A new prescription leaves you queasy on a Wednesday afternoon. A hard week at work stirs up something you thought you had put behind you. A question about your treatment plan occurs to you the day after a session ends. In a traditional schedule, each of those moments waits for the next appointment. Concierge therapy at Cottonwood Psychiatry exists for exactly those in-between days: it adds a direct, secure messaging line to Dr. Colleen McGuire, so you can stay connected to your care without booking a full visit every time something comes up.
The Gap a Regular Appointment Schedule Leaves
Most psychiatric and therapy care is organized around scheduled visits. That structure works well for the deeper work, but life does not hold its questions until the calendar says it is time. Side effects appear between visits. Symptoms shift. Plans that looked clear in a session can feel less certain a week later.
When there is no simple way to ask, people tend to do one of two things: wait and worry, or make a change on their own. Neither is ideal. The concierge add-on is designed to close that gap by giving you a way to check in with the physician who already knows your history.
It works alongside your existing care rather than replacing it. Your regular appointments, whether for psychiatric medication management or ongoing therapy, continue as planned. Messaging fills the space around them.
How Messaging Through Spruce Works
Concierge members are connected to Dr. McGuire through Spruce, a secure messaging platform built for healthcare. Once you sign up, Dr. McGuire walks you through how Spruce works and how to get the most out of it.
Through Spruce, patients can:
Ask questions about their treatment plan
Get guidance on symptoms or side effects as they come up
Request minor medication adjustments between visits
Reach out for support and reassurance during a difficult stretch
Stay connected to their care without scheduling a full appointment
Because the practice is fully telehealth-based, messaging fits naturally with how care is already delivered. If you are new to virtual care, our practice’s telehealth overview explains how appointments by phone or computer work.
A Few Weeks with Messaging, in Practice
Consider someone who has just started a new medication after an evaluation. In the first week, they notice trouble falling asleep and send a short message asking whether that is expected and whether taking the medication at a different time of day might help. A few days later, a stressful family visit leaves them shaken, and they write to check in rather than carrying it alone until the next session. Toward the end of the month, they mention that one strategy from therapy is working and another is not, so the next appointment can start where it matters.
None of those messages needed a full visit. Each one, left unanswered, could have turned into weeks of uncertainty, a skipped dose, or a session spent catching up. That is the practical case for a messaging line: smaller questions get answered while they are still small, and appointments stay focused on the deeper work.
What to Send, and What Belongs Somewhere Else
Messaging is built for questions that matter but are not emergencies. A good rule of thumb: if it can safely wait a few hours for a thoughtful reply, it is a good fit for Spruce.
Messages that suit the service include a side effect you want to understand, a question about how to approach a dose change Dr. McGuire has already discussed with you, a check-in after a hard day, or a quick update on how a new strategy from therapy is going.
What does not belong in a message is a crisis. Concierge support is not a substitute for emergency care, and the practice does not take after-hours calls. If you are having thoughts of harming yourself, or you or someone else is in immediate danger, call or text 988 to reach the Suicide and Crisis Lifeline, call 911, or go to the nearest emergency room.
When Replies Arrive
Dr. McGuire personally reads and responds to every message. During business hours, Monday through Friday from 8:30 AM to 5:30 PM Mountain time, you can expect a response within one to four hours. Messages sent in the evening or over a weekend are answered the next business day.
That predictability is part of the value. Knowing roughly when you will hear back makes it easier to decide whether something can wait for a reply or needs a different route.
One Doctor Holding Both Halves of Your Care
A messaging line is only as useful as the person reading it, and this is where Cottonwood Psychiatry is different. Our practice is led by Dr. Colleen McGuire, a psychiatrist with board certification who also delivers evidence-based therapy herself. Elsewhere, a question about a side effect might go to a prescriber who has never heard what came up in therapy, while the therapist who has heard it cannot speak to the medication. Concierge members avoid that split: the physician answering a message holds both the medical and the therapeutic side of their care.
Dr. McGuire earned her medical degree from Touro University California, served as Chief Resident during her University of Colorado psychiatry training, and taught and practiced at Denver Health as an Attending Psychiatrist and Assistant Professor. Her experience spans inpatient, outpatient, and telepsychiatry care. Her clinical focus includes trauma, midlife hormonal issues, and alternatives to medication. You can read more about her background on the Cottonwood Psychiatry team page.
Is a Monthly Messaging Add-On Worth It for You?
Concierge therapy tends to be a good match for people who:
Want peace of mind knowing support is a message away
Have occasional questions between appointments
Are adjusting to a new treatment plan or a recent medication change
Prefer a more personal, ongoing connection with their physician
It may matter less if your care is stable and your questions comfortably fit into your scheduled visits. The service is a flat monthly subscription, and current details are on the concierge therapy page. Cottonwood Psychiatry is a self-pay practice and does not accept insurance.
Before You Sign Up: Questions Patients Raise
Does messaging replace my regular appointments?
No. Concierge support sits alongside your scheduled visits. Messaging handles the smaller questions and check-ins that come up in between, while evaluations, therapy sessions, and fuller medication reviews still happen in appointments.
Can I message about a medication problem?
Yes, for non-urgent concerns. Patients can ask about side effects and request minor medication adjustments between visits. Dr. McGuire will let you know if a question needs a full appointment instead of a message.
Who reads my messages?
Dr. McGuire personally reads and responds to every message sent through Spruce.
What if I need help outside business hours?
Messages sent after hours are answered the next business day. Concierge support is not designed for emergencies. In a crisis, call or text the Suicide and Crisis Lifeline, call emergency services, or go to the nearest emergency room.
Ask About Adding Messaging to Your Plan
If the stretch between appointments is where you most often feel on your own, concierge messaging may be worth a conversation. Dr. McGuire can explain how it would work with your current care and whether it fits what you need right now. Send us a note through our contact form, or call us to ask about getting set up on Spruce.
Dr. Colleen McGuire, DO, is a Board-Certified Psychiatrist with a holistic approach to mental health. She completed her medical training at Touro University and residency at the University of Colorado, where she served as Chief Resident. Specializing in trauma, midlife hormonal issues, and alternatives to medication, Dr. McGuire integrates therapies like Acceptance and Commitment Therapy (ACT). Licensed in multiple states, she is known for her empathetic, client-centered care and dedication to mentoring. Outside work, she enjoys piano, swimming, and spending time with animals.
Schedule an Appointment
Start your journey toward the life you’ve always wanted with the help of Dr. McGuire at Cottonwood Psychiatry, and contact us today. Fill out our contact form below.
Please note that we do not do after-hours calls. If you are in an emergency situation please call an emergency hotline.