Marla Richard, MD

Dr. Boski Patel holds the position of psychiatrist at Talkiatry. She is double board-certified in geriatric and adult psychiatry and she has been practicing for over 3 years. Dr. Patel's practice focuses on medication management and she typically in conjunction with supportive therapy in 30-minute follow-up visits. On occasion, Dr. Patel may believe that additional therapy is also needed and asks that you bring a therapist into your care team to provide the best outcome. She received her undergraduate degree from the University of Pittsburgh, and then went on to receive her medical degree from Penn State University. Following medical school, she completed general psychiatry residency training at the University of Connecticut where she was Chief resident of outpatient psychiatric services. During that time, she was also chosen as an Honors scholar by the American Association of Geriatric Psychiatry. After training, she moved to California to do her geriatric psychiatry fellowship at Stanford. Following her fellowship, she worked at Kaiser Permanente in clinical roles of outpatient, geriatric, and C/L.

Dr. Ruiz is a compassionate psychiatrist specializing in adult and maternal mental health. She develops personalized treatment plans to address anxiety, depression, bipolar disorder, ADHD, OCD, PTSD, PMDD, and perinatal conditions. Her goal is to help patients reconnect with their values and live balanced, fulfilled, and meaningful lives.

Her passion for medicine began in childhood, inspired by curiosity about the mind and body. She earned an Honors Chemistry degree with  magna cum laude and completed her medical training and psychiatry residency at Texas Tech University Health Sciences Center. With a strong scientific foundation, Dr. Ruiz understands the role of medications, and embraces holistic healing through connection, gratitude, and spirituality.

Dr. Ruiz has experience in diverse clinical settings and has received national awards including the AWP International Fellowship and ADMSEP Innovations Award. She is dedicated to advancing maternal mental health screening and treatment through clinical care and education.

Dr. Ruiz combines pharmacotherapy (medication) with psychotherapy to create individualized treatment plans. Therapy provides powerful tools to manage thoughts, emotions, and behaviors that support balanced brain chemistry. Research shows that medication helps restore this balance more quickly and effectively, especially in moderate to severe cases.  

Dr. Ruiz likens medication for the brain to fertilizer for a garden. Imagine your mental health as a vibrant garden—when well-nourished, it can thrive with resilience, beauty, and balance. But when symptoms like depression, anxiety, ADHD, or mood instability take hold, they act like invasive weeds, crowding out healthy growth and making it hard to enjoy the space. Medication acts like fertilizer, strengthening the garden’s natural systems so the healthy parts can reclaim their place and flourish. Just as some gardens need only seasonal care while others require more consistent tending, medication plans are personalized to support each person’s long-term mental wellness. When the garden is healthy, there's more room to grow, connect, and fully enjoy life.

With a strong background in chemistry and pharmacology, Dr. Ruiz prioritizes educating her patients about how medications work and why they can be helpful. She believes patients should take an active role in understanding their diagnosis and treatment. Her approach emphasizes diagnostic clarity, medication management, patient education, and brief psychotherapy based on cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT).

Your first appointment is a supportive, in-depth conversation to share your story, challenges, and goals. Dr. Ruiz will review your medical and psychiatric history and assess symptoms using a whole-person approach that considers biological, psychological, and social factors.

Together, you’ll develop a personalized plan that may include lab work, medication, and therapy. Initial visits last 60 minutes for thorough evaluation; follow-ups typically last 20–30 minutes, focusing on medication management and brief therapy. If needed, Dr. Ruiz can refer you to in-house or community therapists for add-on therapy support.  

Throughout your care, Dr. Ruiz prioritizes shared decision making to ensure you feel informed, empowered, and supported.

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Dr. Amber Blue is a board-certified psychiatrist trained in Adult Psychiatry. She completed her residency at Yale University. She offers medication management in 30-minute follow-up visits informed by her psychotherapy experience. Occasionally, she may believe additional therapy would be beneficial, and therefore, she recommends that you add a therapist to your care team for the best results. She has received specialized training in psychoanalytic psychotherapy at Columbia University and NYU. Over the past three years, Dr. Blue has worked in college student health centers and private practice. She has a wide range of experience in treating various mental illnesses including depression, bipolar disorder, anxiety, and OCD. Her approach is to educate clients on their mental health, available pharmacologic and psychotherapeutic options, and to collaborate with them in formulating an evidence-based treatment plan.

Amanda Rivera, PMHNP, is a board-certified Psychiatric Mental Health Nurse Practitioner through the lifespan, certified by the ANCC in 2020. She earned a Bachelor of Science in Psychology with a biology minor from Clarkson University, followed by a Bachelor of Science in Nursing and a Master of Science in Nursing from St. John Fisher College. Amanda has over 15 years of experience in mental health, beginning in 2010 as a Therapy Aide at Rochester Psychiatric Center. She has practiced across inpatient hospitals, state psychiatric facilities, outpatient community clinics, correctional settings, group homes, and telehealth/private practice. She works with patients ages 16 and older and is highly experienced in trauma, mood and anxiety disorders, ADHD, autism, psychotic and personality disorders, substance use, and parenting challenges. She values working with families to strengthen the family unit.

Amanda values open communication and collaborates with patients to establish clear, meaningful treatment goals. She provides a warm, supportive environment where patients feel heard, respected, and empowered to take ownership of their mental wellness. Treatment is individualized, with medication decisions guided by a careful balance of safety and symptom relief. Appointments are conversational in nature, allowing care to be more personalized as patients share openly.

Amanda begins each visit by ensuring privacy and safety, then explores the concerns prompting care before gathering a biopsychosocial history through collaborative discussion. She provides education throughout sessions to help patients understand diagnoses and lived experiences. Medication options are discussed based on comfort level and clinical need. Follow-ups are scheduled at the end of each visit, with frequency adjusted as stability is achieved.

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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. Alfers is a board-certified psychiatrist specializing in adult psychiatry. He has been practicing for over 11 years. He completed his undergraduate education at Virginia Tech, graduating Cum Laude with degrees in Biology and Chemistry. Following graduation, he attended a research internship at the National Institutes of Health where he received a Post-baccalaureate Intramural Research Training Award. Dr. Alfers completed his medical degree from the Western University of Health Sciences in Pomona, CA. He completed his General Psychiatry Residency at Georgetown University, where he served as Chief Resident. After residency, he entered private practice in McLean, VA. Dr. Alfers takes a comprehensive approach to patient care. He integrates biological, psychological, and environmental factors into treatment planning. He focuses on developing a meaningful therapeutic relationship and providing medication interventions for specific treatment goals. Dr. Alfers provides interpersonal psychotherapy in conjunction with medication management services. Dr. Alfers has a special interest in the treatment of multiple mental health conditions, including depression, anxiety, bipolar disorder, PTSD, ADHD, and OCD. Dr. Alfers treats adults ages 18 to 65 years old. For established patients of Dr. Alfers, please call 917-634-5311 to schedule an appointment and let the care coordinator know you are an established patient.