Adult therapy screener

Welcome to OCD Spectrum! We understand that taking the first step to seek therapy can be incredibly challenging. Many people end up waiting years before making this call. We want to acknowledge your bravery in reaching out. Maybe this wasn't easy to do but you've taken an important step toward reclaiming your life from OCD and anxiety. Now, together, let's get to work on living the life that YOU want to live.

Let's do this.
Note: This screener is intended for adults age 18 and over and for those seeking individual or group therapy services. If you are under the age of 18, the parent of a child seeking treatment, or if you are looking for an appointment with the psychiatrist (Dr. Riley), please call us directly for an appointment.
At OCD Spectrum, we are dedicated to providing excellent clinical care. Please note that while we do not participate with insurance plans, we understand the importance of financial considerations in healthcare. To assist you in maximizing your benefits, we offer super bills upon request. These documents comprehensively outline the services rendered, which will allow you to seek out-of-network (OON) benefits from your insurance provider. It's important to mention that currently, Dr. Flower is the only provider who participates in insurance and is exclusively affiliated with UPMC. We appreciate your understanding and look forward to working with you towards a brighter, healthier future.*

I understand that OCD Spectrum does not accept insurance but will provide a super bill upon request to help with OON benefits
We strongly believe that the most crucial aspect of a successful and beneficial therapy experience is the compatibility between the patient and the therapist. This encompasses both a therapeutic rapport and the therapist's competency in addressing the issue. If, upon reviewing the screener, during the intake session, or at any subsequent point, we find that the fit is not optimal for any reason, we may suggest a referral to another provider.*

I understand that completing this form does not guarantee that I will be seen at OCD Spectrum
If you would rather skip this brief screener, please feel free to pick up the phone and talk directly to our dedicated Office Manager, Michelle Camper, at 412-444-8776 ext. 506. She is available Monday to Friday from 8am to 4pm.
Name

First NameLast Name
DOB

MonthDayYear
Date
Please let us know how you identify yourself
Email
example@example.com
Phone Number
Please enter a valid phone number.
1. How did you find us?

Google searchReferral from my doctor or other health professionalRecommended by my schoolDirectory like Psychology TodaySocial mediaOther
2. The therapists at OCD Spectrum specialize in OCD and the spectrum of similar disorders. Which of these issues do you identify as your primary concern?

OCDGeneral anxietyPanic attacksBody focused repetitive behaviorsSchool refusalPhobiaNeedle or medical phobiaHealth related anxietyIntrusive thoughtsSocial anxietyOther
3. In addition to anxiety-related concerns, there are other common areas that may co-occur or exist independently. While we may be able to provide some support in these areas, it's crucial for us to be informed of their presence. In certain cases, we might request further details or recommend consultation with specialized professionals either before or during the course of treatment. Kindly indicate below if you have experience with any of the following, and if so, whether they have been present within the last three months:

Previous suicidal behaviorsIf yes, did they occur within the last 3 months?Non-suicidal self-injury (e.g., cutting, at any point)If yes, did they occur within the last 3 months?History of substance abuse or dependenceIf yes, did they occur within the last 3 months?Aggressive tendencies (physical or sexual, at any point)If yes, did they occur within the last 3 months?Manic or Hypomanic episodes (at any point)If yes, did they occur within the last 3 months?Anorexia and/or disordered eatingIf yes, has this been a problem for you within the last 3 months?
4. In addition to what you have indicated above, is helpful for us to hear a brief description of why you are seeking treatment at this time. In your own words, please write a little about why you would like to talk with us. This will help us to see if we are a good fit for what you are seeking.
5. Please indicate your preference for therapy sessions. Your preference will help us plan and schedule your sessions in a way that best suits your comfort and convenience.

In-office sessions (face-to-face)Virtual sessions (via video call)No preference, open to either option
6. Are you interested in group or individual therapy? Group therapy is very effective and can allow you to connect with other people going through similar issues. It can also get you into treatment sooner than individual therapy in times when there is high demand. With this in mind, which type of therapy are you currently leaning towards?

IndividualGroupBothI'm not sure
7. Please let us know if you have a preference regarding the gender identity of your therapist. We strive to accommodate your preferences to ensure you feel comfortable and supported during your treatment. If you don't have a preference, please feel free to let us know as well.

No preferenceMaleFemaleNon-binaryPrefer not to say
8. You're almost done! After completing this form, we'll be in touch to set up a potential intake session. How would you prefer to be contacted?

Phone callEmailNo preference. Any method is fine.
9. If you do prefer to receive a phone call, please let us know which hour-block of time would be best to give you a call. Rest assured, the call will be brief, and likely take less than 15 minutes. Our office manager will make every effort to reach you within the timeframe you choose.
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