Integrative Psychiatry

From our office in Mill Valley, CA, our dedicated team serves patients from San Francisco, the Bay Area, and all over the world.

Led by Director of Integrative Psychiatry Inna Zelikman, PMH-NP, we recognize the importance of continuously evolving our  mental health services and developing innovative approaches and individualized treatment plans in order to best provide our clients with exceptional care.

Want to know more? Book a free information session today with our intake team to find out how we can help.

Book An Information Session
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Conditons We Treat

Major Depressive Disorder (MDD)

Adrenal Fatigue

Obsessive-Compulsive Disorder (OCD)

Bipolar Disorder and Other Mood Disorders

Fibromyalgia (FMS)

Disordered Eating

Anxiety Disroders

Dual Diagnosis

Eating Disorders

Treatment-Resistant Depression

Thyroid Issues

Neuroendocrine Imbalance

Complex and Developmental Trauma

Sleep Disorders

Menopause, Premenstrual Dysphoric Disorder, and Hormonal Imbalance

Post-Traumatic Stress Disorder (PTSD)

Chronic Fatigue Syndrome (CFS)

Clients We Work With

People who continue to struggle with emotional imbalances, even after being prescribed various psychiatric medications

Those interested in a hands-on treatment style

Clients seeking alternative pharmacological and experiential treatments

Clients interested in a more holistic approach to wellness

People who have tried everything but can’t seem to get results

People who are seeking KAP to address unprocessed trauma

Explore Our Mental Health Services

Integrative Psychiatry in the Bay Area

Integrative Psychiatry is a holistic approach to mental health care that combines traditional psychiatric treatments with complementary and alternative therapies. This approach considers the interconnectedness of psychological, social, and spiritual factors with physical health in understanding and treating mental health conditions. Integrative psychiatrists often incorporate various modalities such as psychotherapy, medication management, nutritional interventions, lifestyle changes, mindfulness practices, and other complementary therapies to address the individual needs of patients and promote overall well-being.

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Comprehensive Assessment

Thorough evaluation encompasses multiple dimensions: a detailed personal history, challenges in life circumstances, and an assessment of the individual's social ecosystem. This includes examining intricate personal relationships, cultural influences, home and work environments, including family dynamics.

Shows Inna Zelikman, PMHNP, treating a patient

Ketamine’s influence can induce altered states of consciousness, facilitating a heightened receptivity to psychotherapeutic insights. Integrating psychotherapy is essential as it enhances the therapeutic outcome, surpassing the effects of ketamine alone. Under the guidance of a skilled professional, individuals engage in introspective reflection, emotional analysis, and meaningful dialogues often resulting in profound realizations, emotional release, and potentially transformative experiences.

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Medication Optimization

The optimization of psychiatric medications involves assisting patients in moving away from ineffective medication regimen to more effective pharmacological choices, including tapering off of SSRIs, high-dose antipsychotics and offering alternative choices to stimulant medications in dealing with mental health issues.

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Nutritional Approaches

Holistic nutrition focuses on the whole person, taking into account mental health, diet, and lifestyle factors. Our supplement regimen is specifically designed to properly support each individual's physical and mental well-being by enhancing the healing process and restoring function.

Our Philosophy of Mental Health

1

Creating Wholeness by Bridging Mind, Body, and Spirit:

At Recovery Without Walls, we believe healthcare extends beyond transient symptom relief. Our approach centers on cultivating a profound sense of connection, guiding patients toward enhanced wellness and wholeness. Rooted in bridging the gap between the body, mind, and spirit, our philosophy acknowledges their interconnectedness in comprehending overall health and well-being.

2

Personalized, Innovative Treatments Administered by Caring Practitioners:

Our practice's philosophy revolves around delivering personalized and innovative treatments through the expertise of our healthcare practitioners. We tailor our approach to each individual, recognizing that every patient is unique and may require a customized solution. By staying at the forefront of medical advancements and continuously exploring new avenues of treatment, we strive to offer innovative and effective treatment options. Our team is dedicated to delivering the highest standards of quality, excellence and compassion in healthcare.

3

Optimal Prescription Strategies:

While acknowledging the role of conventional medications in treatment, we steer clients away from prolonged ineffective psychopharmacology or excessive irrational polypharmacy toward personalized prescription approaches. Our emphasis lies in tailored protocols and regimens, prioritizing effective pharmacological choices that avoid fostering dependency. Additionally, we integrate nutritional solutions and promote sustainable lifestyle decisions to facilitate brain healing and restore optimal functioning, respecting each client's unique needs and goals.

Contact Us

Reach out to our clinical intake team for a consultation

Get in Touch

An Alternative to Wilderness Programs

Holistic Mental Health Treatment for Teens & Young Adults

Current approaches for addressing teens’ mental health challenges, behavioral issues and substance use often involve sending them to wilderness programs, which are typically followed by enrollment in boarding schools. These programs are generally very rigid and tend to use a one-size-fits-all approach to complex conditions. Historically they rely on punitive “therapies” that are unsafe and ineffective. 

In addition, taking teens away from their family, friends, and familiar environments can be traumatizing, creating the perception that they are the problem rather than viewing teens’ issues through the lens of their social environment and the family system. Teens who experience imbalance in their ecosystem and have significant trauma are at a higher risk of developing mental illness. 

Teens can develop maladaptive behaviors and significant emotional dysregulation when environmental changes and trauma remain unaddressed. They are offered conventional treatments that focus primarily on cognitive approaches and prescription medications. Often, boundaries are enforced through negative consequences.

Recovery Without Walls provides a flexible, compassionate and holistic in-home program that takes into consideration an individual’s unique circumstances during treatment planning.

Custom Care

We personalize treatment based on the severity of mental health conditions and the individual patient's needs.

Dedicated Support

In cases where parents are overwhelmed with managing their teens’ behavior, we can build in therapeutic companions that provide care and supervision on as-needed basis. They can serve as a supportive buffer to lessen friction between teens and their parents.

Rational Pharmacology

Our goal is to provide medications on a short-term basis to help with emotional regulation and promote restorative sleep to allow teenagers to have more flexible thought processes and be more receptive to therapeutic suggestions.

Improving Nutrition & Fitness

We begin by identifying problematic eating patterns or unhealthy relationships with food, followed by prescribing supplements that are specifically designed to properly support each teen's physical and mental well-being. Supporting diet, nutrition and physical fitness is an important part of therapeutic treatment.

Supplementary Therapeutic Modalities

Recovery Without Walls employs Somatic Therapy to help teens resource and work with trauma, as well as Ecotherapy as a technique to help teens relax their defenses and facilitate pressure-free dialogue with our care team in a relaxed, non-clinical setting.

Explore Our Services

Integrative Psychotherapy

Whether drawing from traditional psychotherapeutic techniques, incorporating somatic and experiential therapies, or exploring the potential of psychedelic-assisted treatments, we are dedicated to providing our clients with the most effective and compassionate care available.

Our multidisciplinary team collaborates closely to assess the latest research, evaluate therapeutic outcomes, and refine our methodologies accordingly. By staying informed and adaptable, we strive to empower our clients on their journey toward healing, growth, and lasting well-being.

Our Therapeutic Offerings:

Psychodynamic Therapy

Psychodynamic therapy is a form of depth psychology that focuses on exploring the unconscious processes and unresolved conflicts that contribute to a person's emotional and psychological distress. The ultimate goal of psychodynamic therapy is to help resolve underlying conflicts, gain insight into unconscious processes, and develop healthier ways of coping with life's challenges.

Somatic Therapy

Somatic therapy, also known as body-centered therapy, is an approach to psychotherapy that focuses on the connection between the mind and body in addressing emotional and psychological issues. Through this process, clients can gain insight into the underlying causes of their emotional difficulties, release stored tension or trauma held in the body, and develop healthier ways of regulating their emotions and responses to stress.

Internal Family Systems

Internal Family Systems (IFS) is founded on the principle that each individual possesses a system of protective and wounded inner parts, all guided by a core perception of self. It posits that we are composed of multiple parts or sub-personalities, many of which we may not fully recognize. As an evidence-based psychotherapy, IFS aids in healing by accessing and addressing these protective and wounded inner parts and is a highly effective tool, especially when combined with KAP or other forms of psychedelic-assisted psychotherapy.

Innate Somatic Intelligence™ Trauma Therapy (ISITTA)

ISITTA is an integrative, relational, and somatic approach to trauma healing. Rooted in Hakomi Therapy techniques, ISITTA incorporates a polyvagal trauma-informed perspective, emphasizing the somatic, relational, and clinical skills necessary for trauma transformation.By establishing connection with the soma, we tap into the innate healing intelligence present within each individual.

Couples Therapy

Couples therapy can address a wide range of relationship issues, including recurring conflicts and feelings of disconnection, while working to improve communication and strengthen relationships.

Family Therapy

A type of psychotherapy that helps family members better understand each other, support one another and work through difficult situations. This approach considers the interconnected dynamics among family members, drawing from family systems theory, attachment theory, cognitive-behavioral techniques and communication strategies.

Ecopsychology/Ecotherapy

Ecopsychology presents a healing paradigm that perceives the human mind and body within the context of nature and the intricate tapestry of existence. It provides a philosophical framework for delving into the profound bond between humans and their environment, scrutinizing its impact on our welfare and guiding us in understanding how nature shapes our emotions, identity, and general well-being. Therapists may incorporate outdoor activities like walks or hikes into treatment to enhance one's affinity with the natural world. This approach recognizes a mutual reciprocity between the natural rhythms of our world and a harmonious psyche.

Schedule an Intake Call

    F.A.Q.

    Understanding and Treating Anxiety

    Holistic Answers for Whole-Person Healing

    What contributes to the development of anxiety disorders?

    Anxiety doesn’t appear out of nowhere, it often has deep, interconnected roots. At Recovery Without Walls, we understand anxiety as a complex interplay between biology, personal history, and life experience. Just like other chronic conditions, anxiety can run in families and has a strong physiological component shaped by genetics and neurochemistry.

     

    Common contributing factors include:

    • Childhood shyness or behavioral inhibition
    • Family history of anxiety or other mental health conditions
    • Early exposure to trauma or persistent stress
    • Hormonal and metabolic imbalances
    • Chronic financial strain or social isolation
    • Being divorced, widowed, or navigating significant life transitions

    These influences can increase vulnerability, but they don’t determine your future. Healing is absolutely possible, and it starts with compassionate, personalized care. In the heart of Mill Valley, we provide a safe, stigma-free space to begin understanding the “why” behind your anxiety and what to do next.

    What are the most common types of anxiety disorders?

    Anxiety can wear many faces, and recognizing its form is the first step toward treatment. Some of the most frequently diagnosed anxiety conditions include:

     

    1. Generalized Anxiety Disorder (GAD):
      Persistent, excessive worry that feels impossible to shut off
    2. Obsessive-Compulsive Disorder (OCD):
      Repetitive, intrusive thoughts and behaviors that feel out of your control
    3. Panic Disorder:
      Sudden surges of intense fear, often with physical symptoms like chest pain or shortness of breath
    4. Post-Traumatic Stress Disorder (PTSD):
      Lingering psychological and emotional distress following trauma
    5. Social Anxiety Disorder (Social Phobia):
      Intense fear of judgment or embarrassment in social settings

    Each of these conditions deserves nuanced, individualized care.

    How is an anxiety disorder diagnosed?

    Anxiety becomes a clinical concern when it begins to interfere significantly with daily life, work, school, relationships, or health. Diagnosis usually involves a thorough clinical interview and sometimes lab work or referrals to rule out physical conditions that can mimic anxiety, such as thyroid disorders, cardiovascular issues, menopause, or medication side effects.

     

    At Recovery Without Walls, we don’t rush to label or pathologize. Instead, we take the time to listen deeply, understand your whole story, and offer integrative assessments that consider your emotional, physical, and energetic health.

    How is anxiety treated at Recovery Without Walls?

    We believe anxiety treatment should be just as multifaceted as the condition itself. That’s why we tailor each care plan to reflect your unique biology, lifestyle, and values.

     

    Evidence-based options may include:

    • Cognitive Behavioral Therapy (CBT) and other trauma-informed talk therapies
    • Somatic and mindfulness-based practices to support nervous system regulation
    • Support groups and community-based healing
    • Integrative nutritional psychiatry and functional medicine
    • Thoughtful, individualized use of medications, when needed

    Rather than defaulting to a medication-first model, we prioritize a “less is more” philosophy, avoiding irrational polypharmacy and using pharmaceutical support only when clinically indicated.

    What medications are used for anxiety and how does Recovery Without Walls approach them differently?

    There are several classes of medications commonly prescribed to help manage anxiety, including:

    • SSRIs (Selective Serotonin Reuptake Inhibitors)
    • SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors)
    • Benzodiazepines
    • Tricyclic antidepressants
    • Beta-blockers for certain performance-related anxieties

    While these can be helpful tools, they’re not always the full answer, and they’re certainly not the starting point for every patient. Our clinical team takes a conservative, evidence-based approach to prescribing, using the smallest effective dose when needed and always aiming to complement medication with lifestyle, somatic, and therapeutic interventions.

    How is Recovery Without Walls different when it comes to treating anxiety?

    Located in the serene surroundings of Mill Valley, our clinic offers a calm, supportive atmosphere where healing feels possible, not clinical or cold. We view anxiety not as a flaw to fix but as a message from the body, asking for deeper attention.

     

    Whether you’re navigating chronic anxiety or recovering from a recent crisis, we offer pioneering care grounded in science, compassion, and your lived experience. From first appointment to long-term support, we walk alongside you with empathy and innovation.

    Depression & Integrative Psychiatry

    Your Questions, Compassionately Answered

    What are the common signs of major depression?

    Major Depressive Disorder (MDD) is more than a stretch of sadness—it can touch every aspect of a person’s life, from how they think and feel to how they sleep, eat, and relate to others. At Recovery Without Walls, we take a holistic view of depression as a mind-body experience rooted in biological, psychological, and social factors.

    Some of the most recognizable signs include:

    • Feeling persistently low or emotionally flat
    • Losing interest in activities that used to bring joy
    • Shifts in appetite and body weight unrelated to intentional changes
    • Insomnia or oversleeping
    • Physical fatigue or loss of energy
    • Restlessness or slowed movements
    • Difficulty concentrating or making decisions
    • Feelings of worthlessness, shame, or guilt
    • Emotional numbness or excessive worry
    • Thoughts of death or suicide

    To be considered major depression, five or more of these symptoms must be present for at least two weeks, with at least one being either low mood or loss of interest.

    If this feels familiar to you or someone you care about, you’re not alone. Our Mill Valley-based team is here to support your recovery through compassionate, integrative psychiatric care.

    Why is depression more common in women than in men?

    While anyone can experience depression, it occurs about twice as often in women. At Recovery Without Walls, we recognize that biology, hormones, and social experiences all intersect to shape mental health. In adolescence, when hormonal changes intensify, rates of depression among girls begin to outpace those of boys, a trend that continues through adulthood.

    Researchers believe this gender difference is influenced by:

    • Hormonal fluctuations across the lifespan
    • Higher rates of certain life stressors and trauma
    • Greater societal pressure around caregiving and appearance
    • A tendency among some women to internalize difficult experiences

    Understanding the full picture of how gender impacts mental health allows us to offer more personalized and effective care. Our integrative approach includes hormone-informed psychiatry, trauma-sensitive therapy, and somatic support, especially for those affected by depression in the context of identity, life transitions, or chronic stress.

    How is the field evolving to better treat depression?

    Depression treatment is changing rapidly, and we’re helping to lead the way. In our work at Recovery Without Walls, we stay on the cutting edge of both established and emerging approaches, integrating them into care plans tailored to each individual’s needs.

    Researchers across the country, and right here in the Bay Area at leading institutions like UCSF, Berkeley, and Stanford, are working to understand how to better match people with the treatment most likely to help them heal. This includes studying biological, psychological, and lifestyle factors to predict which therapies will be most effective, from psychotherapy and nutrition to neurobiological interventions.

    At our clinic, we integrate conventional psychiatry with forward-thinking strategies like ketamine-assisted therapy, nutritional psychiatry, and mindfulness-based interventions to support whole-person healing.

    What are some of the most promising new treatments for depression?

    One of the most exciting breakthroughs in recent years has been the use of ketamine for treatment-resistant depression. Originally developed as an anesthetic, ketamine has shown remarkable effectiveness in rapidly reducing depressive symptoms, often within hours, especially for those who haven’t responded well to traditional medications.

    Here at Recovery Without Walls in Mill Valley, we offer ketamine-assisted psychotherapy in a safe, structured environment to thoroughly-assessed cases as part of a wider, integrative treatment plant. While ketamine is dissociative and must be used with care, we combine it with psychotherapy and integrative support to help catalyze meaningful change, not just symptom relief.

    Our goal is not only to reduce suffering but to support sustainable, long-term healing. That’s why we continue to follow the research, invest in clinical training, and treat each patient with the individualized attention and deep compassion they deserve.

    F.A.Q.

    Understanding and Treating Anxiety

    Holistic Answers for Whole-Person Healing

    What contributes to the development of anxiety disorders?

    Anxiety doesn’t appear out of nowhere, it often has deep, interconnected roots. At Recovery Without Walls, we understand anxiety as a complex interplay between biology, personal history, and life experience. Just like other chronic conditions, anxiety can run in families and has a strong physiological component shaped by genetics and neurochemistry.

     

    Common contributing factors include:

    • Childhood shyness or behavioral inhibition
    • Family history of anxiety or other mental health conditions
    • Early exposure to trauma or persistent stress
    • Hormonal and metabolic imbalances
    • Chronic financial strain or social isolation
    • Being divorced, widowed, or navigating significant life transitions

    These influences can increase vulnerability, but they don’t determine your future. Healing is absolutely possible, and it starts with compassionate, personalized care. In the heart of Mill Valley, we provide a safe, stigma-free space to begin understanding the “why” behind your anxiety and what to do next.

    What are the most common types of anxiety disorders?

    Anxiety can wear many faces, and recognizing its form is the first step toward treatment. Some of the most frequently diagnosed anxiety conditions include:

     

    1. Generalized Anxiety Disorder (GAD):
      Persistent, excessive worry that feels impossible to shut off
    2. Obsessive-Compulsive Disorder (OCD):
      Repetitive, intrusive thoughts and behaviors that feel out of your control
    3. Panic Disorder:
      Sudden surges of intense fear, often with physical symptoms like chest pain or shortness of breath
    4. Post-Traumatic Stress Disorder (PTSD):
      Lingering psychological and emotional distress following trauma
    5. Social Anxiety Disorder (Social Phobia):
      Intense fear of judgment or embarrassment in social settings

    Each of these conditions deserves nuanced, individualized care.

    How is an anxiety disorder diagnosed?

    Anxiety becomes a clinical concern when it begins to interfere significantly with daily life, work, school, relationships, or health. Diagnosis usually involves a thorough clinical interview and sometimes lab work or referrals to rule out physical conditions that can mimic anxiety, such as thyroid disorders, cardiovascular issues, menopause, or medication side effects.

     

    At Recovery Without Walls, we don’t rush to label or pathologize. Instead, we take the time to listen deeply, understand your whole story, and offer integrative assessments that consider your emotional, physical, and energetic health.

    How is anxiety treated at Recovery Without Walls?

    We believe anxiety treatment should be just as multifaceted as the condition itself. That’s why we tailor each care plan to reflect your unique biology, lifestyle, and values.

     

    Evidence-based options may include:

    • Cognitive Behavioral Therapy (CBT) and other trauma-informed talk therapies
    • Somatic and mindfulness-based practices to support nervous system regulation
    • Support groups and community-based healing
    • Integrative nutritional psychiatry and functional medicine
    • Thoughtful, individualized use of medications, when needed

    Rather than defaulting to a medication-first model, we prioritize a “less is more” philosophy, avoiding irrational polypharmacy and using pharmaceutical support only when clinically indicated.

    What medications are used for anxiety and how does Recovery Without Walls approach them differently?

    There are several classes of medications commonly prescribed to help manage anxiety, including:

    • SSRIs (Selective Serotonin Reuptake Inhibitors)
    • SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors)
    • Benzodiazepines
    • Tricyclic antidepressants
    • Beta-blockers for certain performance-related anxieties

    While these can be helpful tools, they’re not always the full answer, and they’re certainly not the starting point for every patient. Our clinical team takes a conservative, evidence-based approach to prescribing, using the smallest effective dose when needed and always aiming to complement medication with lifestyle, somatic, and therapeutic interventions.

    How is Recovery Without Walls different when it comes to treating anxiety?

    Located in the serene surroundings of Mill Valley, our clinic offers a calm, supportive atmosphere where healing feels possible, not clinical or cold. We view anxiety not as a flaw to fix but as a message from the body, asking for deeper attention.

     

    Whether you’re navigating chronic anxiety or recovering from a recent crisis, we offer pioneering care grounded in science, compassion, and your lived experience. From first appointment to long-term support, we walk alongside you with empathy and innovation.

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