Sarah Debrey, MD

Dr. Alejandra Vivas is board-certified in adult psychiatry and board-eligible in child and adolescent psychiatry. She completed her general psychiatry residency at Montefiore Medical Center and a child and adolescent fellowship at Mount Sinai School of Medicine. Dr. Vivas brings extensive experience from outpatient, emergency, and telepsychiatry settings. She has advanced training in CBT, Motivational Interviewing, and Psychodynamic Therapy. Fluent in English and Spanish, she is committed to culturally sensitive, individualized care.

Dr. Vivas fosters a warm, respectful, and professional space where patients feel seen and empowered. She values open communication and builds collaborative relationships to align treatment with each person’s values, goals, and lifestyle. Her approach is integrative and flexible, grounded in evidence-based methods to support lasting, meaningful change.

Dr. Vivas begins with a thorough evaluation to understand each patient’s history and goals. She creates customized treatment plans that may include therapy, medication, or both. Drawing on CBT, Motivational Interviewing, and Psychodynamic Therapy, she adapts care to meet evolving needs, aiming to relieve symptoms, foster resilience, and support long-term well-being.

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Rebecca Kostopoulos, PMHNP, is a board-certified psychiatric nurse practitioner committed to helping individuals facing mental health challenges lead full and balanced lives.

Her practice primarily focuses on medication management, often combined with supportive or emotionally focused therapy during 30-minute follow-up visits. When appropriate, Rebecca may recommend involving an additional therapist to ensure the most effective and comprehensive care.

She earned her Master of Science in Nursing with a specialization in psychiatry from Columbia University and her Bachelor of Science in Nursing from Boston College. Her training includes psychiatric diagnosis, medication management, and both psychodynamic and cognitive-behavioral therapies.

With over a decade of experience, Rebecca has evaluated and treated adults in a variety of clinical settings. Her previous roles include working at Elmhurst Hospital’s Comprehensive Psychiatric Emergency Program, Gracie Square Hospital’s inpatient unit, as well as in community health centers and skilled nursing facilities.

As a nurse practitioner, Rebecca believes that mental health is just as vital as physical health. She values the therapeutic relationship and approaches treatment with empathy and collaboration, ensuring that each patient receives personalized and compassionate care.

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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. Mark Varela is a board-certified psychiatrist joining Talkiatry directly out of residency. He focuses primarily on medication management, often accompanied by brief cognitive, motivational, or supportive therapy. He may request that you also meet with a therapist regularly for your benefit. Dr. Varela received his medical degree and general psychiatric residency training both from Texas Tech University Health Sciences Center in West Texas. He treats young adults and adults with a wide variety of mental health concerns, including ADHD, mood disorders, anxiety, OCD, and PTSD.

Cecilia Wild is a board-certified psychiatric-mental health nurse practitioner (PMHNP-BC) with a strong background in treating patients across the mental health spectrum. She earned her Bachelor of Science in Nursing from Illinois State University and began her career in a women’s residential facility specializing in mood disorders, eating disorders, and PTSD. She then transitioned to inpatient adolescent psychiatry, where she became a charge nurse and obtained her Psychiatric-Mental Health Nursing Certification (PMH-BC) from the American Nurses Credentialing Center (ANCC). Inspired by her passion for mental health, she pursued her master's degree at the University of St. Francis to become a PMHNP.  

Cecilia has extensive experience treating patients at all levels of care, including inpatient, PHP/IOP, and outpatient settings. She later transitioned to telehealth, providing medication management to college students. She is passionate about mental health advocacy, particularly within the LGBTQ+ community.  

Cecilia takes a team-based, individualized approach to care. She believes in the importance of education, open communication, and empowering patients in their treatment journey. She emphasizes a holistic perspective, incorporating medication management, therapy, and lifestyle modifications.  

Cecilia prioritizes a trauma-informed approach, recognizing the significant role trauma plays in mental health. She integrates mindfulness techniques, motivational interviewing, and lifestyle changes to support overall well-being. By fostering a collaborative and supportive environment, she helps patients build resilience and achieve their mental health goals.

Dr. John Hendrick is a practicing psychiatrist who has recently served as medical director for clinical services at Erlanger Behavioral Health Hospital in Chattanooga, TN. After several years of private practice, he had served as Chief of Inpatient Psychiatric Services and then as Chief of Psychiatry at Mountain Home VA Medical Center. During his time at Mountain Home VA he was also a Professor of Psychiatry at Quillen Medical School at East Tennessee State University where he taught General Psychiatry courses and the Neurosciences of Psychiatry. His specialties include affective and anxiety disorders and he has specific expertise in neuropsychiatry, psychopharmacology and alternative treatments for affective disorders. He is a Distinguished Life Fellow of the American Psychiatric Association and is a Past President of both the Tennessee Psychiatric Association and the Southern Psychiatric Association. He has been awarded a Distinguished Service Award from the United States Public Health Service. He has been twice named the Outstanding Teacher Award from the ETSU Psychiatry Residency program and was awarded Course Director of the year for the Neurosciences residency course he developed. He holds an Irma J. Bland Award for Excellence in Psychiatric Education from the APA. He has an extensive psychiatric background in practice and as a teacher. He practices psychotherapy from an Eriksonian perspective and is well versed in individual and psychodynamic psychotherapies.