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Information for Referring Providers

This page is for licensed healthcare and mental health providers seeking referral collaboration.

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I work with adults whose trauma-related symptoms persist despite standard interventions—particularly when nervous system dysregulation, dissociation, shutdown, or early shock responses are present.

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Referrals commonly come from:

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* Psychiatrists

* Psychiatric Nurse Practitioners (PMHNP / CNP)

* Primary Care Providers (PCP)

* Therapists and other mental health specialists

Clinical Focus

I primarily work with adults presenting with:

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  • Complex or developmental trauma

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  • Dissociation, shutdown, or collapse responses

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  • Nervous-system-driven anxiety or panic

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  • Somatic symptoms with limited response to medication alone

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  • High-functioning clients with internal fragmentation

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My role is psychotherapy-focused and trauma-specialized, not medication management.

How This Work Often Complements Medical Care

Many referrals occur when clients:

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  • Continue to experience trauma symptoms despite medication trials

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  • Have difficulty tolerating standard trauma therapies

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  • Show strong insight but persistent physiological reactivity

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  • Experience shutdown, dissociation, or autonomic instability

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This work is often adjunctive to psychiatric or medical care, not a replacement for it.

Treatment Approach (Brief Overview)

My clinical stance emphasizes:

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  • Nervous-system-led pacing

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  • Careful stabilization before depth processing

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  • Attention to orienting, shock, and defensive responses

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  • Integration over symptom chasing

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Modalities may include:

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  • Deep Brain Reorienting (DBR)

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  • Ego State Therapy

  • Nervous system regulation work

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  • Brainspotting-informed trauma processing

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Approaches are integrated based on client readiness and tolerance.

Coordination & Communication

With a valid release of information, I’m open to:

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  • Brief coordination of care

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  • General treatment focus and pacing updates

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  • Risk-related or safety-relevant communication

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I typically avoid sharing detailed trauma content unless clinically necessary.
The goal is clear role boundaries and supportive coordination.

Practice Information

  • Private-pay psychotherapy practice

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  • Adults only

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  • Superbills available for out-of-network reimbursement

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  • No prescribing or medication management

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  • Located in Tucson, Arizona

When to Refer / When Not to Refer

When to Refer

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Referral may be appropriate when an adult patient or client:

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  • Continues to experience trauma-related symptoms despite adequate trials of standard psychotherapy and/or medication

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  • Shows dissociation, shutdown, collapse, or autonomic instability during trauma processing

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  • Presents with strong insight but persistent somatic or nervous-system-driven symptoms

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  • Has a history of developmental, attachment, or early relational trauma

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  • Becomes overwhelmed or destabilized in exposure-based or directive trauma approaches

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  • Is medically and psychiatrically stable enough for outpatient, depth-oriented psychotherapy

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This work is often adjunctive to psychiatric or medical care and can complement ongoing medication management or primary care treatment.

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When Not to Refer

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Referral may not be appropriate when an individual:

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  • Requires inpatient, residential, or intensive outpatient level of care

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  • Is experiencing acute psychosis, mania, or unmanaged substance dependence

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  • Is seeking medication management only

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  • Requires court-mandated treatment or forensic evaluation

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  • Is unable to maintain basic safety between sessions

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  • If you’re unsure about fit, a brief consult is often the best next step.

Make a Referral or Consult on Fit

Submit Secure Referral 

Download PDF

Send to:

nandotherapy@proton.me

(Hosted on Proton Mail)

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