I may ask you to have a checkup by your primary care doctor to rule out medical problems that may be triggering your emotional or behavioral problems. Or, I may simply ask you to obtain certain laboratory tests to rule out common conditions, such as thyroid dysfunction, that may present as a psychiatric problem.
If you decide to pursue treatment with me, for therapy or medication, we will make follow-up appointments for regular sessions lasting 50 minutes.
All talk therapies, i.e., psychotherapies, have in common a collaboration between the therapist and patient that facilitates new learning. What is learned depends on the specific technique. I provide several kinds of therapy including insight oriented dynamic therapy in which patients come to view their own history with new meanings; cognitive behavioral therapy (CBT), in which patients develop new patterns of thought and action to replace maladaptive old ones; and eye movement desensitization and reprocessing (EMDR), used for trauma, which neutralizes the negative impact of past events. Taking an active role in your therapy enhances its successful outcome. This includes working on your issues both during and between sessions.
Today a wide array of medications can be effective for many psychiatric problems. Should you need, and choose, this kind of treatment, I will inform you of its potential benefits and side effects and will guide you closely in its proper use. Your questions will be answered before taking the medicine, and at every point along the way.
The choice of medication and its dose needs to be individualized. Under certain circumstances, I may ask you to obtain a genetic test that can assist in choosing a medication and dosing it. After the first day of taking a new medication, or after a dose change, I will ask you to telephone me to make sure it "agrees with you" and to make adjustments for any side effects. Most psychiatric medications take time to work. Regular follow-up appointments are essential to optimize the dose and gain maximum benefit.
Sometimes therapy and medication can work together to achieve faster and more complete success.