Questions you probably have.

Both are doctoral-level professionals, but they do different things. A psychologist (like Dr. Dowling) holds a PsyD or PhD, and specializes in assessment, diagnosis, and therapy. A psychiatrist is a medical doctor (MD) who primarily prescribes and manages medication.

At Breakwater, Dr. Dowling provides thorough psychological assessment and evidence-based therapy. He doesn't prescribe medication. However, if medication might be helpful, he can coordinate with your prescriber or help you find one. Many clients work with both a psychologist and a psychiatrist. The psychologist handles therapy and the psychiatrist manages medication.

No. You can self-refer for both therapy and ADHD assessment. No referral from a physician, therapist, or other provider is required. Just book a free consultation and we will take it from there. If your insurance plan requires a referral for mental health services (some HMO plans do), we recommend checking with your insurer first, but most plans we work with don't require one.

Yes. All therapy sessions and assessment appointments are conducted via secure, HIPAA-compliant video. You can be seen from anywhere in Oregon: Portland, Bend, Eugene, Medford, the coast, rural areas, anywhere. The only requirement is that you are physically located in the state of Oregon during your session.

The research consistently shows that telehealth therapy is equally effective as in-person care. And for many people, it is actually more convenient and comfortable. No commute, no waiting room, just therapy from wherever you feel most at ease.

We see adolescents and adults for therapy. For ADHD assessments, clients must be 18 or older due to the nature of the evaluation tools we use. We don't work with young children. If you are looking for a child psychologist, we are happy to point you in the right direction during a consultation.

We offer daytime, evening, and weekend appointments throughout the week to accommodate different schedules. Whether you need a midday session during a lunch break or an after-work appointment, we have options. Availability varies, so book a consultation and we will find a time that works for your life.

Most people have their first session within one week of their consultation. We intentionally keep our caseload manageable so you don't end up on a waitlist. When you are ready to start, we are ready to see you.

Assessment answers a specific diagnostic question: Do I have ADHD? What is actually going on? It involves structured testing across multiple data points and produces a comprehensive written report with a diagnosis, supporting evidence, and actionable recommendations.

Therapy is ongoing treatment. It means managing a diagnosis, building skills, working through challenges, and making lasting change.

Many clients do both, and they complement each other. If you start with an assessment at Breakwater and then move into therapy, your therapist already knows exactly what the evaluation found. No handoff, no re-explaining your history.

Your PCP can do a brief screening, but that is different from a comprehensive evaluation. Screenings typically involve a short questionnaire and a conversation. They catch obvious presentations but often miss subtler ones, especially in adults who have spent years developing coping strategies that mask their symptoms.

A comprehensive psychological evaluation uses multiple validated instruments, a structured clinical interview, collateral data from someone who knows you well, and integrated scoring. It looks at the full picture, including conditions that mimic ADHD (like anxiety, depression, or sleep disorders) and conditions that co-occur with it. The result is a thorough, accurate answer, not a best guess.

Then you get a clear answer, and that is still valuable. The evaluation doesn't just test for ADHD. It screens for anxiety, depression, PTSD, and other conditions that can look like ADHD or contribute to similar symptoms. You will walk away understanding what is actually going on and what to do about it, regardless of the diagnosis. Many people find real relief just in having clarity after years of uncertainty.

Yes. Your report includes ADA-compliant documentation with specific recommendations for accommodations tailored to your situation. It is designed to be accepted by employers, universities, and professional testing agencies (like the LSAC for the LSAT, AAMC for the MCAT, NBME for medical licensing exams, and similar bodies). If you need the report formatted for a specific institution, let us know and we will make sure it meets their requirements.

Observer ratings strengthen the evaluation by providing an outside perspective on your daily functioning, but they aren't required. If you don't have someone you are comfortable asking, or if your situation makes it impractical (you live alone, you aren't close with family, etc.), we can still complete a thorough assessment without them. Luke will factor the absence of observer data into his analysis and rely more heavily on other data sources.

Most assessments are completed within one to two weeks. There are two live sessions (the clinical interview and the results session), plus self-report measures you complete on your own through our secure portal (about 45-60 minutes at your own pace), and observer ratings completed by someone who knows you well (about 20 minutes). The total time investment is significant because this is a real evaluation, not a quick screen.