A primer on treatment...

I provide a limited amount of individual or family-focused treatment. Whenever feasible I try to employ a stepped care model of treatment. This means that I may combine self-help methods, intermittent consultation, office visits, community intervention, and technology-based solutions. Obviously, no one model of care is appropriate for every situation, so the initial session typically consists of an overview and attempt to gain an understanding of the situation.

Some of the areas that I think about include:

1. Is there a problem? Sounds simple enough, but, especially within the realm of psychology and mental health, people come in all sorts of personalities, filled with strengths, quirks, and deficits. Just because someone does things differently or takes a little longer to understand a concept, does this mean they have a problem?
2. If a problem exists, how serious is it? Some problems are best handled by.... doing nothing. In the literature, this is known as "watchful waiting." A prime example is a child who will not pay attention in preschool or follow directions. Not all children develop at the same rate or level, so giving it a few months can help determine whether intervention is truly needed. A single parent consultation, reading a self-help book, or combining the the two can often be an effective strategy.
3. If there is a problem... is therapy needed? If watchful waiting and/or self-help, possibly combined with intermittent consultations are not effective, then more sustained treatment may be indicated. Remember, each situation is unique and typically requires development of an approach that is best suited to meet the needs of the family, maintaining cost effectiveness, and of course, keeping in mind what has been demonstrated to be most effective, based on relevant research.

Primary Therapeutic Orientations: I mostly employ a cognitive-behavioral therapy approach to cases, combined with more traditional behavior therapy approach. Often, my interventions also include elements of social learning theory approach.  You can read more about cognitive therapy by visiting the Association for Behavioral and Cognitive Therapies. There are many sources of information regarding social learning theory; click here to view one.

Tracking Progress: I am a strong believer in developing some form of user-friendly data system in my work with clients to help them track progress. Some of the systems I have developed, such as for school districts, have been fairly sophisticated, but others for individuals clients have been quite simple. I like developing secure online forms for clients since it allows them to keep me (or other clinicians or school teams) abreast of their progress or difficulties in between sessions. I have been doing so since 2002 and have experienced no problems with this technology.

Going Outside the Office: The businesses near my office provide a wonderful extended therapeutic environment for addressing many of the types of problems for which clients are seeking help. Generalizing gains which occur in the office is a paramount concern for effective treatment. With Gelsons market, Office Depot, numerous types of restaurants and other stores, clients can practice assertiveness skills, work on social anxiety, improve attentional and executive functioning, and rehearse a variety of social and impulse control skills.