Kyra Fragnito, MD

Background and credentials

Dr. Jessica Matthews is a board-certified general psychiatrist. She earned her medical degree from the University of Texas Health Science Center at San Antonio and completed her psychiatry residency at Tripler Army Medical Center in Honolulu, HI. After her training, she was stationed at Fort Hood, TX, where she worked as a staff physician in the inpatient unit at Carl R. Darnall Army Medical Center and later became the inpatient medical director. She subsequently transitioned to outpatient care, serving as a staff physician and later as clinic chief in the outpatient embedded behavioral health clinics. She continued working as a staff physician after leaving the military.

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Treatment approach

Dr. Matthews specializes in medication management, often incorporating supportive and cognitive-behavioral-focused therapy into treatment. Follow-up visits typically last 30 minutes, during which she evaluates progress and adjusts treatment as needed. She takes a collaborative approach and may recommend additional therapy when she believes it will optimize patient outcomes. Her primary areas of focus include treating adults with depression, anxiety, and stress/trauma-related disorders.

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What you can expect in a first visit

During the first visit, patients can expect a comprehensive evaluation where Dr. Matthews takes the time to understand their symptoms, history, and treatment goals. She prioritizes a structured yet patient-centered approach, discussing medication management options while considering therapeutic interventions tailored to individual needs. If necessary, she may recommend additional therapy as part of a well-rounded treatment plan.

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Why Talkiatry?

We’re a virtual mental health practice that makes it easy to find great care. We combine quality and convenience to help you thrive—faster. Our providers, like this one, are highly trained experts who specialize in medication management and collaborate with you on a treatment plan that fits your needs and comfort level.

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Dr. Jennifer Ruch is a board-certified psychiatrist who strives to understand her patients' lived experiences and aspirations to develop supportive therapeutic relationships through empathetic listening, mutual trust, and respect. She collaboratively creates individualized care plans that align with personal treatment goals in a safe and judgment-free environment. After completing her Bachelor of Science degree in Human Biology with a focus in psychology from the University of California, Merced, she earned her medical degree from Lake Erie College of Osteopathic Medicine. Dr. Ruch completed her General Psychiatry Residency at Arnot Ogden Medical Center in New York. Her clinical experience involves treating individuals of all age groups from diverse populations and socioeconomic backgrounds suffering from anxiety, depression, bipolar disorder, psychotic disorders, neurodevelopmental disorders, and neurocognitive disorders. She has provided care in inpatient and outpatient psychiatric facilities, the Veterans Affairs Medical Center, emergency rooms, state facilities, and an inpatient chemical dependency center. She also performed pre-procedure psychological evaluations for bariatric and spinal cord surgeries, and psychiatric consult liaison services on medical units and has clinical training in inpatient and outpatient neurology. Her clinical experience incorporated treatment modalities such as pharmacotherapy and interventional psychiatry, including Transcranial Magnetic Stimulation and Spravato. Dr. Ruch integrates a wide array of psychotherapy as needed; however, her practice primarily focuses on medication management while utilizing referrals to therapists and providing collaborative care for optimal outcomes.

Ashley is an ANCC board-certified Psychiatric Mental Health Nurse Practitioner with over a decade of experience in Psychiatry. She has worked in inpatient and outpatient settings, crisis centers, and psychiatric emergency rooms. Ashley is deeply committed to working collaboratively with individuals to enhance their well-being, creating a personalized care plan tailored to each person’s unique needs.

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Her approach integrates medication management, supportive psychotherapy, and lifestyle interventions. As a prescriber specializing in psychopharmacology, Ashley provides comprehensive medication management while utilizing a shared decision-making model. She actively involves clients in their treatment planning, discussing various options to determine the most effective path forward.

During the initial session, Ashley prioritizes establishing a comfortable, open environment where clients feel at ease. She will review medical and psychiatric history, discuss treatment goals, and explore different therapeutic options based on individual preferences. Ashley encourages questions throughout the process to ensure a collaborative and supportive treatment experience.

Dr. Caitlin Gardiner is a board-certified psychiatrist specializing in child and adolescent psychiatry and psychotherapy. Dr. Caitlin Gardiner's practice is based on the biopsychosocial model and believes that the foundation of healing is in psychotherapy and human connection. She is known for incorporating therapy into her medication management practice. Typically she offers 30-minute follow-up visits for medication management with focused therapy based on individual needs. As a known helper, Dr. Gardiner started her career with a bachelor's degree in social work from Cazenovia College in Cazenovia, NY. After changing career paths, she received her medical degree from SUNY Upstate Medical University in Syracuse, NY. She stayed upstate to complete her general psychiatry residency, where she was chief resident at the beginning of the COVID-19 pandemic. Following this, she completed her child and adolescent psychiatry fellowship at Upstate due to the high quality of training. Dr. Gardiner has completed 3 years of advanced training in Dynamic Deconstructive Psychotherapy as well as specialized training in DBT. Dr. Gardiner is a well-rounded psychiatrist who enjoys treating youth and young adults during transitional phases of life while providing a safe and supportive environment. She believes strongly in reducing polypharmacy and providing high-quality medication management through a therapeutic and developmental lens.

Bryan Larson is a Psychiatric Mental Health Nurse Practitioner (PMHNP) with a Doctorate of Nursing Practice from Washington State University (2019). He earned his Bachelor of Science in Nursing from Walla Walla University in 2003 and worked for over a decade as an emergency department nurse. Since 2019, he has provided outpatient psychiatric care for diverse patients, offering medication management and support for a variety of mental health diagnoses.

Bryan works with patients from all backgrounds with a focus on treating each individual uniquely. He emphasizes meeting patients “where they’re at” and collaborates in a supportive environment to achieve personalized treatment goals, ensuring every patient feels understood and valued.

During the initial appointment, Bryan reviews a patient’s psychiatric history and current concerns to develop a tailored treatment plan, which may include medication and/or therapy services. He fosters a welcoming environment and continually adjusts care plans to align with each patient’s goals, supporting long-term mental health improvement.

Dr. Santos is a psychiatrist with more than 4 years of experience practicing in a variety of settings with an emphasis on psychiatric outpatient care. She is experienced in treating several psychiatric disorders including but not limited to: Bipolar and Related Disorders, Depressive Disorders, Anxiety Disorders, Trauma and Stressor Related Disorders, Obsessive-Compulsive and Related Disorders, and Substance Related and Addictive Disorders. Dr. Santos received her medical degree from the University of Queensland in Brisbane, Australia / Ochsner Clinical School in New Orleans, Louisiana. She completed her residency training at Louisiana State University in Shreveport, Louisiana. Dr. Santos tailors her approach to the individual patient. She focuses on medication management and incorporates several therapeutic techniques including supportive therapy, cognitive behavioral therapy, acceptance therapy and mindfulness.