DR. Jake Creviston
DNP, RN, PMHNP

The road to my career as a psychiatric nurse practitioner has somewhat odd beginnings…

But these beginnings informed my approach to therapy.

An abstract, black and white art piece of hands covering a stark and featureless face.

Art by Bethany Garrison

Curiosity has informed the way I practice. I believe in a “yes, and…” approach that allows you to explore without judgement. As your therapist, it is more impactful for me to help you heal than it is to “fix” you. The truth is that there aren’t easy fixes, but a commitment to the hard work of healing has proven to be a more effective method of treatment for my clients. I don’t have all of the answers, but the answers often reveal themselves as we collaborate to uncover more about who and what you are. 

While I may have the tools to guide you through your exploration, I’m also on the same journey. I, too, engage in weekly therapy and mentorship, and have for years. I have found it remarkably healing and enriching. I am of better service to my clients when I also prioritize my mental health. 

My practice is open to people of all identities, socio-political affiliations, and socioeconomic statuses. I operate with an understanding that our differences must be acknowledged and celebrated, especially in an environment that requires intense vulnerability. While it isn’t your responsibility to teach me, I am open to learning and hope, in turn, that increased understanding will enhance the depth of our relationship.

Think of me as your co-pilot on life's turbulent expedition. 

Visit my Psychology Today profile for more information about my specialties, qualifications, and credidations.

A smiling picture of Jake.

Service and curiosity have been consistent themes in my career. From my experience in the U.S. Coast Guard to my 10+ years in nursing (ER and ICU), international mission service, mental health professorship, and now my practice as a psychiatric mental health nurse practitioner, I’ve intended to serve my communities with humility, compassion, and curiosity. 

After responding to the terror attacks on September 11th, 2001 with the U.S. Coast Guard, I wondered how my peers — and our nation — would respond to such intense trauma. We were afraid, angry, and impulsive — all expected and appropriate responses to trauma. I wanted to learn how to manage those responses in order to heal, or at least intentionally move forward.

As an Emergency Room and ICU nurse, I was confronted with a similar, existential question: how and why do humans respond to trauma? How do we treat a 35-year-old husband who has instantly lost his wife to complications of an undiscovered cancer? Because he needs treatment, too. In the end, I found that physical ailments often required more clearly defined “fixes'' than the psychosocial ones.

A friendly picture of Jake.

FAQs

Will I always suffer from my diagnosis or can I be cured?

Will I always suffer from my diagnosis or can I be cured?

Most of us who suffer from psychological distress find yourself relieving patterns of this distress. There is often great fear that these patterns will continue throughout life. Life's circumstances and biological attributes may predispose us to or reinforce some of these patterns but it is possible to alter them. So much of our suffering is related to the stories we tell ourselves e.g., "I'm always going to be anxious." or "My depression keeps me from doing..." Though we may on occasion still feel anxiety, depression, or other distress, it is possible to suffer much less from them by reframing our stories, to allow the emotional experience to reveal its message and then allow it to pass. With effective therapy and treatment, clients should experience less stress less often.

Can you give me an accurate diagnosis?

Can you give me an accurate diagnosis?

I can use the Diagnostic and Statistical Manual of Mental Disorders (DSM) to diagnose particular symptoms and am often compelled to by insurance requirements. Some clients find great benefit in having a label for the challenges of their lived experiences and some find a diagnosis to be a burden or a challenge to their actualization. I am cautious to use diagnostic labels to help clients heal. It's worth noting that psychiatric diagnostics are merely a label to describe a set of symptoms and do not explain the origin of our challenges, symptoms and sufferings nor do they dictate treatment.

How will I know if therapy is working?

How will I know if therapy is working?

Fabulous question. I remember being about a year into therapy before thinking, "huh, something is changing for the better." Others experience profound shifts and gains much sooner and some later. The gains in my particular therapeutic practice are often more broad than clients expect. Most clients want to feel better. Though this is a common outcome, more commonly clients tend to report being able to better weather life's hardships, increased joy, sense of purpose, presence with others, a stronger sense of self and personal desires and confidence to achieve them, bolstered confidence, increased awareness and more intentionality. I encourage clients to set goals around merely learning more about yourself so as to create space for the unforeseen benefits therapy may spark.

How long will I need to take medication?

How long will I need to take medication?

This depends. It can often take several tries before finding a medication that works well. Most of the literature recommends staying on a medication for about a year after symptoms have abated. Sometimes folks desire and warrant staying on them longer. Again, we will work collaboratively to make a safe and effective medication management plan, including discontinuation.

Do I need medication?

Do I need medication?

I do not tend to use the word "need" when it comes to medication. There are times when medications can be very helpful in treating symptoms so distressing that they challenge our ability to do the deeper, more sustaining work of psychotherapy. I approach medication management in a very collaborative manner, involving the client in all decisions, choices and doing my best to educate clients so they may make the most appropriate and informed decisions about the chemicals they put in their body.

What if we're not a good fit?

What if we're not a good fit?

Humans are tricky animals. I understand I will not be the right fit for every prospective client. I encourage clients to give the process some time. If we truly are not the best fit, the client and I have the right to terminate the relationship at any time. We will have a final session to discuss referrals, feedback as appropriate, and offer closure to our relationship.

What does payment look like?

What does payment look like?

My biller will verify your benefits and let you know the out-of-pocket cost to see me. I collect payment after each session by emailed invoice. I can also save clients' credit cards to further automate this process. Bear in mind that deductibles reset at the first of the year, at which time clients are responsible for out-of-pocket costs commiserate with the agreed rate at which your insurance carrier will reimburse me for applicable services until the deductible is met.

Do you do CBT?

Do you do CBT?

Though I do incorporate many attributes of CBT, DBT and other "brief therapy" modalities, I do not focus on them nor do I adhere to their manualized formats.

What is the time commitment of psychotherapy?

What is the time commitment of psychotherapy?

I often ask prospective clients to commit to at least three initial sessions in order to develop a sense of fit before making a decision to continue. I tend to see folks weekly and sometimes biweekly often for indefinite amounts of time. It may take several months to a year before recognizing profound gains.

What is your training?

What is your training?

My background in health began as an ER and ICU nurse where I guided many patients and families through the process of critical illness and sometimes death. I continued on to earn a Masters as a Psychiatric-Mental Health Nurse Practitioner and then furthered my studies by completing a Doctor of Nursing Practice degree focused on mental health and leadership in 2015. I have had weekly to biweekly mentorship in therapy since 2014.

How do you see clients during the COVID pandemic?

How do you see clients during the COVID pandemic?

I have switched to nearly 100% virtual appointments since the COVID-19 pandemic. As such, I use a HIPPA compliant virtual video conferencing platform to meet with patients. I also offer socially-distanced walking appointments contingent on weather and current pandemic precautions. Feel free to ask about these options. In non-pandemic times, I see clients face-to-face in my office and plan to go back to face-to-face as soon as safe to do so.

Jake has helped bring about major positive change in my life. We have journeyed through difficult depression, starting medication, stopping medication and continue to enrich my life.

I finally feel safe, understood, and accepted enough to begin untying the knots in my mind that have held me down for a very long time.

Working with Jake has helped me to understand myself, my wounds, and my perceptions / reactions to those around me.

Jake has helped bring about major positive change in my life. We have journeyed through difficult depression, starting medication, stopping medication and continue to enrich my life.

Jake meets me exactly where I am. He has always made me feel like I'm in the drivers seat in my therapeutic process, and has guided me to a more grounded life.

Jake isn't afraid to push on emotionally charged topics, but has a knack at knowing when to show compassion and understanding when you need it.

Jake's openness and honesty about not having the answers or a quick fix. While I set out looking for tools to fix myself, I gained insight that has been much more valuable.

Jake is compassionate, real, and easy to talk to. I’ve opened up about some pretty ugly things and have never once felt judged or misunderstood.The work we’ve done has been tremendously healing.

Jake is transparent with his thoughts and feelings, and encourages a slow, thoughtful process. He has a gentlenss as well as a bravery in connection and vulnerability.

Jake is a great listener and picks up on subtleties like phrasing and body language to dive deeper into the issues we discuss.