The Talking Cure
Emotional problems are complex – there is seldom a simple solution to them. All of my patients are treated with compassion and dignity. I am LGBT affirming, and I don’t discriminate based on anything.
Some of the problems commonly addressed in treatment include depression, bipolar disorder, anxiety, phobias, OCD, sexual problems, and relationship troubles.
Your treatment here is completely confidential and your medical records are protected from disclosure to others by federal and state law, subject to some very specific limitations (such as the investigation of child abuse). Of course, if you authorize the release of your medical records, I am required to comply, so please be careful what you sign. This can be especially problematic when applying for life or health insurance, so you may want to consult with me or your attorney before you sign any blanket authorization for the release of your records. In any case, if I receive a request for your records I will attempt to contact you prior to releasing them.
I avoid the trap of the “mad surgeon”, who takes out every patient’s appendix, regardless of the illness, because that’s what he does best. I have studied various treatment approaches extensively and we will work together to find the most effective, evidence based treatment for your problems. The treatment approaches might include:
•Psychiatric Consultation Sometimes patients know exactly what kind of treatment they want, but often it’s hard to know what’s available and effective. Over the course of several sessions, we’ll review your history, try to understand where the problems began, and put together a preliminary treatment plan which may involve psychotherapy, medication, or other kinds of services.
•Psychodynamic Psychotherapy Patients are seen for 45-60 minute sessions, generally once or twice weekly. The focus is on helping the patient understand their thoughts, feelings, and behaviors, thereby relieving emotional symptoms, improving relationships, and freeing the individual to pursue happiness.
•Cognitive Behavioral Psychotherapy (CBT) has been shown to be particularly effective for Post Traumatic Stress Disorder (PTSD), especially when combined with Exposure Therapy.
•Psychoanalytic Psychotherapy is an intensive treatment, usually 3 to 5 times weekly. Seeing the therapist this frequently allows for increased access to disavowed or repressed aspects of the past and the self. It is the most effective treatment for achieving profound and lasting insight and change. Sometimes lying on the couch helps, but that’s always optional.
•Partner Psychotherapy After a period of evaluation, during which each partner will be seen individually, the couple is seen once a week or once every other week. Homework and exercises are often recommended. To make fast progress, it sometimes helps for both partners to also be in individual psychotherapy.
•Family Psychotherapy Families are usually seen in 45 – 90 minute joint sessions, one or two times per month. The focus is on improving family communication and helping the family become a healthy, open and loving unit.
•Group Psychotherapy Patients generally spend 18 months – 3 years in group therapy, but there is no set time limit. Group psychotherapy can be an economical and effective treatment method.
•Medication Enhanced Psychotherapy Sometimes medication can help a lot, especially for things like sleep, anxiety and severe depression. I always try to minimize the dose and number of medications, but I don’t believe in needless suffering if effective medication is available. As your treatment progresses, we will usually try to slowly taper any medications that were prescribed in the course of your therapy.
•Life Coaching You don’t need to have emotional problems to benefit from psychotherapy. Having a safe place to talk things through and get some honest feedback can be tremendously growth promoting. Since I am a psychiatrist, everything you say to me is confidential and protected by law. I can’t – and won’t – talk to anyone about it. Nonprofessional life coaches can still be subpoenaed and compelled to testify. Psychiatrist are subpoena-proof! The fee for life coaching is $115 per session (45 minutes). Since no emotional disorder exists, insurance will not cover any part of the fee. Don’t trust your life and your mind to someone who sat through a 40 hour seminar to get a “life coach certification” – hire a true professional instead.
•Inpatient or Partial Hospitalization I make every effort to avoid hospitalization, but if a crisis occurs, I will work with the patient and family and facilitate admission to the best available program. Psychiatric bed space is scarce in the Dallas area, so there is no guarantee that a particular hospital will be able to accept a patient, but I have admitting privileges at Texas Health Presbyterian Dallas.
•Suboxone Consultation Opiate addiction is a growing and dangerous problem. You will have access to a full range of substance abuse treatment options, and if long term suboxone is right for you, I’ll prescribe it and help you adjust.
A “standing appointment” is a regular, reserved time for a psychotherapy appointment that is held for the patient throughout the course of treatment. That is, the time is reserved until treatment is discontinued and the patient gives notice that the time is no longer to be reserved. The patient is billed for all standing appointments, whether or not they attend, unless the canceled appointment can be filled with another patient, or unless the appointment is rescheduled at a mutually agreeable time within the same week. Standing appointments offer the advantage of securing the same time each week and encourages the keeping of regular appointments, but do represent a greater financial commitment than scheduling each appointment individually.
Your treatment may involve any one or a combination of these approaches. After a careful and patient exploration of your problems, together we will discuss the options and agree upon a plan that is likely to be most helpful.
Sometimes it becomes necessary to switch to a different approach as the patient or situation changes. For instance, a patient in individual therapy may transition to group as he or she grows, or marital therapy may become important if relationship issues begin to dominate the patient’s difficulties .