Treatment Policies
These treatment policies have been generated through the years of my practice in both the public and private sectors of mental health and reflect what has been most effective in my helping those I work with. We can certainly discuss any of the treatment policies below and adjust them on an individual basis to reflect our unique relationship.
Contact
Text: the best way to get a response from me is to text 916-616-5531.
Fax: 888-965-0573
Phone Calls: 916-616-5531. This is not the best way to contact me, but I try to respond to phone calls within 24 hours.
Mail: John Thor Cornelius, MD.
PO Box 73736
Davis, CA, 95617
Emergencies: If there is ever an emergent psychological concern for yourself or others, you can leave a message with me but then you should immediately call 988 or the Sutter Center for Psychiatry at (916)386–3000. If there is a concern about your physical health call 911.
Refills: I recognize that medications are important, and so should you. To insure that you do not run out of medications, please check your medication supply regularly and prior to appointments so new prescriptions can be supplied at that time. Inform me of your need for refills at least 10 days prior to when they are due. The best way for you to contact me is by text at (916)616-5531. Please include all the details I need to fill the prescription in the text. Due to the volume of the tasks and other responsibilities I have, advance planning, patience and persistence will be required on your part to get refills outside of appointment times.
Scheduling Appointments
When you make an appointment with me you are reserving a space in my office and have agreed to pay my fee for that time. While I understand there are times when you may be unable to make a scheduled appointment time, missing the appointment is not an exemption from payment for that time. Except in the situation where you are medically incapacitated (i.e. hospitalized or bedridden with an infectious disease to the point you cannot use Zoom), missed appointments without notice or on short notice are charged the regular fee.
If an appointment time is changed within fourteen days of the appointment time, I will attempt to fill that time with another patient. If that time slot is not filled however, you will be charged the full fee for that session time. If you request extended or repeated absences, a specific arrangement will need to be made with me otherwise you will be expected to pay for the missed appointments. If you have specific or unique circumstances in this regard an agreement needs to me made in advance of missed appointments.
Please be aware that I must triage the needs of all my patients to provide an overall balance of care. Therapy patients I am regularly working with generally have a higher priority for appointment times than patients who work with me solely on an intermittent basis. However, in times of need, I reserve the right to reschedule appointment times.
Infectious Disease Protocol
I am fully vaccinated with boosters and regularly screen myself and engage in symptom monitoring of all infectious disease, including COVID-19. The office space has a HEPA Filtration system and I monitor the local infectious disease burden closely. Given these precautions I do see individuals in person, but frequently see individuals over Zoom as necessary. I expect you to contact me if you are unvaccinated, partially vaccinated, or are ever experiencing any physical symptoms of infection before coming to my office.
Payment
My regular hourly rate is $225 per 50 minute session.
I expect payment for sessions on a regular basis, which can be on an individual session, weekly or monthly basis. I prefer checks for payment if at all possible, but I also accept cash and credit cards. I can also be paid online through my HIPAA compliant, Therapy Notes Medical Portal where you can keep track of your running balance after setting up your account.
Paperwork
While I understand getting paperwork filled out is important, I prioritize other aspects of patient care over the immediate filling out of paperwork such as insurance forms, disability paperwork, letter completion, etc. Plan ahead and prepare to wait seven days for medication refill requests to be completed and up to three weeks for more involved paper work to be filled out. If you feel a need for paperwork to be filled out more quickly, we may use some of the appointment for the filling out of paperwork.
Confidentiality & Medical Records
Therapy is a vulnerable and intense experience that regularly contains deeply personal information. It is critical that there is a safe environment to discuss and explore anything that may come up. I take confidentiality extremely seriously. These are the situations where I will discuss identifying information with other people:
To provide the best care for those I work with, I do engage in a lifelong process of ongoing learning which includes consultation. This is a regular part of the mental health profession, a part of continuing medical education, and is in your best interests for you to receive the best possible care. Part of this process is the discussion of de-identified information, where individual identifying information is not discussed but some clinical information is explored for training purposes. An example of this may be when a group of professionals are discussing clinical treatments for trauma and someone describes a clinical situation where an individual they worked with had a specific kind of flashback during a session and asks for advice about how to be most effective in the care of that individual at that moment. Identifying information, such as the individual’s name, birthdate and address are not discussed and even information such as race, age, gender, familial situation, and medical or psychological history are only mentioned if that information is felt to be central to nature of issue being explored. All participants in these discussions are required by their professional licensure and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to maintain strict confidentiality.
Therapy records are a difficult and sensitive issue as they are inherently identifiable, regularly contain deeply personal information that I need to track to provide the best individual care, but are simultaneously rarely of specific value for medical or even psychiatric care or evaluations. The records are in shorthand and, due to the nature of psychoanalysis, cannot possibly be all inclusive of the material explored in any one session. I have encountered multiple situations where the release of records had severely negative consequences due to the type of information contained in the records, information that is generally misunderstood and misused by those without psychoanalytic training or without the full context of the individual history and treatment milieu. Given that I have seen the general release of records go wrong so many times, I do not release therapy notes except on direct order from a Judge. To provide necessary and helpful information in a contextualized way, after a discussion with an individual and a signed release, I can generate a focused treatment summary that should address any issue they want covered in a way that prioritizes confidentiality and maintains a safe therapeutic space.
Session Length
Sessions times are generally 50 minutes, and begin within the first 10 minutes of the hour.
Disability Evaluations
I do not conduct disability evaluations.
Insurance
I do not directly work with insurance companies and am not on any insurance panels. I am happy to talk to medical doctors or those trained in psychoanalysis regarding the justifications for the treatments (I discuss the scientific evidence supporting psychoanalysis in comparison to other treatments here). However, I do not have any office staff and simply don't have the time to engage in the lengthy bureaucratic processes with insurance companies. I do provide a super bill that should have the necessary information for reimbursement, but while many people have used it for successful reimbursement, I do not guarantee you will be reimbursed for services and strongly recommend you look into this prior to work with me. The insurance policy and agreements for reimbursement are between you and your insurance company. The responsibility for payment for my services are yours and independent of your insurance company and policy.
Medicare: I do not accept Medicare, nor am I a Medicare provider.
These treatment policies have been generated through the years of my practice in both the public and private sectors of mental health and reflect what has been most effective in my helping those I work with. We can certainly discuss any of the treatment policies below and adjust them on an individual basis to reflect our unique relationship.
Contact
Text: the best way to get a response from me is to text 916-616-5531.
Fax: 888-965-0573
Phone Calls: 916-616-5531. This is not the best way to contact me, but I try to respond to phone calls within 24 hours.
Mail: John Thor Cornelius, MD.
PO Box 73736
Davis, CA, 95617
Emergencies: If there is ever an emergent psychological concern for yourself or others, you can leave a message with me but then you should immediately call 988 or the Sutter Center for Psychiatry at (916)386–3000. If there is a concern about your physical health call 911.
Refills: I recognize that medications are important, and so should you. To insure that you do not run out of medications, please check your medication supply regularly and prior to appointments so new prescriptions can be supplied at that time. Inform me of your need for refills at least 10 days prior to when they are due. The best way for you to contact me is by text at (916)616-5531. Please include all the details I need to fill the prescription in the text. Due to the volume of the tasks and other responsibilities I have, advance planning, patience and persistence will be required on your part to get refills outside of appointment times.
Scheduling Appointments
When you make an appointment with me you are reserving a space in my office and have agreed to pay my fee for that time. While I understand there are times when you may be unable to make a scheduled appointment time, missing the appointment is not an exemption from payment for that time. Except in the situation where you are medically incapacitated (i.e. hospitalized or bedridden with an infectious disease to the point you cannot use Zoom), missed appointments without notice or on short notice are charged the regular fee.
If an appointment time is changed within fourteen days of the appointment time, I will attempt to fill that time with another patient. If that time slot is not filled however, you will be charged the full fee for that session time. If you request extended or repeated absences, a specific arrangement will need to be made with me otherwise you will be expected to pay for the missed appointments. If you have specific or unique circumstances in this regard an agreement needs to me made in advance of missed appointments.
Please be aware that I must triage the needs of all my patients to provide an overall balance of care. Therapy patients I am regularly working with generally have a higher priority for appointment times than patients who work with me solely on an intermittent basis. However, in times of need, I reserve the right to reschedule appointment times.
Infectious Disease Protocol
I am fully vaccinated with boosters and regularly screen myself and engage in symptom monitoring of all infectious disease, including COVID-19. The office space has a HEPA Filtration system and I monitor the local infectious disease burden closely. Given these precautions I do see individuals in person, but frequently see individuals over Zoom as necessary. I expect you to contact me if you are unvaccinated, partially vaccinated, or are ever experiencing any physical symptoms of infection before coming to my office.
Payment
My regular hourly rate is $225 per 50 minute session.
I expect payment for sessions on a regular basis, which can be on an individual session, weekly or monthly basis. I prefer checks for payment if at all possible, but I also accept cash and credit cards. I can also be paid online through my HIPAA compliant, Therapy Notes Medical Portal where you can keep track of your running balance after setting up your account.
Paperwork
While I understand getting paperwork filled out is important, I prioritize other aspects of patient care over the immediate filling out of paperwork such as insurance forms, disability paperwork, letter completion, etc. Plan ahead and prepare to wait seven days for medication refill requests to be completed and up to three weeks for more involved paper work to be filled out. If you feel a need for paperwork to be filled out more quickly, we may use some of the appointment for the filling out of paperwork.
Confidentiality & Medical Records
Therapy is a vulnerable and intense experience that regularly contains deeply personal information. It is critical that there is a safe environment to discuss and explore anything that may come up. I take confidentiality extremely seriously. These are the situations where I will discuss identifying information with other people:
- I will talk with other professionals or your family members at your request.
- I assess that the life of you or another person is at significant risk.
To provide the best care for those I work with, I do engage in a lifelong process of ongoing learning which includes consultation. This is a regular part of the mental health profession, a part of continuing medical education, and is in your best interests for you to receive the best possible care. Part of this process is the discussion of de-identified information, where individual identifying information is not discussed but some clinical information is explored for training purposes. An example of this may be when a group of professionals are discussing clinical treatments for trauma and someone describes a clinical situation where an individual they worked with had a specific kind of flashback during a session and asks for advice about how to be most effective in the care of that individual at that moment. Identifying information, such as the individual’s name, birthdate and address are not discussed and even information such as race, age, gender, familial situation, and medical or psychological history are only mentioned if that information is felt to be central to nature of issue being explored. All participants in these discussions are required by their professional licensure and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to maintain strict confidentiality.
Therapy records are a difficult and sensitive issue as they are inherently identifiable, regularly contain deeply personal information that I need to track to provide the best individual care, but are simultaneously rarely of specific value for medical or even psychiatric care or evaluations. The records are in shorthand and, due to the nature of psychoanalysis, cannot possibly be all inclusive of the material explored in any one session. I have encountered multiple situations where the release of records had severely negative consequences due to the type of information contained in the records, information that is generally misunderstood and misused by those without psychoanalytic training or without the full context of the individual history and treatment milieu. Given that I have seen the general release of records go wrong so many times, I do not release therapy notes except on direct order from a Judge. To provide necessary and helpful information in a contextualized way, after a discussion with an individual and a signed release, I can generate a focused treatment summary that should address any issue they want covered in a way that prioritizes confidentiality and maintains a safe therapeutic space.
Session Length
Sessions times are generally 50 minutes, and begin within the first 10 minutes of the hour.
Disability Evaluations
I do not conduct disability evaluations.
Insurance
I do not directly work with insurance companies and am not on any insurance panels. I am happy to talk to medical doctors or those trained in psychoanalysis regarding the justifications for the treatments (I discuss the scientific evidence supporting psychoanalysis in comparison to other treatments here). However, I do not have any office staff and simply don't have the time to engage in the lengthy bureaucratic processes with insurance companies. I do provide a super bill that should have the necessary information for reimbursement, but while many people have used it for successful reimbursement, I do not guarantee you will be reimbursed for services and strongly recommend you look into this prior to work with me. The insurance policy and agreements for reimbursement are between you and your insurance company. The responsibility for payment for my services are yours and independent of your insurance company and policy.
Medicare: I do not accept Medicare, nor am I a Medicare provider.
Upcoming Times I Will Be Out of the Office:
Time Away Summer 2024
Memorial Day Monday May 27th
Week of June 15th to the 23rd
July 4th and 5th
July 20th through August 4th (2 weeks)
Time Away Summer 2024
Memorial Day Monday May 27th
Week of June 15th to the 23rd
July 4th and 5th
July 20th through August 4th (2 weeks)
What I Do
I am a medical doctor with specialized training in the field of psychiatry and psychoanalysis who has dedicated my life to try and help those who experience chronic psychological suffering and dissatisfaction in their lives. This can be expressed in multiple ways including, but not limited to, problems with severe moods or mood fluctuations, dealing with the repercussions of traumatic events, dissatisfaction in relationships, problematic ways of relating to others, distressing or dysfunction ways of thinking or a long-term process of distressing but seemingly inescapable thoughts. Individuals sometimes have carried diagnoses such as depression, bipolar disorder, post-traumatic stress disorder, anxiety disorders, personality disorders, schizoaffective disorder, schizophrenia, addiction or attention deficit disorder.
Our work begins with a period of consultation. My initial consultation is usually two hours long to provide the time necessary to begin to discover the root causes of your symptoms. After the initial consultation, we discuss different ideas of how we will work together, which may include medications, psychoanalysis or a host of other possible treatments. I will refer to other specialists (cognitive and behavioral therapists, endocrinologists, primary care physicians, family therapists, etc.) as required for your care. You are an active participant in this process and it is only through mutual agreement that treatment occurs.
If we agree to work together we will generally meet on a regular basis. Our meetings will include discussing medications, but much of the time will be spent exploring the ways you are with your thoughts and feelings. This means creating and maintaining an environment where we can examine and occasionally challenge the way you are with yourself and others. You need to be willing to meet frequently for this treatment to accomplish its goals.
While I do prescribe medications, be aware I am very sparing in their use. I do this after a reading of the medical literature that generally shows the benefits of these medications are far less than what is promoted by pharmaceutical companies, and come with far more complicated side effects than previously believed. Do not come to see if me if you simply want regular and rapid adjustments to your medication regimens. That is not how I work.
Individuals who come to see me are generally experiencing extreme psychic distress. The distress if often multifactorial and longstanding. Please do not expect longstanding distress to immediately disappear upon meeting with me, it is not how this process works. Instead, expect us to begin a process of deep exploration and discovery. The fact that the process of uncovering psychic material often means uncovering emotionally painful aspects of one’s life is an unfortunate but necessary aspect of our work. The work is intensive, regular, ongoing and evokes a large array of thoughts and feelings. There will be periods of intense feelings or the emergence of troubling forms of thought which may include dreams and nightmares, disturbing bodily experiences or even periods of confusion and disorientation. In addition, people have layers and aspects of themselves that may only be visible at certain times, in certain situations, or after certain milestones in our work have been achieved.
I also believe that the unique relationship that develops between the patient and myself plays an important role in finding a path that leads to lasting change. There are many ways this is important, but a key ingredient to any therapeutic relationship is not simply how you are, or how I am, but how we are together. This dynamic relationship is fundamental to any process of psychic change.
This kind of work is also exploratory. I will not generally ‘tell you what to do’ or have a rigid ‘treatment plan’ that predicts what will happen. We will explore what emerges in our relationship and time together. People may be surprised in that we will pay explicit attention to the nuanced patterns of thinking and imagination, such as spontaneous thoughts and behaviors, bodily phenomenon, dream material or aspects of creativity such as artistic endeavors or writings. We will explore areas where you may be excited, wishful or ashamed. Also, while I am generally more active than most psychoanalysts, many people may experience me as quiet during many sessions and it takes time to realize the deep value of contemplative reflection.
I believe that while there are aspects of a person’s distress that cannot be changed (such as a person’s history, or the fact that they have a genetic disposition towards depression), I also believe that ‘symptoms’ (such as sadness) are usually not ‘random’, ‘organic’ or ‘chemical’ in nature, but instead linked to a variety of stimuli related to a person’s current experience, current way of thinking and ways of relating to others. While we cannot change a person’s genetics or history, by spending focused time with a person’s current thought processes, change can be made in how people experience themselves and have relationships to others. This is true down to fundamental aspects of thinking itself.
I believe that deep and lasting psychic change is similar to other substantial changes a person tries to accomplish in their life. The process is slow and generally develops over long periods of time through sustained attention and work. It is also similar as there will be forces at work that will naturally resist such changes that will both need to be addressed and overcome.
Most of my sessions are 50 minutes in length. We will start within the first ten minutes of the hour or half hour and continue for 50 minutes.
For those who are aware of the different forms of psychoanalytic treatment, I identify myself with the work of Donald Winnicott, Wilfred Bion and the Intersubjectivists.
See 'What is Psychoanalysis' for more.
I am a medical doctor with specialized training in the field of psychiatry and psychoanalysis who has dedicated my life to try and help those who experience chronic psychological suffering and dissatisfaction in their lives. This can be expressed in multiple ways including, but not limited to, problems with severe moods or mood fluctuations, dealing with the repercussions of traumatic events, dissatisfaction in relationships, problematic ways of relating to others, distressing or dysfunction ways of thinking or a long-term process of distressing but seemingly inescapable thoughts. Individuals sometimes have carried diagnoses such as depression, bipolar disorder, post-traumatic stress disorder, anxiety disorders, personality disorders, schizoaffective disorder, schizophrenia, addiction or attention deficit disorder.
Our work begins with a period of consultation. My initial consultation is usually two hours long to provide the time necessary to begin to discover the root causes of your symptoms. After the initial consultation, we discuss different ideas of how we will work together, which may include medications, psychoanalysis or a host of other possible treatments. I will refer to other specialists (cognitive and behavioral therapists, endocrinologists, primary care physicians, family therapists, etc.) as required for your care. You are an active participant in this process and it is only through mutual agreement that treatment occurs.
If we agree to work together we will generally meet on a regular basis. Our meetings will include discussing medications, but much of the time will be spent exploring the ways you are with your thoughts and feelings. This means creating and maintaining an environment where we can examine and occasionally challenge the way you are with yourself and others. You need to be willing to meet frequently for this treatment to accomplish its goals.
While I do prescribe medications, be aware I am very sparing in their use. I do this after a reading of the medical literature that generally shows the benefits of these medications are far less than what is promoted by pharmaceutical companies, and come with far more complicated side effects than previously believed. Do not come to see if me if you simply want regular and rapid adjustments to your medication regimens. That is not how I work.
Individuals who come to see me are generally experiencing extreme psychic distress. The distress if often multifactorial and longstanding. Please do not expect longstanding distress to immediately disappear upon meeting with me, it is not how this process works. Instead, expect us to begin a process of deep exploration and discovery. The fact that the process of uncovering psychic material often means uncovering emotionally painful aspects of one’s life is an unfortunate but necessary aspect of our work. The work is intensive, regular, ongoing and evokes a large array of thoughts and feelings. There will be periods of intense feelings or the emergence of troubling forms of thought which may include dreams and nightmares, disturbing bodily experiences or even periods of confusion and disorientation. In addition, people have layers and aspects of themselves that may only be visible at certain times, in certain situations, or after certain milestones in our work have been achieved.
I also believe that the unique relationship that develops between the patient and myself plays an important role in finding a path that leads to lasting change. There are many ways this is important, but a key ingredient to any therapeutic relationship is not simply how you are, or how I am, but how we are together. This dynamic relationship is fundamental to any process of psychic change.
This kind of work is also exploratory. I will not generally ‘tell you what to do’ or have a rigid ‘treatment plan’ that predicts what will happen. We will explore what emerges in our relationship and time together. People may be surprised in that we will pay explicit attention to the nuanced patterns of thinking and imagination, such as spontaneous thoughts and behaviors, bodily phenomenon, dream material or aspects of creativity such as artistic endeavors or writings. We will explore areas where you may be excited, wishful or ashamed. Also, while I am generally more active than most psychoanalysts, many people may experience me as quiet during many sessions and it takes time to realize the deep value of contemplative reflection.
I believe that while there are aspects of a person’s distress that cannot be changed (such as a person’s history, or the fact that they have a genetic disposition towards depression), I also believe that ‘symptoms’ (such as sadness) are usually not ‘random’, ‘organic’ or ‘chemical’ in nature, but instead linked to a variety of stimuli related to a person’s current experience, current way of thinking and ways of relating to others. While we cannot change a person’s genetics or history, by spending focused time with a person’s current thought processes, change can be made in how people experience themselves and have relationships to others. This is true down to fundamental aspects of thinking itself.
I believe that deep and lasting psychic change is similar to other substantial changes a person tries to accomplish in their life. The process is slow and generally develops over long periods of time through sustained attention and work. It is also similar as there will be forces at work that will naturally resist such changes that will both need to be addressed and overcome.
Most of my sessions are 50 minutes in length. We will start within the first ten minutes of the hour or half hour and continue for 50 minutes.
For those who are aware of the different forms of psychoanalytic treatment, I identify myself with the work of Donald Winnicott, Wilfred Bion and the Intersubjectivists.
See 'What is Psychoanalysis' for more.
What I Do Not Do
I no longer begin treatment with patients solely for the aim of managing their medications. I recommend those patients seek care from other providers who specialize in medication management.
I do not prescribe marijuana or pain medications to any of my patients for any reason.
I do not prescribe medications for medical or psychic conditions that are outside my scope as your psychoanalyst for any reason.
If addictions are part of what you struggle with, you must be willing to address this in treatment and consider engagment in 30 day treatments or other substance abuse programs such as Alcoholics Anonymous. If you are unwilling to engage in these treatments and do the hard work of facing your addictions, our work together will likely be unsuccessful.
I no longer begin treatment with patients solely for the aim of managing their medications. I recommend those patients seek care from other providers who specialize in medication management.
I do not prescribe marijuana or pain medications to any of my patients for any reason.
I do not prescribe medications for medical or psychic conditions that are outside my scope as your psychoanalyst for any reason.
If addictions are part of what you struggle with, you must be willing to address this in treatment and consider engagment in 30 day treatments or other substance abuse programs such as Alcoholics Anonymous. If you are unwilling to engage in these treatments and do the hard work of facing your addictions, our work together will likely be unsuccessful.