve an accurate diagnosis or diagnoses. This is essential to choosing the right treatments, including the choice of medication that will benefit you the most.

If you have a significant other or spouse, it is helpful to have them at the initial psychiatric evaluation to provide feedback. You may not be fully aware of your symptoms or forgotten relative information from the past that could shed light on your history to help your provider in the assessment.

What are common emotions and behaviors of adults with ADHD?

.Adults suffering from ADHD experience a range of emotions and behaviors such as procrastination, low frustration tolerance, boredom, poor concentration, and forgetfulness. These symptoms may be the result of the difficulties adults face when dealing with ADHD. The severity of these symptoms often varies with the situation. Other potential symptoms of ADHD in adults include chronic lateness, poor organization skills, avoiding tasks or projects requiring sustained focus, mood swings, difficulty managing anger, relationship problems, and low self-esteem from dealing with a lifetime of disappointment and failures.

After a comprehensive evaluation, your provider may determine your symptoms are rooted in a disorder other than ADHD. The good news is that whatever your symptoms, your provider will help you gain relief from your symptoms and help you return to a productive and fulfilling life.

What causes ADHD in adults?

The exact cause of ADHD is unknown, but researchers believe it may be linked to an imbalance in neurotransmitters that affect the brain.

What treatment options are available for adults with ADHD?

Adult ADHD treatment may include medication, interpersonal therapy, behavioral therapy, and coaching. Stimulant medication is first line treatment for ADHD. Since ADHD in adults is most often co-occurring with one or more other disorders, like mood, anxiety, depression, or insomnia, your provider may recommend additional medication or a medical referral to rule out a medical cause of your symptoms. The decision to start any medication or treatment plan will be thoroughly discussed and agreed upon by you and your provider. 

Medications are not a cure for ADHD, but they may be able to help control ADHD symptoms. Medication may not be right for everyone with ADHD, but it can play a vital role in the total treatment plan along with coaching and other therapies.

Psychiatric Evaluations & Diagnosis

Do I need laboratory testing (aka "blood work")?
Your KEGE Center provider will order laboratory testing (blood work) at the start of treatment for a variety of purposes, including to rule out medical causes of psychiatric symptoms, to record baseline data before prescribing medications that may lead to lab abnormalities, and to screen for general medical problems. Depending on the medication prescribed, routine blood work may be needed to monitor drug levels, A1C, blood cell count, lipid levels, and kidney/liver/thyroid function. In otherwise healthy patients, annual blood work is adequate for monitoring.

All labs are ordered electronically through Sonora Quest or Labcorp. The cost is typically covered by most insurance plans.

Does my child need to attend the evaluation?

Yes. Your child must attend all scheduled appointments. If you want to meet with your provider without your child present, this can be done during the child’s appointment or an additional appointment can be made for a fee.

In the case of divorce, are both parents required to attend?

The child must attend their appointments with a legal guardian who has the capacity to make medical decisions for the child. This person is usually a parent. In the event that the parents are divorced or separated, at least one parent must attend the child’s appointments, but both are welcome and encouraged to attend.

PLEASE NOTE: It is imperative that both parents are “on the same page” and in agreement with the child’s planned treatment, including medication(s). Our providers are not in a position to mediate between parents or “sell” non-attending parents the value of treatment. We will coordinate with other members of your child’s treatment team, i.e. therapist, coach, pediatrician, etc., with the signing of a Release of Information form.

For your convenience, we offer video visit appointments with the opportunity for all interested parties to connect from wherever they are to take part in the child’s psychiatric visits.

Why can't I just go to my pediatrician or primary care doctor (PCP)?

Primary care doctors and pediatricians are quite often the first providers to hear concerns from patients about ADHD symptoms. These providers have very limited time to make a diagnosis and prescribe medication. When they do… Is it the right medication? The correct dose? Is it the right diagnosis? Were there any considerations for the likely co-occurring conditions associated with ADHD or were they only targeting inattention or hyperactivity?

You have to ask yourself, if PCPs make regular referrals to specialists, i.e. cardiologist, neurologists, surgeons, etc, when seeking a diagnosis or for cases requiring more focused care, why not refer for psychiatric care?

As you can read on this site, ADHD is complicated and so is its treatment. This is why KEGE Center was started. Our ADHD specialists have a full 2 hours to complete a comprehensive psychiatric evaluation to reach an accurate diagnosis of all disorders present, discuss medications and treatment options, and educate you and/or your child on what to expect going forward.

If I was diagnosed elsewhere, do I still need an evaluation?

Yes. All new clients to KEGE Center receive a thorough psychiatric evaluation by an ADHD specialist. We want to make sure the diagnosis is accurate and that no other conditions were missed. It is very helpful to your KEGE Center provider to see a copy of any previous progress notes and evaluations for a complete discussion of the current diagnoses and the plan forward.

Quite often we see patients who started treatment elsewhere and after months or years of medication trial and error, their symptoms continued, worsened and/or new symptoms emerged.

Our Specialists will take the time to get the diagnoses right at the evaluation.

Medications

How much do medications cost?

The cost of medications, both brand name and generics, varies greatly depending on insurance coverage and pharmacies. To avoid medication that is too expensive, discuss medication costs with your provider.

If cost is a concern or you will be paying out of pocket for your medication, a free prescription discount card, like GoodRx, can save you up to 80% off the retail price. Even for patients who have health insurance, GoodRx can still help you find prices that are lower than a typical co-pay.

How is ADHD medication taken?
Stimulant medication comes in immediate-release (IR), sustained-release (SR), or extended-release XR formulations. While immediate-release stimulants require dosing two to three times a day, extended-release stimulants can be taken once a day in the morning. Some patients find that a long-acting medication “wears off” early in the day and require an afternoon “booster” of an immediate-release medication.

Non-stimulant medications may be prescribed once daily or more often depending on the medication and the symptoms they are intended to treat.

For children who have difficulty swallowing pills, there are liquid medications, chewable pills, or capsules that can be opened and sprinkled on food or mixed with a liquid.

How long does ADHD medication take to work?

Parents can see beneficial results in their child within 30 to 60 minutes of taking a proper dose of stimulant medication and depending on the formulation. For children with impulsivity and hyperactivity, the results can be quite dramatic, but less obvious for children with the inattentive type.

Non-stimulant medications can take a couple of weeks before a therapeutic response is achieved. When ADHD medication is effective, the severity of many of the symptoms will lessen. Behavioral therapy may help with any lingering symptoms.

Can my child take a break from medication?

Some parents want their children to take a break from their stimulant medication on weekends, holidays, and school breaks. There used to be a belief that stimulant medication “stunts growth in children” and the breaks helped the children “catch up.” This is unfounded. ADHD does not take a break. Your child with ADHD has it 24/7, 365 days a year. So, the choice to hold the stimulant medication depends on the severity of the untreated symptoms. We have some parents that give medication every day because their child’s impulsivity and hyperactivity is so severe. Other parents take breaks from medication on weekends and school breaks because their child does not need it to concentrate (predominantly inattentive type).

For older children and teens, ADHD medication can help them outside of school to complete homework, participate in extracurricular activities, pay attention while driving, resist the impulse to engage in vaping, smoking, substance use, and risky behavior.

Taking breaks from non-stimulant medication is not as straight forward. These medications need to be taken daily due to their method of action. Missing doses may undermine their benefit and result in withdrawal effects.

Will my child's personality be changed on ADHD medication?

When prescribed properly, stimulants and other ADHD medications help most children to become better able to focus and concentrate and to reduce hyperactivity and impulsivity, but they do not change a child’s personality. Children may not always agree with observations from their parents or teachers about their behavior or their personality while on medication. The ability to report changes in their internal feelings tends to increase with development. Children in 2nd or 3rd grade may report no changes in how they feel even though they are much improved.

Teens and older children may notice that they can concentrate more in class and might be less bored or restless. However, adolescents also may perceive that medication makes them less appealing, lively, or friendly to their peers. Despite the noticeable positive effects of their medication, they may refuse to take it because they worry their peers will reject them.

With that said, if you, the parents, notice a personality change (such as a lack of emotional response) or if your child is continually irritable while taking medication, the dose of the medication may be too high for them. Please talk to your provider about your observations.

Therapy & Coaching

What is the difference between therapy and ADHD coaching?

Both therapy and ADHD coaching are great alternatives for someone looking to make a change in their lives. Therapy is typically better suited for someone with a diagnosed mental illness such as severe depression or anxiety, obsessive-compulsive disorder, etc. Therapists have different modalities they work from but therapy will generally be less directive than life coaching and more focused on feelings, gentle support, and exploration of past issues.

ADHD coaching tends to be a more directive approach where the coach helps the client define and achieve goals, develop a plan and structure for creating the desired results in their life, and holds the client to a high level of accountability to their goals. ADHD coaching is typically better suited for a client that is already functioning relatively well but would like some guidance or motivation to enhance specific areas of their life. Therapists use a blend of both of these depending on the needs and desires of our clients.

How do I find a therapist or coach?

KEGE Center partners with highly trained and effective therapists and coaches throughout the Phoenix Valley and Arizona. Please contact us for a referral in your area.

Video Visits

Do I need to sign up for an account or download software?

No, you don’t need to create an account or download any software to use our videoconferencing platform.

After scheduling your appointment, you will receive an email with a link to our secure platform. On the day of your appointment, you will check-in at your scheduled time and your provider will start the call when they are ready.

Is this secure?

All data is encrypted, patient sessions are anonymous (only we know who you are) and no patient info is stored persistently. We use the AES cipher with 128-bit keys to encrypt audio/video, and HMAC-SHA1 to verify data integrity.

What is the cost?

The cost for all appointments is the same for video or in-person visits.

How do I get rid of an echo?

The following steps should be done by you and your provider:

  • Use headphones
  • Reduce the volume of speakers
  • Move the microphone away from the speakers
How can I improve video quality?
  • Restart your computer: restart your computer before your first call.
  • Wifi: be close to your wifi router, make sure no other parties on the network are using up the bandwidth or streaming video (i.e. Netflix, YouTube, etc.), and you don’t have a lot of browser windows open.
  • CPU/GPU usage: ensure no high intensity programs are running on the computer.

Ready to book a psychiatric evaluation?