Bryan Morales, MD

Dr. Ariela Karasov completed her psychiatry residency at Stanford, serving as Chief Resident in her final year, and pursued a fellowship in Neuropsychiatry at Stanford Hospital. She is board certified in Behavioral Neurology and Neuropsychiatry and has worked as a National Expert in bipolar disorder at the VA. She has experience treating Generalized Anxiety Disorder, Obsessive-Compulsive Disorder, Bipolar Disorder, PTSD, and Depression, as well as patients with comorbid neurologic and mental health conditions. Dr. Karasov has also taught residents as adjunct clinical faculty at the University of Wisconsin Hospital and Clinics.

Dr. Karasov takes a collaborative approach, actively engaging patients in treatment planning and decision-making. She incorporates therapy into her practice, emphasizing each individual’s values and what gives their life meaning and purpose. Patients can expect a thoughtful, empathetic, and patient-centered environment where their goals and experiences are prioritized.

She values a thorough evaluation to understand how medical, psychological, and social factors contribute to a patient’s presentation. When appropriate, she invites family members or friends to provide collateral information to ensure a complete understanding, guiding a tailored and effective treatment plan.

Dr. Jen Wygant is a board-certified psychiatrist who specializes in adult psychiatry. She completed her residency training in general adult psychiatry at the University of Michigan and received her medical degree from Rocky Vista University College of Osteopathic Medicine. However, she took a non-traditional path to medical school. She earned her undergraduate degree in nursing at Northern Michigan University where she also did Army ROTC and competed on their cross-country ski team. After graduation, she went on to work as a nurse in the Army and compete on the US National Biathlon Team.

During her training, Dr. Wygant gained extensive experience treating a wide range of diagnoses with particular emphasis on PTSD, anxiety and depression in diverse populations, including college students, LGBTQIA+ individuals, perinatal individuals, Veterans and those with socioeconomic disadvantages.

Through her work as an Army nurse, lifestyle as an elite level athlete, and training as an Osteopathic physician she has developed a holistic and compassionate approach to providing care as well as an understanding of challenges unique to athletes and Service members. She integrates multiple types of therapy into her medication management appointments and collaborates with patients to form an individualized and empowering care plan that aligns with their goals and priorities.  

Dr. Wygant looks forward to working with you!

Dr. Pipalia is board-certified in both adult psychiatry and internal medicine. Since graduation from residency, he gained specialized experience in treating veterans with terminal illness, specifically Amyotrophic Lateral Sclerosis (aka Lou Gehrig's Disease), at the VA Medical Center in Portland, OR. He combines both psychotherapy and medication treatment to provide holistic care that addresses not only your mental health but also the parts of your life that surround and are deeply intertwined with your mental health. When more intensive psychotherapy is warranted, he collaborates with an experienced psychotherapist to serve you better. With his experience of internal medicine, he is also comfortable with navigating complex medical issues that may interact with your mental health. Dr. Pipalia is a graduate of St. George's University School of Medicine. He completed a combined Psychiatry & Internal Medicine residency training program at East Carolina University. He went on to complete a fellowship in Clinical Informatics at Oregon Health & Science University, learning how to use modern digital technologies and patient data to improve patient care. His academic activities include a presentation he has given multiple times on Illness Identity, teaching other clinicians how having an illness can change how we perceive our place in the world and how to help patients manage their relationship with illness.

Dr. Matthew Richter has experience practicing in outpatient and inpatient settings, as well as with military and confinement populations. He earned his medical degree from the Uniformed Services University of the Health Sciences and completed a psychiatry residency at Walter Reed National Military Medical Center, followed by a forensic psychiatry fellowship at the National Capital Consortium.

Dr. Richter fosters a safe, non-judgmental space where patients can explore their feelings and experiences freely, met with unconditional positive regard. He prioritizes active listening and deep empathy, ensuring each patient feels heard, understood, and valued as a unique individual throughout their treatment journey.

Initial sessions focus on a collaborative exploration of a patient’s history, current challenges, and core values, forming the foundation for a personalized treatment plan. Dr. Richter emphasizes shared decision-making, integrating therapeutic modalities—including medication when appropriate—while honoring patient autonomy and aligning with their vision for well-being.

Dr. Routhier was born in Quebec, Canada. She attended medical school at Ross University School of Medicine and graduated in three years with high honors. She trained as a psychiatry resident at Case Western Reserve School of Medicine in Cleveland, OH where she served as a junior attending and the medical student coordinator. She then was recruited by Monterey County Behavioral Health, CA as a clinical psychiatrist where she provided medication management and psychotherapy services to over 400 patients over the course of five years. She also created and led two dialectical behavior therapy groups for teens and young adults while training therapists and social workers to become group facilitators.

Dr. Routhier firmly believes in the mind-body connection. She feels that when the mind suffers, the body hurts as well and vice versa. As a result, she has developed a holistic approach to psychiatry and is comfortable offering a wide array of treatment modalities such as breathwork, dialectical behavior therapy, guided meditation, supportive psychotherapy, behavioral activation and medication management. She maintains that autonomy and a thorough understanding of one’s diagnosis and prognosis are critical for progress and healing. Her broad range of worldly experiences gives her the ability to work in a non judgemental, open-minded and authentic fashion. She connects with clients with ease and is passionate about self-awareness, constant evolution and empowering people so they can find their own way to happiness and health. She pushes her clients to find ways to build a life worth living, way beyond the goal of symptom resolution typical to psychiatry.

1. Getting to know you/understanding your “why”. Why are you seeking mental health treatment and why now? 2. Establish a list of issues and improvement zones. 3. Creating therapeutic goals. What do you want to work on? 4. Choosing treatment modalities to directly address these goals within a specific time frame. I provide updated and evidence-based information, and YOU choose what we do. 5. Figuring out the root causes to problems, symptoms and maladaptive behaviors/habits. How did this all start? Where does it come from? 6. Regular check-ins on how the treatment plan and therapeutic relationship are working for you. Are we a good fit? Are we meeting your goals/expectations? If not, back to the drawing board!

Dr. Sabish Balan is a Board-Certified Psychiatrist with subspecialty certifications in Geriatric Psychiatry, Psychosomatic Medicine, and Addiction Medicine. He completed his medical education in India at Government Medical College, Kozhikode, followed by psychiatry training at the All India Institute of Medical Sciences (AIIMS), New Delhi. After relocating to the United States, he pursued residency at St. Luke’s Roosevelt Hospital Center and advanced fellowships at The Zucker Hillside Hospital and St. Luke’s Roosevelt Hospital Center. With over 17 years of psychiatry experience in the U.S., he has held leadership roles at NYC Health + Hospitals – Harlem and currently provides care at Northwell Health Phelps Hospital Addiction Treatment Services and the BeHealth Program. Fluent in English, Hindi, Urdu, and Malayalam, Dr. Balan brings a global perspective to patient care.

Dr. Balan strives to meet patients where they are, offering a warm and supportive environment that values the whole person. He integrates a bio-psycho-social approach to care, ensuring that patients feel heard, respected, and understood throughout their treatment journey.

In initial sessions, Dr. Balan takes a detailed history to understand each patient’s concerns, background, and goals. From there, he collaborates with patients to develop individualized treatment plans that align with their personal values and objectives, fostering partnership and long-term wellness.