Sumbal Akhter, DO

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.

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.

‍

Dr. Bardugon is a board-eligible psychiatrist who specializes in the treatment of adults. He has experience in treating patients with various forms of depression and anxiety, bipolar disorder, OCD, ADHD, PTSD, and substance use disorders. He seeks to provide a safe, non-judgmental, gender affirming space for patients as they strive to lead a happier, more contented life. After a pediatrics residency, Dr Bardugon worked for 13 years as a pediatric ER physician. His interest in psychiatry was piqued during this time as he witnessed the emergence of a child and adolescent mental health crisis. While ultimately deciding to focus his efforts on the treatment of adults, Dr Bardugon is keenly aware of the influence of child development and family systems on the behavioral health of adults. Dr Bardugon employs a holistic, multimodal treatment approach. Aiming to treat the whole person, he stresses the importance of nutrition, exercise, and sleep. Dr Bardugon believes an informed patient actively engaged in decision making surrounding treatment has the best chance of effecting lasting change. Believing in the synergistic effect of talk therapy and medication, he incorporates one or more talk therapy techniques including motivational interviewing, cognitive behavioral therapy, and supportive and psychodynamic psychotherapies into most sessions. He often recommends formal participation in some form of talk therapy and is happy to collaborate with other providers.

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.

Dr. Adele Veksman is double board-certified in adult psychiatry and psychosomatic medicine, with over 14 years of experience diagnosing and treating a wide range of psychiatric conditions. She approaches each patient as a unique individual, offering a non-judgmental space to help patients develop into their best selves. She focuses primarily on medication management to alleviate symptoms while working with patients on behavioral changes to address underlying issues. If additional therapy is needed, she may suggest adding a therapist to your care team to provide the best outcome. Dr. Veksman received her medical degree from St. George's University and then completed a residency in psychiatry and fellowship in psychosomatic medicine at Zucker Hillside Hospital at Northwell Health. Next, she was an attending and ER psychiatrist at North Shore University Hospital providing psychiatric care to medically ill patients. She then transitioned to adult outpatient care at Maimonides Medical Center, treating various psychiatric illnesses. Throughout her career, she taught and supervised residents and medical students.

Background and credentials

Dr. Jenny Joseph is a board-certified adult psychiatrist. She earned her medical degree from St. George's University School of Medicine and completed her adult psychiatry residency at New York Medical College at Metropolitan Hospital Center. She has experience working with diverse patient populations and treating a range of psychiatric conditions.

‍

Treatment approach

Dr. Joseph specializes in medication management for various psychiatric conditions, including mood, anxiety, and psychotic disorders. She employs a patient-centered approach that emphasizes empathy, open communication, and collaboration. In addition to pharmacological treatment, she incorporates psychoeducation and supportive therapy to help patients better understand and manage their conditions. When beneficial, she may recommend additional therapy and coordinate care with a therapist to ensure comprehensive treatment.

‍

What you can expect in a first visit

During the first visit, patients can expect a thorough evaluation that explores their symptoms, treatment history, and personal goals. Dr. Joseph takes the time to listen and understand each patient's needs, ensuring that their treatment plan is tailored to their specific concerns. She provides a compassionate and structured approach to medication management while fostering a collaborative environment where patients feel supported in their mental health journey.

‍

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.

‍