It takes courage, committment and trust to enter into treatment involving one's emotional health. I view a treatment relationship as a collaboration where the doctor and patient are equal participants in the treatment process.
In the thirty years I have practiced medicine, I've been humbled by the advances in research, technology and availability of new treatments. However, I have been discouraged by the erosion of the doctor/patient relationship that has taken place in our country. I am committed to providing "an old school" approach in my practice style. I take the time that is necessary to get to know a patient (and, if indicated, their family) and work with he or she in a way that respects the importance of the therapeutic relationship in achieving treatment goals.
I believe in educating patients about their mental health issues. Knowledge is power. I believe that the more a person knows about their problem or illness, the easier it becomes to overcome it or cope with it.
I am well trained and experienced in delivering both expert psychopharmacology and psychotherapy. As a psychiatrist who is equally skilled at both, I believe that a patient benefits by having one treatment provider rather than splitting treatment between a psychiatrist and a therapist. In my opinion, sub-optimal treatment may occur without an integrated approach to medication management and psychotherapy. However, if I believe there is another provider in the community who may have more skills to treat a particular problem or that a “better fit” may be achieved with another provider, I will refer the person to that provider for therapy and assure a coordinated treatment approach. If patients are seeing another provider for therapy, I will see them in my practice for medication management only if I have a working relationship with the therapist.
I do not recommend medications for all patients. A third of my patients are seen for psychotherapy alone. I guide my patient’s choices about treatment by reviewing the research and my clinical experience with them. If research shows that psychotherapy alone may be as effective as medications for a particular problem, I will involve the patient in a choice about which they prefer and reassess the choice after a period of treatment.
Many patients ask me which theoretical approach I use in psychotherapy. Throughout my academic and clinical career, I have been fortunate to have gained experience with many forms of psychotherapy. Although I was originally trained as a psychodynamic therapist, I have developed expertise in cognitive behavioral therapy, exposure and response prevention therapy, panic control therapy, mindfulness based cognitive behavioral therapy, acceptance and commitment therapy, solution focused therapy, and behavioral activation. I am also familiar with principles of dialectical behavioral therapy and, although not my area of expertise, use elements of this therapy when treating patients who would benefit by these skills. Although I treat both male and female adults in my practice, I have additional interest in specific issues in therapy for straight and gay men. I have also developed an interest in treating young adults in their twenties as effective treatment of psychiatric disorders during this important period of development may have a significant impact on the transition to adulthood.
Choosing a type of psychotherapy to use with a particular patient is based on the presenting problem, the patient’s learning style, patient motivation and patient preference. As an experienced therapist, I constantly re-evaluate the effectiveness of a certain approach and flexibly move from one approach to another as needed. I am an active psychotherapist. In my work with patients, I have found that lifestyle changes and alternative therapies may be important for some people to achieve their treatment goals. I assess diet, exercise, the use of substances (such as alcohol, marijuana, caffeine), the use of vitamins and supplements and stress management strategies. For those open to alternative treatments, I may recommend yoga, mindfulness practice, acupuncture or meditation as additional strategies to combat mood, anxiety, or attentional problems.
Relief from distressing symptoms, change and growth do not occur solely from a medication intervention or from participating in a series of psychotherapy sessions. It requires the courage to gain insight into one's inner life, to explore new perspectives, to develop new coping skills and to overcome the avoidance and fear that may stand in the way of change. Through psychotherapy, medication or a combined approach a patient has the opportunity to experience life in a different and more fulfilling way.