What is addiction psychiatry?
Addiction psychiatry is an ABPN-recognized subspecialty of psychiatry requiring an accredited one-year fellowship after general psychiatry residency. It addresses the diagnosis and treatment of substance use disorders and co-occurring psychiatric conditions:
- Distinct training: Addiction psychiatrists complete additional supervised training in pharmacology of addictive substances, withdrawal management, MAT prescribing, motivational interviewing, and integrated care models.
- Distinct scope: General psychiatrists may not be trained to prescribe buprenorphine, manage acute withdrawal, or differentiate substance-induced from primary psychiatric disorders.
- Distinct standard for SUD populations: ASAM and APA practice guidelines recommend addiction psychiatry or addiction medicine specialists for patients with moderate-to-severe substance use disorders and co-occurring psychiatric conditions.
At Ascend, the prescribing physician is Dr. Bishop, DO, who is board-certified in family medicine and addiction medicine. Addiction medicine and addiction psychiatry have overlapping competencies — both subspecialties carry recognized board certification and meet the standard for dual diagnosis prescribing.
Who provides psychiatric services at Ascend?
Psychiatric services at Ascend are directed by a board-certified physician and supported by a licensed clinical team:
- Dr. Bishop, DO: Board-certified in family medicine and addiction medicine. Directs psychiatric and MAT prescribing across PHP, IOP, and outpatient maintenance.
- Licensed master's-level therapists: Provide CBT, DBT, EMDR, and trauma-focused therapy under the coordinated treatment plan.
- Registered nurses and behavioral health technicians: Conduct medication administration, vital sign monitoring, and side-effect surveillance.
- Case managers: Coordinate appointments, lab work, prior authorizations, and continuity-of-care handoffs with outpatient psychiatrists.
Every patient is assigned a clinical team that meets weekly to review progress against treatment goals. Psychiatric findings, medication changes, and therapy progress are documented in a single integrated medical record so that decisions in one domain inform decisions in the other.
Questions About Who provides psychiatric services?
Call our 24/7 admissions line or verify your insurance online.
How does psychiatric evaluation work in PHP and IOP?
Psychiatric evaluation at Ascend follows ASAM and APA documentation standards and is structured across the treatment episode:
- Admission evaluation: A 60-to-90-minute clinical interview covering psychiatric history, DSM-5 diagnostic assessment, substance use history, medical comorbidities, suicide risk, and current medications. Baseline labs and EKG when clinically indicated.
- PHP follow-up: Weekly psychiatric appointments during partial hospitalization. Symptoms tracked with validated rating scales — PHQ-9 for depression, GAD-7 for anxiety, PCL-5 for PTSD, MDQ for bipolar screening.
- IOP follow-up: Biweekly psychiatric appointments during intensive outpatient. Medication titration, side-effect management, and lab monitoring continue. Telehealth appointments are available when clinically appropriate.
- Discharge planning: Coordination with outpatient psychiatrist or primary care prescriber, written medication plan, prior authorization assistance, and 30-day prescription bridge.
The frequency of psychiatric contact is calibrated to symptom acuity and medication adjustments — patients newly started on lithium, lamotrigine, or buprenorphine receive closer surveillance than patients stable on long-term maintenance therapy.
“A general psychiatrist may treat your depression. An addiction-trained psychiatrist treats your depression while also recognizing the alcohol use driving it, prescribing MAT alongside the antidepressant, and coordinating care with the therapist in the same building. That integration is the standard for dual diagnosis.”
What conditions does the psychiatric team treat?
Ascend's psychiatric team diagnoses and treats the DSM-5 conditions most commonly co-occurring with substance use disorders. SAMHSA's 2022 NSDUH reports 21.5 million U.S. adults have co-occurring SUD and mental illness:
- Mood disorders: Major depressive disorder, persistent depressive disorder, bipolar I and II disorder, cyclothymic disorder.
- Anxiety disorders: Generalized anxiety disorder, panic disorder, social anxiety disorder, agoraphobia, specific phobias.
- Trauma and stressor-related disorders: PTSD, complex PTSD, acute stress disorder, adjustment disorders.
- Neurodevelopmental disorders: Adult ADHD, with non-stimulant pharmacotherapy prioritized in SUD populations.
- Substance-induced disorders: Substance-induced depressive, anxiety, and psychotic disorders that resolve with sustained abstinence and pharmacological support.
- Personality disorders: Borderline, antisocial, and avoidant personality disorders, addressed primarily through DBT and integrated psychotherapy rather than psychotropic medication.
Psychotic disorders requiring acute inpatient stabilization are referred to higher levels of care. Ascend admits patients once they are medically stable and able to engage in PHP or IOP programming.