Navesink Team Member
Kara Rafael, MSN, APN, PMHNP-BC

What drew you to this type of work?
Psychiatry is a field that values nuance, context, and the understanding that no two people experience distress in the same way. I’ve always been drawn to work that requires curiosity about human behavior — how people cope, adapt, and function through stress, change, and uncertainty. Mental health is rarely straightforward, and I appreciate that psychiatric care requires curiosity and a willingness to look beyond surface-level symptoms.
What resonates most with me about this work is the opportunity to see each person as an individual, rather than a diagnosis. Effective psychiatric care considers biology, life experience, environment, habits, and timing — not just symptoms in isolation. I value work that allows for individualized care, thoughtful decision-making, and a treatment approach that evolves as a person’s life and needs change.
What do you value most in the clinician–client relationship?
I place a strong emphasis on transparency, collaboration, and mutual understanding. Clients should always know why a recommendation is being made and how it fits into the larger treatment plan. I never want care to feel rushed, confusing, or transactional.
I view psychiatric treatment as a partnership. My role is to offer clinical expertise, explain options clearly, and help clients make informed decisions that align with their goals and values. When clients feel heard, informed, and involved, care becomes more effective and sustainable.
What do you want clients to know before their first session?
You don’t need to have everything figured out before your first appointment. Many people seek psychiatric care during periods of overwhelm, transition, or uncertainty, and it’s okay if things feel unclear at the beginning.
The first session is not about quick fixes or immediate decisions. It’s about understanding what’s going on, how symptoms are affecting daily life, and what options exist moving forward. My goal is for clients to leave feeling more informed, supported, and confident in the direction we’re taking together.
How do you integrate different approaches to meet each client where they are?
Psychiatric care is never one-dimensional. I don’t view medication as the only solution — or always the best one. While medication can be helpful, psychiatric care is broader than prescribing alone. I take an integrative approach that looks at sleep, nutrition, physical activity, daily structure, stress levels, and overall lifestyle alongside medication management.
I want to understand how treatment is affecting a client’s real, day-to-day life — how they’re sleeping, functioning at work, managing relationships, and moving through their day. Medications are regularly revisited, adjusted, or discontinued as needed, and they are never treated as a permanent or automatic solution. The goal is always to support health, functioning, and quality of life in a way that feels sustainable.
What types of clients tend to resonate most with your approach?
Clients who appreciate a thoughtful, integrative, and collaborative approach tend to resonate most with my style. Many are looking for psychiatric care that feels comprehensive rather than rushed — care that takes into account how mental health intersects with physical health, habits, and lifestyle. Clients who are looking for a better understanding of what’s driving their symptoms – not just a prescription.
I work well with individuals who value transparency, ask questions, and want to feel actively involved in their care. My approach tends to resonate with people who want psychiatric care that feels grounded, human, and practical.
”Kara Rafael was incredibly thorough and comprehensive in her evaluation when I came to her struggling with anxiety. She made herself available throughout the entire process, always ready to answer questions and provide the support I needed. Her approach not only helped me manage my symptoms but also made me feel truly cared for and understood.“
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