SERVICES

I see a variety of clients for individual, group and couples psychotherapy and the focus of therapy varies, but may address such things as:

• Depression
• Anxiety
• Relationship Issues
• Life Transitions
• Post-Traumatic Stress Disorder (PTSD)
• Obsessive-Compulsive Disorders (OCD)
• Assertiveness Skills
• Women's Issues
• Parenting Issues
• Health and Medical Psychology

Scroll down to see brief descriptions of these conditions and issues.

I also offer:

• Assertiveness Skills Training
• Support groups
• Relaxation Skills Training
• Smoking Cessation.
• Level I Eye Movement Desensitization and Reprocessing (EMDR-1)
• Menopausal Issues Decision-Making Model

Depression: Although many people become depressed at some point during their life span, there is a distinction between feeling sad for a given period of time and a clinical depression. Those experiencing a severe depression may experience a depressed mood for most of the day, every day, markedly diminished pleasure in activities, sleeping problems, fatigue, diminished ability to think, feelings of worthlessness and recurrent thoughts of death. These symptoms continue for over 2 months and are not better accounted for by bereavement. The lifetime risk for Major Depressive Disorder varies from 10% to 25% for women and 5% to 12% for men. Episodes of Major Depressive Disorder often follow a severe psychosocial stressor, such as the death of a loved one or divorce. In therapy we work to understand the origin of the current problems and work to find viable solutions. Therapy can also be useful in helping people identify problems early on, so as to address them before they become overwhelming. The ultimate goal of therapy is to help people resolve their concerns and to learn more effective coping skills.

Anxiety: Everyone experiences anxiety at certain points in their lives, and this, in many cases, is a natural response to the uncertainties of life. However, if an individual experiences anxiety that significantly impairs their ability to function, it is important to try to resolve that impairment. There are a variety of Anxiety Disorders (e.g. Panic Disorder, Agoraphobia, Specific Phobia, Social Phobia, Obsessive Compulsive Disorder, Posttraumatic Stress Disorder, Acute Stress Disorder, and Generalized Anxiety Disorder). One goal of therapy in treating anxiety is to identify the "triggers" that elicit anxiety. Another goal is to learn and practice relaxation techniques that the individual can implement when faced with the triggers for anxiety. For those individuals who have a long-standing history of anxiety, it is also helpful to identify and come to terms with the origins of their fears in order to reduce and effectively manage their responses to stressful situations.

Relationship Issues: We all face times in our lives when we have difficulty in our interactions with others, whether they are family, friends or co-workers. Oftentimes these roadblocks can be examined and addressed within therapy. Sometimes it may be as simple as improving communication skills while other times it may require a deeper examination of the underlying conflict involved in those problematic relationships.

Life Transitions: As we move through life we all face periods in our lives where we move out of one role into another (e.g., leaving home, getting married or divorced, children leaving home, job changes, death of a loved one, retirement, etc.). Anytime we encounter transitions we are likely to feel somewhat uncomfortable and it may elicit questions about how we will bring meaning to our new role in life. One goal of therapy in addressing these transitions is to clarify these meanings and learn to cope with the ambiguities that go along with the move from one role to another.

Post-Traumatic Stress Disorder (PTSD): The essential feature of PTSD is the development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury to oneself, an acquaintance or a close family member. In response to such stressors the individual experiences, intense fear, helplessness or horror, a heightened arousal and recurrent intrusive thoughts that cause significant impairment. The lifetime prevalence rate ranges from 1% to 14%. Because individuals who have experienced a severe trauma often have had their sense of trust of the world betrayed, a key component of therapy for PTSD is the re-establishment of trust within the context of the therapeutic relationship. Another key component of therapy is to develop relaxation skills and self-care. Within this context, the therapist and the client can begin to resolve the trauma and regain a sense of well being in the world.

Obsessive-Compulsive Disorder (OCD): The essential features of OCD are recurrent obsessions or compulsions that are severe enough to be time consuming (i.e., they take more than 1 hour a day) or cause marked distress or significant impairment. At some point during the course of the disorder the person has recognized that the obsessions or compulsions are excessive or unreasonable. Obsessions are persistent ideas, thoughts or impulses that are experienced as intrusive and cause anxiety or distress. Compulsions are repetitive behaviors (e.g., hand washing, ordering, and checking) or mental acts (e.g., praying, counting, repeating words) the goal of which is to prevent or reduce anxiety or distress. The lifetime prevalence rate is 2.5%, and usually begins in adolescence or early adulthood. Therapy usually addresses the obsessions and compulsions, and helps the individual find more adaptive ways of coping. Furthermore, if this is a long-standing problem, the relationship between a compassionate and trustworthy therapist and the client can help the client resolve the personal issues that are associated with the disorder.

Assertiveness Skills: Assertiveness is an essential skill in adult communications, yet many of us have not been taught appropriate ways of asserting ourselves. Instead, we may respond to situations by being passive (i.e., "I don’t have any needs"), aggressive (i.e., "You must fulfill my needs, or else") or passive-aggressive (i.e., "I’m not going to tell you what I need, but if you don’t fulfill my needs you’re going to pay"). During my internship at the Veterans Medical Center in Gainesville, Florida I taught assertiveness skills classes. Assertiveness skills teach the individual methods of asserting themselves in such a way that they can clearly articulate their needs without being aggressive with another person. An interesting outcome of these classes was that, after 10 weeks of assertiveness training, there was a statistically significant decrease in the levels of depression of the participants. Participants indicated that they felt a sense of increased empowerment because they had developed better communication skills. These skills are developed through practice and receiving feedback in therapy.

Women's Issues: There are a number of socio-cultural issues that women must face that are unique to them. It is helpful for women to be able to identify and articulate some obstacles that they face in life. After identifying those issues, I assist women in developing useful strategies for facing those issues.

Parenting Issues: Parenting is one of the most challenging and important jobs we have. Oftentimes we parent as we were parented, simply because we aren't aware of options. Based on Rudolph Dreikur's book: Children: The Challenge I help parents examine the roadblocks they encounter in parenting. One ultimate goal of this work is to help the child and parent understand the idea that there are logical consequences for our actions. Once this concept has been integrated into parenting, the child learns a valuable lesson that should last a lifetime.

Health and Medical Psychology: is another major area in which I provide services. Those services assist individuals and their families in coping with physical illness associated with such things as heart disease, cancer, AIDS, liver disease, geriatrics, and pre-and post-surgical support and the psychological issues (e.g., anxiety, depression, and grief) that frequently accompany illness.