Whether or not medications are indicated and useful is a common question many patients face. We are confidant in our ability to diagnose and prescribe medications when indicated. Our approach is best described as conservative with the use and dosing of medication. Achieving maximum benefit with minimal or no side effects is our goal. Once a medicine is successfully prescribed, we continue to monitor and advise about the proper use, maintenance and eventual discontinuation of medication.
For the past 30 years, psychiatric medicine has been a burgeoning area in health care. Prozac, first marketed in 1987, ushered a new generation of medicines which were effective, better tolerated and safe. The 1990’s was designated by President George Bush and the National Institute of Health as “The Decade of the Brain” to foster expansion in research. In 2003, the Human Genome Project was finally completed and promises to further our understanding of mental function and neurochemistry. Now, we can easily perform genomic testing in our office to better estimate how you will metabolize medications in your liver. Theses medical advances allow us to apply this knowledge in a discerning manner for your psychiatric care.
Psychotherapy is a form of treatment which uses talking and conceptualization to help. Where medication is indicated, the combination of medication and psychotherapy yields the best results than either one alone. Psychotherapy used alone has proven to be helpful and often enjoys the longest remission rates. Sigmund Freud introduced talking therapy in the late 1800’s. Since then, the different types of psychotherapy has grown with the expansion of psychological theory and philosophy. Modern research helps us to better assign a certain type of psychotherapy to a specific condition. Often times a psychotherapist will develop an expertise in a specific type of therapy with a specific population of patients. Our job is to inform you of what is best suited for you and to help in coordinating your care with providers in our community.
Therapies can vary based upon who the target audience is, such as individual therapy, family therapy, marital/relational therapy, or group therapy. Therapies can vary based upon their methodology, such as Cognitive-Behavioral Therapy, Supportive Therapy, Interpersonal Psychotherapy, Dialectal Behavioral Therapy, Insight-Oriented Psychodynamic Therapy, Behavioral Therapy, Educational Disorder Counseling, Existential Therapy, etc.
Psychological testing is performed by a trained psychologist accustomed to administrating certain tests. Psychoeducational testing is often used to assess intellectual aptitude and learning processes. Discrepancies in aptitude and processing can reveal learning disabilities and provide valuable information for students, parents and educators. Neuropsychological testing is another approach which assesses cognitive functioning when there has been some trauma to the brain or a disease process effecting the brain such as dementia. There are subjective psychological tests which describe one’s personality characteristics, psychological defense strategies, perspectives and relational styles.
Psychological testing is most useful when you have a well formed question which the tests were devised to answer. By beginning with an accurate and thorough evaluation we are able to collaborate with psychologists who are trained to further investigate the question at hand.
With the growth of our knowledge about how the brain functions, so also has been the growth in the various modalities of treatment. Some of these modalities have a strong research basis and history, and others seem intriguing but have shown only selective benefit. We recommend evidence based treatment, but there are treatments which we have found effective anecdotally though not always reproducible. An important question with regards to alternative therapies is what is the risk of harm – psychologically, physically or financially?
We do not practice these alternative therapies ourselves, but will recommend when it is appropriate, and work along with others who use Transcranial Magnetic Stimulation, Electro-convulsive Therapy, Neurofeedback, Homeopathic therapies, Hypnosis, Eye Movement Desensitization and Reprocessing (EMDR), etc.