Fletcher & Associates Psychological Services, P.A.  provides expert confidential, goal-oriented counseling services to individuals, couples, families, children, and adolescents. Our practice includes therapy for people of all ages coping with symptoms of depression, anxiety, stress, or those wanting to feel better about themselves. We provide counseling for family therapy, marital issues and/or individual issues.

Dr. Fletcher is a Board Certified Diplomate Fellow in Psychopharmacology which allows her to consult with prescribing physicians about medication. Dr. Fletcher is not a prescribing physician. With your written permission, she can consult with and provide your current physician with a treatment update and your physician can prescribe the appropriate medication. For those in need of medication, she can also make a referral to select physicians with whom she has carefully established strong, professional relationships. These physicians are considered among the top in their field of medicine, and will work closely with our associates to ensure that mutual patients receive the best possible care. The treatment update and any referrals necessary are provided as part of your therapy at no additional cost.

It really isn't a matter of whether or not we take your insurance, but will your insurance provider reimburse you for our services? That depends on the decisions you made with your insurance provider when you first signed up for the policy and whether or not you have met your deductible. At your appointment we will collect full payment for our services and give you a receipt with all of the necessary information so you can file yourself.

When you are ready to schedule an appointment, contact our office at (972) 612-1188 and we will be happy to assist you.

We are happy to work with you to ensure that your child is absent from school as little as possible. Afternoon and early evening appointments are highly desirable, therefore they are quickly filled. We are typically able to accommodate this preference when an appointment is scheduled well in advance. When your child misses school due to an appointment in our office, we will provide you with a note specifying the date and time of the appointment; this note can be submitted to your child's school for an excused absence. When a child or adolescent is receiving assessments, it is important to know that all assessments are scheduled during weekdays between 9am and 2pm. Assessments for children and adults are not scheduled after school or work hours since it is important for evaluations to be conducted when someone is less likely to be fatigued.

We are happy to reschedule your appointment with at least 24 hours notice. If an appointment is cancelled within 24 hours of the scheduled session or a patient fails to show up for a previously scheduled appointment, they will be charged the full fee for the missed appointment. We have this policy as a courtesy to other patients waiting for appointments who might be able to get an appointment sooner when others give proper notice.

The term AD/HD is for Attention-Deficit Hyperactive Disorder. The term ADD, used to describe Attention-Deficit Disorder, is becoming obsolete. Instead, professionals are using the term AD/HD exclusively with further clarification based on the most predominant symptoms falling into three different categories: AD/HD Inattentive type; AD/HD Impulsive-Hyperactive type; and AD/HD Combined type. More and more when the term AD/HD is used, it doesn't necessarily mean the diagnosed person has hyperactivity.

The core symptoms of AD/HD are the same for all ages but the manner in which different age groups are assessed varies slightly. All age groups must meet the same criteria for the diagnosis. Our comprehensive assessments for all age groups include an extensive clinical interview, review of history, behavioral observation, behavior checklists (appropriate for each age group), and review of records. Each assessment also includes screening for depression, anxiety, and other emotional and behavioral difficulties. For AD/HD assessments for children and adults we also include the Quotient/ADHD™ System as part of the assessment. Further assessment of Learning Disabilities may also be necessary, but this is done as a separate assessment.

What makes our assessments different is, in addition to the customary ways AD/HD is assessed, we also use the Quotient/ADHD™ System, a cutting edge technology. We are currently the only private practice in North Texas providing this unbiased, objective assessment. Developed by physicians at Harvard, the Quotient/ADHD™ System is considered the missing link for the diagnosis of AD/HD and provides an objective and unbiased measurement of the symptoms of AD/HD. While the Quotient/ADHD™ System has been used for research purposes for over 10 years, it has only been available in doctors' offices for approximately five years.

Fletcher & Associates uses the same Quotient/ADHD™ System as Edward Hallowell, M.D. of Harvard Medical School, author of Driven to Distraction. More on the Quotient/ADHD™ System at www.biobdx.com.

We provide comprehensive, cost-effective assessments for children, adolescents, and adults. By gathering and reviewing extensive information for each assessment, we are able to accurately determine the presence of AD/HD symptoms as well as screen for the possibility that something other than AD/HD may be present. We provide not only the assessment, but also individualized recommendations and will review various options for treatment. Every assessment includes a detailed, written report and individualized recommendations.

We have found that sometimes a child diagnosed with AD/HD based on the results of the more traditional, subjective methods of evaluation does not actually have AD/HD, but is displaying some of the same symptoms as a result of other causes. The Quotient/ADHD™ System technology, combined with our comprehensive evaluation methods, will either confirm a previous AD/HD diagnosis or rule out the diagnosis of AD/HD and help determine a more accurate diagnosis and treatment plan. Once diagnosed, Quotient/ADHD™ can also help determine the effectiveness of medication a child is taking to treat AD/HD.

Whether we test on or off medication depends on your reason for the evaluation. If you wish to confirm the diagnosis and want a baseline of your performance using the Quotient/ADHD™ System, we recommend you schedule the test for early in the morning, then administer the medication immediately following the test.

If you wish to determine the effectiveness of the medication, we recommend you schedule the test for late morning and administer the medication approximately three hours prior to the appointment.

Most people prefer to have the test administered off medication so that they are able to see the results without the effect of the medication. Once the assessment is completed and we present the results, you may wish to discuss having a second test on medication in order to compare the results.

Materials are filled out in advance of the Initial Consultation:

Prior to the first appointment, our office will email directions and forms to be filled out in advance and brought to the initial appointment. For children, parents will need to complete forms we provide to the classroom teacher and for parents. This information is provided with instructions in the initial email. For adults being assessed, directions and forms will also be emailed in advance for the person being assessed to complete and bring to the initial appointment. Once the directions are received, if there are any questions prior to the initial appointment, please contact our office at info@FletcherPhD.com.

Initial Consultation:

For children up to age 18, the initial consultation provides an opportunity for parents and child to meet together with Dr. Fletcher to discuss the child's health and behavior history, as well as any concerns they may have. For adults, a similar interview is conducted to understand the history of the problem. At the end of the initial session, we will decide together if it is appropriate to proceed with the evaluation or explore other options.

Behavioral Evaluation and the Quotient/ADHD™ System:

Provided everyone agrees that it is appropriate to proceed with the evaluation, we can continue the evaluation using the Quotient/ADHD™ System. If the person being assessed IS NOT taking any medication previously prescribed for AD/HD at the time of the initial consultation, the test will most likely be administered immediately following the consultation. If the person being assessed IS taking medication prescribed for previously diagnosed AD/HD, we may determine that it would be appropriate to schedule the testing session to occur at a later date off medication, depending on the individual circumstances.

Results Consultation:

This results appointment, typically scheduled less than two weeks after the testing session, is for us to present the results and discuss potential treatment options for any diagnoses that may apply. The patient will receive a comprehensive, written report featuring the details of the assessment, any diagnoses that may apply, and appropriate recommendations for what should happen next. We ask that young children and teenagers not attend the final appointment when the results and recommendations are discussed. Adults being assessed may want to have their spouse attend the results appointment.

When a child comes to our office for any reason, we do what we can to make them comfortable. The assessment requires an initial consultation with you and your child which gives us the opportunity to decide what is needed in the assessment. Even though we are "testing," parents usually prepare their children for assessments without using the word "test." Instead, children tend to respond well when told they are coming to our office so that we can get to know them better and make recommendations that will help them be more successful at home and school.

Dr. Fletcher is a Board Certified Diplomate Fellow in Psychopharmacology which allows her to consult with prescribing physicians about medication. Dr. Fletcher is not a prescribing physician. With your written permission, she can consult with and provide your current physician with a copy of the assessment report and your current physician can prescribe the appropriate medication. At your request, you may also obtain a referral to a select physician with whom we have carefully established strong, professional relationships. These physicians are considered among the top in their field of medicine and will work closely with our associates to ensure that mutual patients receive the best possible care. The assessment report and any referrals necessary are provided as part of the evaluation at no additional cost.

The total fee for this comprehensive evaluation is $850 for children and adults. This fee includes the total cost for all appointments, all testing fees, and a comprehensive written report featuring the test results and detailed recommendations. We require payment in full at the beginning of the first appointment. We also provide additional consultation with physicians and teachers up to 30 days after the results appointment when appropriate at no additional fee.

Our objective is to provide peace of mind with respect to any diagnosis that may be made or eliminated. Our comprehensive assessment method takes into consideration multiple factors that must be evaluated as a whole in order to reach the most accurate diagnosis possible. In addition to gathering data from numerous sources (parents, teachers, child, test results), we perform extensive analysis of the data to reach a definitive conclusion, and provide the time necessary to discuss the results and recommended treatment in detail.

In addition, we are the only North Texas private practice provider currently offering assessments using the Quotient/ADHD™ System. Finally, we take time to get to know the person being assessed, and we review the results to make sure the results, the recommendations, and the suggested next steps are understood.

Initial consultations and evaluation sessions are always scheduled between 8:00 am and 1:00 pm. When you are ready to schedule an initial consultation, contact our office at (972) 612-1188 and we will be happy to assist you.

We have found that conducting the initial consultation and objective testing during the morning hours works best to achieve the most accurate results. The person being assessed should get a good night's sleep the night before, and arrive at our office well-fed and rested. If your child misses school as a result of an appointment in our office, we are happy to provide you with written confirmation of the appointment to be submitted to the school for an excused absence.

Dr. Fletcher is available for up to 30 days after you receive the assessment results to answer any follow-up questions or to consult with teachers. Brief follow-up provided within 30 days of receiving the assessment results will be provided at no additional charge. Requests for follow-up that is considered to be more extensive, or occur after the 30 day period, will be assessed an additional fee to be determined as necessary on a case-by-case basis.

We perform comprehensive assessments that help determine whether or not a Learning Disability is present in any of the academic areas identified by the Texas Education Agency. A Learning Disability is determined if a student's academic performance on standardized tests is well below his or her performance on an IQ test. All assessments are provided with a child's individual needs in mind so that only what is necessary for the assessment is given. This decision is based on the main concerns of parents and teachers and the child's most disruptive symptoms. A majority of children and adolescents are given the current WISC to determine their IQ and a current Woodcock-Johnson Achievement Test Battery to determine the standardized achievement scores. The two tests are compared to rule out the presence of a Learning Disability. This type of assessment can determine whether or not a Learning Disability is present in reading, written language, and/or math.

Assessing for a possible Learning Disability will require approximately three appointments. The first appointment consists of an initial consultation to determine the main concerns. Every child is different and it is important to get a thorough history of the problem; during this first appointment, which will typically last one hour, both you and your child will be interviewed about the history of the problem.

The second appointment may take place either immediately following the initial consultation or scheduled for another day. It is during the second appointment that the actual testing will be done. Testing for a Learning Disability takes approximately three hours to complete, including any necessary breaks. In order to achieve the most accurate results, it is best to complete all of the testing in one session rather than several separate, shorter sessions.

The third appointment, which the parents should attend without their child, is scheduled for approximately one week following the test session. A written report that includes all of the information discussed during this appointment will be provided. This includes specific recommendations for home and school.

If there is some concern about whether or not a Learning Disability may be the problem, we recommend that parents schedule an initial consultation to first discuss the concerns. During this initial consultation, any previous testing your child may have taken can be discussed, and copies of school work can be reviewed. At the end of this appointment, parents can discuss with Dr. Fletcher whether or not additional testing is really necessary.

Sometimes parents prefer to attend the initial consultation without their child in order to discuss their concerns privately in an open and honest manner. Our objective in this first appointment is to begin gathering information about your child's history and learn about your main concerns. It is up to you whether or not you want your child to attend this particular appointment; the second appointment, when the actual assessment is done, can be scheduled for another time.

The fee for this comprehensive evaluation is based on a charge of $200 per hour. Payment is required at the time of each appointment. A receipt will be given to you that will show what type of session occurred and how much you paid; you can use the receipt for insurance reimbursement.

Our objective is to provide parents with "peace of mind" with respect to any diagnosis that may be made or eliminated. Our comprehensive assessment method takes into consideration multiple factors that must be evaluated as a whole in order to reach the most accurate diagnosis possible.  We also screen for symptoms of depression, anxiety, social problems, Attention-Deficit/Hyperactivity Disorder (AD/HD), and other behavior and emotional difficulties.

In addition to gathering data from numerous sources (parents, teachers, child, test results), we perform extensive analysis of the data to reach a definitive conclusion, and provide the time necessary to discuss the results and recommended treatment in detail with parents. We will explain our findings to you in a manner that you can understand. You also will be given a comprehensive, written report that will include all the information about the results and recommendations. This report can be shared by you with your child's school so they know how to best help your child.

When a child comes to our office for any reason we do what we can to make them comfortable. The assessment requires an initial consultation with you and your child which gives us the opportunity to decide what is needed in the assessment. Even though we are "testing," parents usually prepare their children for assessments without using the word "test." Instead, children tend to respond well when told they are coming to our office so that we can get to know them better and make recommendations that will help them be more successful at home and school.

Initial consultations can be scheduled anytime. We suggest appointments for actual assessments with your child be done earlier in the day. When you are ready to schedule an initial consultation, contact our office at (972) 612-1188 and we will be happy to assist you.