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I offer evaluation, coordination, and treatment of a wide range of psychiatric and medical-psychiatric problems affecting adults, adolescents, and children. I draw from a diverse treatment repertoire that includes focused psychotherapy that is monitored to assure progress is occurring. When other professionals are involved, I endeavor to organize this group into a treatment team and coordinate its operation.
The services I offer include:
Any or all of the above services may be included in the comprehensive approach to evaluation and treatment I call The Collaborative Psychiatry Method.
Psychiatric Evaluation & Treatment
A psychiatric evaluation is recommended for people who find themselves or their children struggling with challenging personal problems. At times these difficulties may require the involvement of professionals from other medical specialties or areas allied to psychiatry and psychology, such as education. The recommended treatment is always focused, aimed at addressing the main problems for which you sought help. It is intended to be time-limited, its duration dependent on the satisfactory resolution of your difficulties.
The clinical evaluation I do may also be accompanied by a psychological or neuropsychological assessment administered by a psychologist. This evaluation is intended to contribute to the accuracy of the diagnosis and formulation of treatment goals. Whether we decide to use medication will, of course, depend on the kinds of problems to be addressed and your preferences.
During the course of and following the evaluation, I usually write at least two reports. They will not be given to others except at your request. The first report, which is relatively brief and practical, is completed after the initial clinical evaluation and assessment. This report will provide a diagnostic impression and a provisional treatment plan. The second report will contain a more definitive diagnosis and a description of the treatment to be implemented.
Medical-Psychiatric Treatment Coordination
When a person’s psychiatric or medical-psychiatric condition is complicated, the opinion of a single professional working alone may be insufficient to determine the best approach to treatment. In situations like these I collaborate with relevant specialists, including other physicians. As required, I assemble and coordinate a treatment team, with the patient and his or her family as integral members. By working in this comprehensive way, diagnosis is more likely to be accurate and treatment more on target.
The Collaborative Psychiatry Method
As mentioned above, my most comprehensive clinical work is organized according to the treatment approach I call the Collaborative Psychiatry Method. This methodology, for adults, adolescents, and children, has been developed by my colleagues and me at the Center for Collaborative Psychology and Psychiatry. The Collaborative Psychiatry Method is designed to maximize precision in diagnostic assessment and treatment. Selected psychological and neuropsychological tests are used as needed and treatment progress is tracked throughout treatment.
To learn more about this treatment approach, see the Collaborative Psychiatry Method fact sheet or read my published articles and books.
Psychological or Neuropsychological Assessment in Coordination with a Psychologist
While some of the tests and checklists we may use are self-administered, much psychological or neuropsychological testing requires the skill of an experienced psychologist or neuropsychologist. The tests used range in complexity from self-assessment instruments like the MMPI to those designed to bring out the subtleties of a person’s inner life. Neuropsychology is a psychological specialty focusing on brain-based disorders, including those that affect attention, learning, memory, organization, and planning. I work closely with the psychologist or neuropsychologist as he or she adds his or her findings to our developing assessment and treatment plan.
Medication
I will include medication in your or your child’s treatment whenever appropriate. Medication for disorders such as depression often does wonders, but not always and not necessarily indefinitely. Numerous studies show that medication is often most effective when combined with well-strategized, collaborative psychotherapy. As a post-graduate fellow at Stanford, I did research in pharmacology. I continue to explore the interface between psychiatry and medicine in my current research and writing.
Collaboration with Other Needed Specialists
Specialized consultations may be required to enrich the diagnostic and treatment process. In complex cases I often can enhance the effectiveness of the work by organizing these professionals into a treatment team, which I am then available to coordinate.
In addition, I frequently consult with other medical specialists. Medical considerations may become a critical part of a psychiatric evaluation. Not every psychiatric disorder reflects an emotional problem. For example, commonly encountered medical conditions such as multiple sclerosis or thyroid disease may present with psychiatric symptoms, hormonal and autoimmune diseases similarly may be accompanied by unexplained psychological concerns, elderly people may be diagnosed as having dementia when in fact they are depressed.
Assessment and Treatment of Children and Adolescents
Children and adolescents are not little adults. They are biologically and psychologically unfinished, even through adolescence. Their thinking and judgment is age specific, evolving through at least their early twenties. This population is susceptible to most psychiatric disorders, but is particularly likely to be afflicted with issues like ADD, learning disabilities, and mood or behavior problems, including early onset bipolar disorder.
Throughout my career I have worked extensively with children, adolescents, and their families. You can find a description of my philosophy and work with children and adolescents in Chapter 6 of Evidence from Within: A Paradigm for Clinical Practice. I am heavily committed to the ongoing place of parents and family in the treatment of children and adolescents. Each always affects the other, and healthy children require well-grounded parents, whether married or divorced. Presenting further challenges are unique parenting situations such as those involving atypical or developmentally disabled children, single parent families, and problematic adoptions, to name only a few. Each group has its own characteristics and requirements.
The ultimate experts on your children and adolescents are you, the child's or adolescent's parents. As we work together, my goals will be to assure that you, the parents, have the proper place in your child’s life, and to provide you with whatever additional parenting skills you may require.
My background lends itself to this kind of developmental thinking. I spent two years doing a fellowship in child and adolescent psychiatry after my residency in general psychiatry. Then I spent several years on the faculty of the University of Michigan Medical School, where I was based at Children's Psychiatric Hospital, and taught and did research in child and adolescent psychiatry. I have a separate Board Certification in Child and Adolescent Psychiatry.
Marital and Parent-Child Counseling
Maintaining a marriage or divorce that facilitates the healthy development of one’s children may not always be easy. Doing so can get even trickier in a blended family, where children come from a spouse’s previous marriage. I can provide marital counseling and parent-child guidance either by themselves or as part of a wider treatment strategy involving multiple family members.
To learn more about my services or explore the possibility of working with me, please call me at (415) 456-6611 or email me by clicking this link.
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