WORKING TOGETHER

Rather than adopting a “one size fits all “ model, my approach is designed to be flexible and responsive to the changing needs of my clients. The therapy process is active both on your part and mine. Different approaches may be needed at different times in the process. Research on effective clinical practices and my 30+ years of clinical experience will help us decide together what may be helpful to you. Therapy approaches such as Interpersonal Psychotherapy and Cognitive Behavioral Therapy, as well as other validated approaches that are supported by scientific research can be brought together in an integrated manner.

In order to understand your unique ethno-cultural experience, I adopt a stance of cultural humility. I practice patient directed, outcome-informed integrative psychotherapy within a behavioral and relational theoretical base. I utilize unstructured interviews and symptom inventories to understand your presenting problems in terms of frequency, intensity, duration, complexity, degree of subjective distress, functional impairment, strengths, resources, and readiness for change. I am interested in and may ask you about your self-identification regarding gender, culture, sexuality, race and ethnicity. I may also ask you for information regarding family constellation, key relationships, critical developmental events, values and core beliefs about yourself and others. I am interested in your preferences for treatment and seek to develop a working case conceptualization that I share with you in a spirit of collaboration.

Empirical literature informs my understanding of relational and patient variables that impact treatment outcomes and support an evidence-based working alliance. Our relationship puts into motion the common factors of instilling hope, creating an expectation that change is possible, providing opportunity for corrective emotional experiences, and both encouraging and facilitating in session focus and practice of new learning. I strive to create a safe space for patients to connect emotionally to themselves and to me, fostering a secure therapeutic attachment, which can help to overcome the emotional and experiential avoidance that they may be experiencing. By monitoring their subjective experience, together we understand more about their daily experience, how they construct their world, and our progress toward achieving their treatment objectives. Within the relational context I utilize a variety of approaches and treatments. I utilize motivational interviewing to help patients understand and resolve ambivalence about change. I utilize the collaborative empiricism and Socratic dialogue of cognitive-behavioral therapy to facilitate new perspectives, hypotheses testing, and measuring the effectiveness of collaboratively designed interventions. Regardless of presenting problem, I assess, monitor and adjust treatment in a patient directed outcome informed manner. Together, we choose items to monitor that are specific to each patient’s goals, symptoms, treatment methods, and desired outcomes with the intention of better understanding their subjective experience outside of my office. This keeps therapy process focused, interesting, and alive for both of us, and seems to enhance the probability that they have the experience of being held in a safe relationship.