My Story

Hello, I’m Dr. Ashley Nelson. I’m a Psychiatric Mental Health Nurse Practitioner (PMHNP) and therapist dedicated to helping individuals move from surviving to truly thriving. With a background in psychiatric nursing, emergency medicine, and specialized training as a Sexual Assault Nurse Examiner (SANE), I bring over a decade of diverse healthcare experience, blending clinical expertise with a deep understanding of human resilience in the face of crisis. My practice focuses on supporting adults, children, and families through life’s challenges — including anxiety, depression, trauma, PTSD, and the unique stressors faced by military members, first responders, nurses, and other helping professionals.

I have a deep passion for working with survivors of domestic violence, sexual assault, and complex trauma, providing a safe, compassionate space where healing feels possible. My approach blends evidence-based psychiatric care with practical, real-life strategies, empowering clients to reclaim their sense of control, rebuild confidence, and create lives that feel meaningful again.

My Story

Hello, I am Steve Hurley, a board-certified Psychiatric–Mental Health Nurse Practitioner (PMHNP-BC), ANCC and AANP certified, with a background in inpatient psychiatry, complex medication management, and high-acuity behavioral health care. I previously served as a U.S. Navy Independent Duty Corpsman (IDC), on ultra deep water drilling platforms and as a Sheriffs Deputy. I understand the high-pressure environment where decisions carry real consequences, stress is constant, and performance is expected regardless of fatigue, uncertainty, or personal cost.

My clinical work emphasizes precise diagnosis, minimal-effective-dose pharmacology, and disciplined follow-up, particularly for mood disorders, anxiety, trauma-related conditions, and treatment-resistant presentations. I have extensive experience in state hospital and inpatient environments managing psychosis, severe mood instability, and risk-sensitive cases.

I provide discreet, high-quality psychiatric care for adults, including professionals, veterans, and individuals in high-pressure roles who value clarity, structure, and accountability in treatment. My approach is practical, evidence-based, and focused on measurable improvement rather than over-treatment.

Our Services for Children, Teens, and Adults

At Mindful Essence, we provide compassionate, evidence-based mental health care for both adults and children. Whether you’re seeking help for yourself or your child, we believe in personalized treatment, shared decision-making, and ongoing support for your mental health journey. Care is available both in-person and through telehealth (if permitted by your insurance).

Diagnostic Evaluations

For Adults

A comprehensive psychiatric evaluation lasting 60–90 minutes.
We review your medical and mental health history, prior medication trials, current symptoms, and goals.
Screening tools such as the PHQ-9 (depression), GAD-7 (anxiety), and PCL-5 (trauma) help guide diagnosis and treatment.
Lab work or vital signs (e.g., thyroid, blood sugar, cholesterol, heart health) may be recommended for a full picture.

For Children & Adolescents

 Age-appropriate evaluations that include input from both the child and parents/guardians.
Focus on developmental history, school performance, behavior, and family dynamics.
Use of standardized rating scales such as the ASRS (ADHD), SCARED (anxiety), and depression/trauma measures.
Collaboration with schools and pediatricians when needed, with signed parent consent.

Medication Management

What Patients Can Expect

Medication decisions are always collaborative. We carefully review benefits, risks, and alternatives.
Prescriptions are sent electronically to your preferred pharmacy (including controlled medication e-prescribing).
Visits are more frequent when starting or adjusting a medication (every 2–4 weeks) and then move to every 2–3 months once stable.
We monitor progress using rating scales, symptom check ins, and labs/vitals when appropriate.

Medications We Commonly Prescribe and Manage

Antidepressants: SSRIs, SNRIs, bupropion, mirtazapine, etc.
Anxiety treatments: buspirone, beta-blockers for performance anxiety; benzodiazepines only when absolutely appropriate with safety planning.
Mood stabilizers & antipsychotics: for bipolar disorder, mood dysregulation, or augmentation of antidepressants.
Sleep medications: favoring non-habit-forming options whenever possible.
Adjuncts: such as hydroxyzine, magnesium glycinate, or other supportive agents.

Our Approach

Start low, go slow: medications are titrated gradually to minimize side effects.
Safe discontinuation: when stopping a medication, we taper slowly to prevent withdrawal effects.
Benzodiazepine stewardship: we prioritize non-benzo options first. If tapering is needed, we use very gradual dose reductions with close monitoring and coping skills support.

Psychotherapy

We believe medication alone is rarely the full answer. Therapy is offered in two formats:

Psychotherapy combined with medication management – for patients who benefit from both.
Psychotherapy alone – available for patients who do not need or wish to use medications.

Therapeutic Approaches May Include:

Cognitive Behavioral Therapy (CBT)
Acceptance and Commitment Therapy (ACT)
Dialectical Behavioral Therapy (DBT) skills
Trauma-focused therapies
Stress management, mindfulness, and coping strategies

Safety & Office Policies

Controlled medications: PDMP is checked regularly; one designated pharmacy; no early refills for lost or stolen prescriptions.
Telehealth: secure audio/video platform with location and emergency contact verification.
Referrals: patients with higher-risk needs (active suicidality, severe substance use, unstable medical conditions) may be referred to higher levels of care.
Emergency planning: all patients are given clear instructions on when to seek emergency help.

The Treatment Journey

Intake Appointment (60–90 minutes): full history, diagnostic review, initial plan.
Stabilization (2–12 weeks): close follow-up while adjusting medications or therapy.
Maintenance: once stable, visits every 2–3 months (or sooner if needed), with periodic labs and therapy check-ins.

Our Philosophy

Our goal is effective symptom relief with the least medication burden possible. We want you (or your child) to feel better, function more fully, and build resilience. We value:

Safety and careful monitoring
Shared decision-making
Integration of skills (therapy, coping tools, lifestyle support) with medication when needed
Respect for patient preferences and family involvement

Contact

We always looking for new and exciting opportunities. Let's connect.

Mindfulessencepsychiatry@gmail.com

864-965-7556