Luna Sanchez Rivera, MD

Deborah Ford PMHNP, FNP is a dually certified board certified Psychiatric Mental Health Nurse Practitioner.  She is also qualified as a family nurse practitioner.  She completed her education at the University of Cincinnati in Ohio and the University of Kennesaw in Ga.  Ms. Ford has 10 years of treating patients with mental health issues.  Working in various settings such as outpatient, inpatient, private practice and telepsychiatry.

Whether you’re struggling with Schizophrenia, ADD, Anxiety, Depression, PTSD, Bipolar, Panic, or other mental health disorders. Together we can work to help equip you with the necessary tools to help you face and overcome challenges. Please understand you are the priority!   Deborah Ford offers encouragement, empathy, hope and understanding by providing compassion and promoting self-care.  In her free time, she enjoys exercise and travel.  Believing that self-love is an essential part of mental wellness.  She believes in continuous learning and is a patient advocate.  As a team, support is provided with the help of psychotherapy such as cognitive behavioral therapy, mindfulness, psychodynamic therapy using motivational interviewing.  Deborah Ford’s Core Values surround Integrity, accountability, diversity, collaboration, inclusion & respect.

Dr. Juliet Nichols has been a diplomate of the American Board of Psychiatry and Neurology since 2002 and has been practicing psychiatry for over 25 years. While an expert in psychopharmacology, Dr. Nichols has an integrative approach to treatment and she often incorporates psychotherapeutic techniques when appropriate, tailoring every treatment to each patient's individual needs. She completed her Psychiatry residency at Stony Brook-SUNY and Geriatric Psychiatry Fellowship at the Albert Einstein School of Medicine. Over the last two decades, Dr. Nichols served as an attending psychiatrist at JT Mather Hospital in Port Jefferson, NY, where she became proficient in delivering stellar psychiatric care in a variety of settings. She specializes in treating adult and geriatric mental illnesses, including: Depression, Anxiety Disorders (eg, OCD, Panic Disorder, GAD, PTSD), ADHD, and Cognitive Disorders in the elderly. Dr. Nichols strives to help her patients gain insights into their inner conflicts, unveil their strengths, accept their limitations, and build their coping skills. Her approach is dynamic, straightforward, and empathic so patients always feel safe, understood, and at ease. She engages the patient to be an active participant in treatment decision-making, creating a strong therapeutic alliance.‍

Robynn Cavaliere, PMHNP-BC, is a nationally board-certified Psychiatric Mental Health Nurse Practitioner. She earned her nursing practice degree from the University of San Diego (USD). Her passion for helping others began at the age of 16 when she became an EMT and volunteered with a local emergency unit. Inspired by a strong belief in service to country and a desire to follow in her brothers’ footsteps, she proudly served in the United States Marine Corps.

Robynn’s nursing journey began over two decades ago, driven by a deep calling to care for others. She started her career as an LVN on medical/surgical/telemetry floors, advanced to an RN in the emergency room, and eventually became a psychiatric nurse practitioner.

Her extensive nursing experience spans a wide range of clinical settings and patient populations, shaping her approach to interviewing, assessment, and intervention. Robynn applies the Biopsychosocial Model in every patient encounter, believing that a comprehensive understanding of the whole person leads to more effective treatment recommendations, improved outcomes, and better prognoses.

She is deeply committed to making a positive impact in her patients’ lives and giving back to the nursing profession. Robynn precepts student nurse practitioners in her practice and serves as a Clinical Assistant Professor at USD, where she helps educate the next generation of healthcare providers.

Robynn emphasizes the importance of comprehensive assessments, active listening, and building therapeutic alliances that foster trust and create a safe space for patients to share their thoughts and concerns. She collaborates closely with patients to ensure they feel heard, encourages active participation in their treatment, and provides education to enhance insight and promote behavioral change. Her approach includes supportive psychotherapy and incorporates techniques from Cognitive Behavioral Therapy (CBT), Interpersonal Therapy, Reality Therapy, and Solution-Focused Therapy during medication management visits.

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Background and credentials  

Dr. Alexandra Baluna, MD, is board-certified by the American Board of  Psychiatry and Neurology. She received her medical degree from  LSUHC-Shreveport and completed her psychiatry residency training at  Montefiore/Albert-Einstein College of Medicine, where she served as chief of  the Consultation-Liaison (C/L) service. Following residency, Dr. Baluna  served as Senior Chief, during which she was honored with the Leo M. Davidoff  Award for Outstanding Achievement in the Teaching of Medical Students. Her  professional experiences include roles at Fordham University, Albert Einstein  Student Mental Health Counseling Center, and most recently, as an outpatient  psychiatrist at Maimonides Medical Center, where she enjoyed teaching and  supervising residents.  

Treatment approach  

Dr. Baluna emphasizes creating a warm, empathic, and nonjudgmental  therapeutic environment. She collaborates closely with patients to develop  personalized treatment plans that consider cultural, biological,  psychological, and social factors. With a strong interest in psychotherapy,  she frequently employs ego-supportive and insight-oriented therapy techniques  during follow-up sessions.  

What you can expect in a first visit    

During an initial visit, patients can expect a welcoming and supportive  atmosphere where Dr. Baluna conducts a comprehensive assessment. This  involves exploring the patient's history, current challenges, and individual  circumstances. The goal of the first session is to collaboratively build an  individualized treatment plan tailored specifically to the patient's unique  needs.  

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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 speciualize in  medication management and collaborate with you on a treatment plan that fits  your needs and comfort level.

Dr. Fatemeh Safian is a board-certified psychiatrist with experience in outpatient, inpatient, and telepsychiatry settings. She completed her residency at Larkin Community Hospital, caring for a diverse range of patients. Dr. Safian diagnoses and treats a wide variety of conditions, including depression, anxiety, OCD, PTSD, trauma-related disorders, phobias, personality disorders, ADHD, bipolar disorder, postpartum depression, and concerns across all age groups. She is dedicated to creating a safe, supportive space where people feel truly heard—believing good psychiatry starts with listening.

Dr. Safian fosters a warm, respectful, and judgment-free environment where patients can share openly. She takes time to understand each person’s symptoms, story, values, and goals. Medication is just one option; she also considers therapy, lifestyle changes, and other supports. Collaboration and trust are central to her approach, with patients guiding the care decisions.

During the first appointment, Dr. Safian conducts an in-depth, unhurried conversation to explore the patient’s history and goals. Together, they develop a personalized treatment plan that may include medication, therapy referrals, and practical strategies. Ongoing follow-ups provide space to track progress, make adjustments, and ensure the patient feels comfortable and empowered.

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!