Depression, Anxiety, PTSD
Support for Cancer and Chronic Medical Conditions
Support for those with a loved one with a serious medical condition
Grief, Loss, and Trauma
Relationship Problems
Significant Life Transitions such as school, new job, or retirement
Insomnia
ADHD
During your initial 90 minute consultation session, I will take a complete medical, psychiatric, social, and family history. I will review any available records. I will ask about all medications and supplements. We will discuss any past medications that you have taken for any type of mental health concerns. We will then discuss the risks and benefits of any medications, as well as the risks/benefits of not using medications before initiating any treatment. I will attempt to answer your questions and address your concerns as fully as possible. Sometimes more than one appointment is needed to complete an intake and discuss a treatment plan.
You may say, ”I’m worried about whether I’ll get addicted to a medicine or whether I’ll ever be able to stop it.” Psychiatrist Dr. Jessi Gold answers this question very nicely in this article.
Several visits are often required to adjust medication. Sometimes the first medicine will work well without any side effects or problems. Commonly we need a few visits, or sometimes a few different medication trials to address your symptoms. Sometimes your concerns can or should be addressed with talk therapy and/or lifestyle interventions.
For patients seeking a new evaluation for ADHD, please know that a medication will not likely be prescribed in the first visit. Please bring an old records of neuropsychological testing completed as a child or as an adult to aid in the evaluation. If a formal neuropsychological evaluation has never been completed, I may request one prior to initiation of medication. I may also request to speak with a family member who knows you well. While I am an out-of-network provider for all insurances, testing can sometimes be covered by insurance. For patients seeking to transfer their treatment from another physician, please know that medicines are not automatically continued, even if previously offered.
Narcotic/controlled substance medications for anxiety or sleep are also not considered “first line” for treatment of anxiety/insomnia, and in fact these medicines can cause harm. This article reviews some risks of benzodiazepines and "benzo-like" medicines. Controlled substance prescriptions are not automatically continued in an initial visit.
Sometimes individuals are already working with another therapist who is a psychologist, social worker, or licensed professional counselor, or marriage and family therapist, and are then referred to me for a medication evaluation. I enjoy working collaboratively with patients and therapists. While you will continue meeting more frequently with your regular therapist, I will periodically communicate with your therapist to ensure we are all on the “same page” with your treatment. Here is a link explaining some of the differences in the many training pathways that can lead one to the title of “therapist.”
I sometimes meet more frequently with patients for a combination of therapy and medication management visits. In these cases, a patient does not meet with another therapist, and I serve the role as both the medication manager and the therapist.
My therapy approach is collaborative and eclectic. I have had training in psychodynamic therapy, cognitive-behavioral therapy, dialectic behavioral therapy, and motivational interviewing. I have a strong appreciation for, though no formal training in somatic experiencing work. If "somatic" or "body work" could be helpful in your care, we can discuss referral options to include that in your treatment. We will develop treatment goals during the first few sessions, and we will reassess them over time. Austin has a strong tradition of training excellent group therapists, and I sometimes work collaboratively with these therapists as well. I have a great respect for the role of using mindfulness, understanding attachment/interpersonal neurobiology, and the connection of psychological trauma to physical pain/illness. In addition to my therapy supervisors and physician educators from residency, the following authors/researchers have influenced my approach to psychotherapy: Dan Siegel, MD, and Bruce Perry, MD , and Irvin Yalom, MD. I have continued my education in psychotherapy by working with a experienced psychoanalytic therapy supervisor, continuing classes from psychotherapy training programs, and attending lectures from the Austin Psychoanalytic group and the Austin Psychiatric Society.