TMS Plus Personalised Anatomical and Psychological State Targeted Treatment Designed Around Your Life

By Dr Gary Galambos | MindSkiller

If you are considering treatment for depression or obsessive-compulsive disorder, you may have two equally important questions: could this help me, and how will I fit it into my life? Work, study, family responsibilities and the distance from a treatment centre can determine whether a course is achievable.

TMS Plus brings these questions together. It combines MRI-guided transcranial magnetic stimulation (TMS) with AI-Personalised Immersive Therapeutics (AI-PIT), within a coordinated course of assessment, preparation, treatment and review. Our three packages — Accelerated, Signature and Modular — offer different ways to organise that care around your clinical needs and circumstances.

Watch the cinematic video   |  Listen to the podcast  

The video introduces the course of care; the podcast offers a longer conversation for patients and families.

Biology psychology and the circumstances of your life

Anatomical targeting uses MRI-guided planning, neuronavigation and mapping to identify the intended stimulation target. Psychological state targeting uses personally meaningful therapeutic media to engage you in work relevant to your symptoms and goals. Social flexibility considers when, where and for how long you can realistically attend.

These are connected parts of biopsychosocial care. Package selection considers your diagnosis and response, your readiness and need for structure, and your work, study, travel and family circumstances. It is a decision made with the treating team.

Biological, psychological and social considerations come together around the person. This is a conceptual illustration of the treatment approach; the additional benefit of combining its components is being evaluated.

A package includes more than TMS sessions

The course overview distinguishes the number of TMS sessions from the total number of healthcare consultations. The total already includes your TMS sessions, alongside the workup and review consultations indicated in your package. These may cover psychiatric assessment, script development, mapping, neuronavigation, sensory personalisation and clinical reviews.

For example, a course described as 35 TMS sessions also involves the additional appointments needed to prepare, coordinate and review that treatment. You should not add the TMS count to the total consultation count: the stimulation sessions are already included.

Your individual quote and schedule explain what is planned, where appointments will occur and the attendance commitment involved. This helps you plan leave, travel and family support for the whole course.

Getting started with assessment and a quote

If you are completely new to the service, the starting point is a psychiatric assessment, often by telehealth. We discuss your symptoms, previous treatments, health, goals and circumstances, answer your questions and assess suitability. Existing patients and people referred within the ecosystem may enter through an established clinical pathway.

Outcome measurement begins early, using questionnaires and, where appropriate, clinician-rated scales. After assessment, the TMS coordinator clarifies the proposed course and applicable Medicare eligibility and rebate arrangements. You receive an individual quote; costs and rebates depend on your circumstances. Once you accept the quote, preparation and script development are arranged.

The coordinated journey moves from assessment and preparation through treatment to reviews and resources to take home.

Three ways to organise your course

The packages make different attendance patterns possible. Our experience so far has not suggested an obvious benefit difference between Accelerated and Signature delivery, but this is a clinical impression rather than established evidence of equivalent effectiveness. We choose the pathway by considering the whole person.

Accelerated concentrated treatment blocks

Accelerated treatment uses twice-daily weekday sessions when clinically appropriate. It can suit people travelling from regional areas, interstate or overseas, or those with a limited window of leave or a university break.

The initial block comprises 20 treatments for treatment-resistant depression (TRD), or 24 for the OCD-focused pathway. A subsequent block may provide a further 15 TRD treatments or 11 OCD-focused treatments. Where both parts are prescribed, these total 35 TMS sessions. A review and agreed interval — often around a month — allow a return for the next part. Accelerated describes the concentration of sessions within the blocks; your coordinator confirms the actual dates.

Signature continuity and a planned transition

Signature provides an initial weekday course followed by progressively spaced weaning or consolidation. The listed pathways contain 35 TMS sessions: 20 plus 15 for TRD, or 24 plus 11 for the OCD-focused pathway.

This can suit people able to attend locally over a longer period, and people who benefit from a clear plan and ongoing structure. We have observed that some patients lose momentum during a break and find it difficult to return. A planned transition can help support engagement as appointments become less frequent.

Modular building the next stage after review

Modular treatment starts with either a 20-treatment TRD module or a 24-treatment OCD-focused module. An agreed interval can allow you to return home before the next stage. In our service, this is often around a month, with intervals of approximately two to eight weeks depending on circumstances and clinical need.

Review then guides the next step: consolidation or weaning for the initial target, or a change from depression-focused treatment to OCD-focused treatment, or vice versa. A change of target may involve further script development, mapping and sensory personalisation.

Modules may use standard or accelerated attendance patterns when appropriate. The modular approach creates opportunities to reassess clinical response and practical needs before committing to the next stage. The interval is individually planned; it is not a prescribed period for the brain to rest.

The Modular pathway can begin with TRD or OCD treatment. An individually agreed interval and clinical review guide consolidation or a change of target; the interval is not a required biological rest period.

Personalisation begins before the first stimulation session

We plan at least two preparatory or script development sessions before treatment begins. These can start remotely, particularly if you are travelling to Sydney. Riverside helps us capture audio and visual material for the personalised content.

You are encouraged to gather meaningful photographs, music, videos and memories, and to consider the activities, relationships and goals that matter to you. MindSkiller e-learning supports this process, especially Module 1.1 on defining goals. Looking through your own material can help clarify what you want to reconnect with and what you hope treatment will make possible.

AI-BEAT draws on positive autobiographical material and behavioural activation themes. AI-ERP uses personalised exposure and response prevention themes for OCD, supporting work on facing triggers and resisting compulsions. Content development is currently led by Dr Gary Galambos and Dr Stéphane Verhaeghe , with nursing and production support; psychologist involvement is developing.

Immersion and your experience during treatment

TMS Plus attends to visual, auditory and olfactory experience alongside anatomical and psychological targeting. When the first personalised video is available, an evaluation helps refine the content and scent profile for you.

Scent is an integrated part of the care model . Feedback from some patients suggests that it contributes substantially to their sense of immersion. Its added clinical benefit, and how immersion relates to response, remain under evaluation. The purpose is to support the therapeutic experience rather than use scent as a standalone treatment for a psychiatric disorder.

TMS can be uncomfortable, and exposure work can be demanding. Tell the team how you are experiencing the sessions so that tolerability and the treatment plan can be reviewed. Personalised media supports engagement; it does not guarantee a painless experience or a particular outcome.

Clinical review determines the next step

We aim to review progress after the initial 20- or 24-treatment block and again after Part 2 or the completed course. Extra reviews can be arranged when a change of plan is needed. Decisions draw on symptom measures, functioning, goals, tolerability and your own experience, with input from trusted supporters when you agree. Clinicians oversee these decisions; AI does not independently choose your treatment.

Care that continues outside the treatment room

MindSkiller supports outcome questionnaires, e-learning, goal reflection and agreed homework between appointments. Psychological treatment, including in vivo exposure, group therapy and inpatient care, can also be coordinated where appropriate. These activities help connect the treatment course with daily life.

AI-REFLECT 1 provides a personalised introduction to the plan. AI-REFLECT 2 brings together learning from the course, strengths, meaningful experiences, goals and agreed next steps. Its principal purpose is as a resource to take home and revisit, although Reflect material may sometimes be used during sessions while other personalised content is being completed.

With your agreement, these resources can also help family members understand the treatment and how to support you. Families have told us that the materials helped them feel supported and better informed. Family-directed podcasts are also being explored. Sharing is agreed with you and respects the applicable consent arrangements.

MindSkiller and AI-REFLECT resources support preparation, learning and continued engagement for patients and, with their agreement, families.

Three locations with coordinated oversight

Treatment is available at Adelaide Street Clinic in Woollahra , City X-Ray at Martin Place , and Beaches X-Ray at Dee Why . You may move between practices by arrangement with the TMS coordinator. Your marked anatomical cap accompanies you, together with coordinated transfer of the prescribed protocol, parameters and relevant clinical information.

MindSkiller supports remote psychiatric oversight and communication across the course. This flexibility depends on coordination and clinical handover, so changes of location should be arranged in advance.

Learning from care and refining the model

The U-INSPIRE and O-INSPIRE naturalistic research programs evaluate feasibility, acceptability, patient experience and signals of benefit across the integrated model. They can inform refinement and future studies, but observational improvement alone cannot establish which component caused a change or prove additional benefit from combining components.

Research participation follows the applicable consent and governance processes. The use of personalised media, sensory elements and emerging measurement tools is guided by clinicians, while their contribution to outcomes continues to be investigated.

Planning a course that you can engage with

The first step is a conversation about what is clinically appropriate and what you can realistically manage. Your goals, support needs, capacity to attend and preference for continuity or separate blocks all help shape the plan.

Contact the TMS coordinator to discuss assessment, an individual quote, treatment locations and scheduling: coordinator@tmsplus.com.au

Speak with the TMS coordinator about assessment, preparation and an individual schedule.

The accompanying video, podcast and slide illustrations were produced using AI-assisted tools. The cinematic video uses a Riverside voice clone of Dr Gary Galambos. Slide illustrations are conceptual and do not depict actual patients or staff. This article provides general information; individual suitability and treatment plans are discussed with the treating team.