Gira Borad, MD

Sebrina Cotton is a passionate advocate for mental health and holistic well-being. With over 7 years of experience in the mental health field, she has worked with diverse populations seeking support in managing various challenges, including depression, anxiety, trauma, relationship/marital issues, grief/loss, and life transitions. Sebrina's approach is person-centered and collaborative. She will hold you accountable to the goals you want to accomplish through a combination of empathy, active listening, and skillful interventions. Sebrina welcomes you to a warm and safe space to bring all of who you are to each session. She will walk alongside you through your therapy journey towards a more fulfilling and meaningful life. In her time outside of sessions, Sebrina enjoys working out at the gym, teaching/practicing yoga, and traveling.

Dr. Robert Smeed, DO, is a board-certified psychiatrist with a passion for healing the human mind and consciousness. He earned his Doctor of Osteopathic Medicine from Lake Erie College of Osteopathic Medicine and completed his Psychiatry Residency at Wayne State University College of Medicine. Certified by the American Board of Psychiatry and Neurology (ABPN), Dr. Smeed served as an outpatient psychiatrist at Veterans Affairs for 11 years, honing his expertise in mental health care. Driven by a deep interest in consciousness and innovative treatments, he combines talking therapies, neuromodulation, and modern psychopharmacology to help patients achieve lasting wellness.

Dr. Smeed is proficient in treating a wide range of psychiatric conditions while specializing in treatment-resistant depression, neurodevelopmental disorders, anxiety and trauma disorders. His treatment style is empathic and collaborative, emphasizing family dynamics and relationships while integrating psychodynamic principles with biopsychosocial models. He approaches each patient with creativity, using open-ended discussions and innovative therapeutic and psychopharmacologic strategies to tailor care, ensuring a personalized and effective treatment experience.

Dr. Smeed begins with open-ended dialogue, allowing patients to develop their narrative, which is often therapeutic. Treatment plans are customized to patient needs and align with diagnostic standards of care. He incorporates medication reviews, mindfulness techniques, cognitive behavioral therapy (CBT), supportive therapy, and psychodynamic approaches. Dr. Smeed also educates patients on lifestyle factors, such as diet and exercise, to support mental health, fostering a holistic and individualized path to wellness.

Dr. Sumbal Akhter graduated from the University of Nevada at Las Vegas Psychiatry residency program. She has a wide range of experience, having worked at the VA, consult liaison psychiatry, and multiple inpatient/outpatient settings. She provides supportive psychotherapy and takes an integrative approach to her practice.

Dr. Gregory Marc Varhely is a board-certified general adult psychiatrist. He grew up in Austin, Texas, and attended Texas State University, where he earned a BA in Psychology and a Master's degree in Biology/Biochemistry. After graduating from medical school at Ross University, he completed his residency in Psychiatry at the Medical College of Wisconsin. Dr. Varhely has served as an outpatient psychiatrist at the Department of Veterans Affairs and acted as an attending physician for resident psychiatrists at Texas A&M and UT Dell Medical Schools. He then acted as a sole proprietor of an outpatient psychiatric medication management and psychotherapy practice in Georgetown, Texas and later started contracting for North Central Health Care Mental Health Clinic, applying psychotropic medication management expertise to community-based treatment facilities in Wisconsin. Dr. Varhely's approach is rooted in forming meaningful connections with his patients. He wholeheartedly believes that psychological suffering stems from a blend of biological, psychological, social, and environmental factors. Dr. Varhely works together with his patients to uncover these factors and create treatment plans tailored to their specific needs using an eclectic blend of the latest in psychopharmacology, as well as psychodynamic, supportive, and cognitive-behavioral therapy.

Gisela Ayub, DNP, PMHNP-BC is a Nationally Certified Psychiatric Nurse Practitioner who received her first master's in nursing from Point Loma Nazarene University (PLNU) and her second Masters of Nursing with emphasis in Psychiatry from Gonzaga University. Gisela also completed her Doctorate in Nursing Practice Degree from PLNU. Gisela’s passion for helping those most in need started when she was just a young girl with a dream of becoming a physician someday. Life did not work the way it was planned for Gisela and she decided to become a nurse. Gisela worked as a registered nurse for over 13 years in different areas of nursing before focusing solely in the area of psychiatry. She has experience working in the areas of medical surgical, medical rehab, cardiac, oncology, labor and delivery and kidney dialysis. But her inspiration to help psychiatric patients was born from seeing the unmet needs of those patients, and the desire to be able to provide more compassionate care. Gisela's desire to become a Psychiatric Nurse Practitioner grew stronger with time, with the only idea in her mind to provide better care for those patients.

During the 1990’s, Gisela served her country proudly and spent 4yrs in the Navy. While attending her first master's in nursing at PLNU, she volunteered at the PLNU city clinic for the uninsured and under-privileged, providing mental health assessments and therapy. After graduating PLNU, Gisela continued providing free therapy to patients at the clinic. In addition, due to her strong background in nursing, Gisela has been able to identify other medical issues that correlate to patients' mental health, and through the use of an extensive questionnaire and ongoing assessment of presenting problems, she has been able to refer patients for additional care. Gisela has also worked as a preceptor, helping other new nurse practitioners understand how to provide the best care possible and communicate with patients.

Gisela believes that it is very important to help the patient feel they are in a safe space, establish a therapeutic environment that builds trust and openness, she listens fully, and uses a comprehensive questionnaire to obtain as much information as possible from the patient, in order to make an accurate diagnosis and select the correct treatment plan. Gisela always works with the collaboration of the patient, as this is the most important part of the treatment plan. Educating patients is also one of her strong suits. Gisela wants to make sure all of her patients are aware of the type of medications they are taking, explore options if needed, and the pros and cons of medications.

Dr. Illise Perlmutter is the Director of Child and Adolescent Psychiatry at Talkiatry. She is double board-certified in child and adolescent psychiatry and adult psychiatry. Before joining Talkiatry, Dr. Perlmutter was the Chair of Behavioral Health and Addiction Services at Bergen New Bridge Medical Center. Prior to Bergen New Bridge, she was the Director of Inpatient Psychiatry at Montefiore Medical Center-Wakefield, in New York. Over 35 years, Dr. Perlmutter has held numerous leadership roles with some of the largest hospital systems in the New York Metro Area. Dr. Perlmutter is a Distinguished Life Fellow of the American Psychiatric Association, a Fellow of the American College of Psychiatrists, and a Distinguished Fellow of the American Academy of Child and Adolescent Psychiatry. She has received awards for her contributions both locally and nationally. Dr. Perlmutter was included in Castle Connolly's "America's Top Doctors” list from 2006-2011 and 2017, as well as "Best Doctors in America” from 2009- 2012. Dr. Perlmutter received her MD from George Washington University School of Medicine and Health Sciences. After an internship in pediatrics, she completed a residency in Psychiatry at Mt. Sinai Medical Center followed by a fellowship in Child and Adolescent Psychiatry at Columbia University/New York State Psychiatric Institute. Dr. Perlmutter has held leadership roles in several academic institutions and is a Clinical Associate Professor of Psychiatry and Behavioral Science at George Washington University School of Medicine and Health Sciences in Washington, D.C. Dr. Perlmutter has authored numerous publications and research articles and has lectured and presented extensively on clinical, epidemiologic, and psychopharmacologic issues in child and adolescent psychiatry. She has made frequent media appearances addressing topical issues in disaster psychiatry during the course of her work in disaster psychiatry outreach.