I am committed to unraveling difficult clinical problems requiring expertise in one or more of the following areas:

• Time-limited or in-depth psychotherapy
• Psychopharmacology (medication)
• Family systems, including family and marital therapy and parental guidance
• Cognitive-behavioral techniques, involving the modification of problematic behavior or thought patterns
• Neurology and neurobiology
• Assessment and treatment of children and adolescents

I have thirty-five years of experience. I am Board Certified in general psychiatry as well as child and adolescent psychiatry. As important, I am passionate about what I do.

I have a close-knit group of experienced clinicians at the Center for Collaborative Psychology and Psychiatry with whom I meet regularly to talk over clinical and theoretical matters. This group includes a psychologist skilled in psychological assessment, a neuropsychologist, a neurologist, and another psychiatrist. Several years ago, I organized the Center for just this purpose. Backing me up are also 15 seasoned psychotherapists who have participated in my consultation groups for at least a year.

Psychiatric problems are almost always complex! Psychiatric treatment is likely to  critical to one's wellbeing. A person's welfare — his or her occupation, as well as children and family — may be on the line. A person's welfare — his or her occupation, as well as children and family — may be on the line. Think about Mark, a Harvard-trained chemist, who becomes depressed and begins to drink at night. His teenage son, the captain of his high school basketball team, was just arrested for vagrancy. His son's teachers "just don't understand why." Such a good family, loving and smart. What could be happening? In the first meeting, the father reveals that he has received a warning that his job may be on the line: the beginning of a convoluted process of self-reflection and remediation.

What about Sally, a twelve-year-old who is bright and personable, but has rages at home that are getting worse? She has some friends, but very few. Her parents disagree about how to handle her, one saying she needs more discipline, the other that she needs more love and tolerance. An observer might speculate that Sally is more than anything a magnet through which her parents express their dissatisfaction with one another.

Or Susan, who is adopted and has Tourette's Syndrome. Her facial tic makes her hard to look at when you are talking to her. Her adoptive father didn't bargain for this grotesque problem. His attacks on Susan, expressing his disappointment, are a stark contrast to how he treats his other three, biological, children. Susan claims that without these attacks she would be perfectly normal. The father says that he treats all of his children equally, without prejudice. Who is the patient here, Susan, the father, or both? What to do about Susan's tics? All previous pharmacological treatments have failed to control them without compromising her alertness and ability to perform in school. Biologically and emotionally, what could be causing these tics?

The point is that the person delivering treatment needs to be well-trained, not only thoughtful and intuitive. Good sense and judgment obviously count, and usually count a lot, but think about the other parts. Essential elements include the range and depth of the therapist's experience, biases, and willingness to look for verification that progress is occurring. Of relevance also may be the therapist's personal life experience, at times including whether he or she has raised children, is happily married, and the expectations and strictures of his or her cultural background. The list is endless and the important issues determining whether a psychotherapist is able to deliver an optimal treatment, can be different in each treatment situation.

Clearly, finding the right therapist is not just a matter of luck. A good match between therapist and patient means a lot. But beware — that is not all there is to effective psychiatric or psychological treatment. Imagine the implications of beginning to treat someone with a medical problem or a brain-based learning disorder after looking only at their psychological needs. Even more, consider the potential impact of unmonitored talk therapy, continuing for months or years, with no attempt made to see if the treatment is producing results.

An initial clinical evaluation of you or your child's needs begins with two to four extended meetings during which time I take a history and get to know you and members of your family. This clinical evaluation is generally followed by neuropsychological or psychological testing conducted by a psychologist or neuropsychologist. The treatment recommendations that result from this evaluation can be manifold. They typically include, but are rarely limited to, focused psychotherapy that is either time-limited or ongoing. This psychotherapy may be insight-directed or emphasize behavioral modification techniques, but it is always problem-oriented. Medication and other medical measures are used as needed. In addition, consultations with other, appropriate specialists may be required.

Adding a second professional, a psychologist or neuropsychologist is often of enormous benefit. That person administers psychological or neuropsychological tests and provides a second clinical as well as test-based opinion The extra time and expense of engaging such a person is usually more than made up for by the fact that these steps are likely to secure the diagnosis and put the treatment on track, just as medical tests direct the physician as he or she attempts to understand the nature of and treat a medical problem. In the end, the result is almost always less wasted time in psychotherapy and a more effective treatment process.

These are the principles by which I work. I have written extensively about them in my four books and professional articles. For more about the services I provide, please visit my Services page. My treatment principles are spelled out on the Center for Collaborative Psychology and Psychiatry website.

Consideration of cost is obviously a critical issue for anyone undertaking a medical or psychiatric procedure. Probably the most unwelcome outcome of any type of evaluation and treatment is early termination because financial resources are being exhausted. It is in part for that purpose that the evaluation phase of a collaborative psychiatry procedure is ideally divided into three segments, with the final decision to undertake treatment proper often postponed until the end of Phase 3. The decision to commit to a full assessment and treatment procedure and the evaluation of costs is typically not finalized until the end of Phase 3.

Charges for psychological or neuropsychological assessment are rendered separately by the psychologist-assessor, who is an independent practitioner. My own time is billed by the hour, and includes charges for office visits, phone consultations, report writing, and collaboration with others.