Andrew Smith approaches psychiatric care with a calm, grounded presence built over nearly a decade in a cardiothoracic ICU. Working first as a patient care assistant and then as a bedside nurse, he learned how to think clearly under pressure, and advocate for people during the hardest moments of their lives. That foundation now shapes how Andrew shows up for his patients and how he stays present with the people in his care.
Specialty & Approach to Therapy
Andrew works with young adults and adults navigating anxiety, depression, and co-occurring substance use, with particular attention to those caught in cycles of rumination, avoidance, or emotional dysregulation. He has experience working with LGBTQIA+ patients and underserved communities, including those managing complex or overlapping challenges during periods of transition.
For Andrew, the patient-provider relationship is where the real work happens. He values getting to know patients over time — understanding who they are beyond a single hard moment, and helping them make sense of what they’re going through at their own pace. He draws from a range of evidence-based approaches, with cognitive behavioral therapy (CBT) as the backbone, complemented by dialectical behavior therapy (DBT) and supportive therapy. When medication is part of the picture, it’s introduced thoughtfully and collaboratively, never one-size-fits-all. Whether the work is helping someone identify intrusive thoughts, or building practical tools for the week ahead, care is tailored based on where each person is.
Advice for Those Seeking Mental Health Care
Andrew’s message to anyone starting therapy for the first time is to give yourself permission to begin without having it all figured out. “You don’t need everything sorted before your first visit. Just showing up is a real step. Therapy is a process, and it’s okay if it takes time to feel comfortable.”
When it comes to choosing a provider, he encourages people to trust how they feel in the room. “Look for someone you feel comfortable talking to — that connection matters more than anything. It’s okay to ask questions about their approach and try a few sessions before deciding. The right provider should make you feel heard, not judged.”
Finding Balance Through Self-Care
When it comes to his personal life, Andrew keeps it intentionally simple. He decompresses by watching TV shows, as well as playing guitar and writing music, which gives him space to reset and clear his head. Holding a clear line between work and personal time is part of how he stays present for his patients the next day.
Andrew and the rest of the Rivia Mind team are here when you’re ready. Reach out to learn more or find a clinician who aligns with your needs.
