Clinical psychology

If you’re wondering about your mental health or have been diagnosed with a disorder, and if things aren’t improving or are getting worse, we might need to talk about what can be done to make you feel better. Perhaps there is a non-chemical addiction that takes up so much of your time and energy. Or we might need to discuss where things stand right now in your life, and which adjustment to a recent or distant event or situation may be affecting your mental status. We could also talk about how you’re coping with PTSD from emotional trauma of any kind (current or from your past) or if you’re relying too much on alcohol or other prescribed or illegal chemicals to make yourself feel better. Anxiety is often a by-product of traumatic life events and situations. If what’s handicapping you is an attention deficit that makes you mess up, postpone or avoid important tasks, let’s talk about improving your self-management skills. We might need to figure out whether there is a bipolar (up and down) pattern to your mood and what we can do to help you better manage these emotional swings, and help you get back to within a normal range. We could also discuss your complicated grief (if you lost someone or something very valuable such as your job), especially if the severe grief seems to last longer than you thought it would. We could take a closer look at your depression and how well the medication you’re taking is helping you, and how adding Cognitive Behavioral Therapy (CBT) may speed up your recovery. Perhaps this is the right time to address your obsessive-compulsive (OCD) thoughts and behaviors, and I could share with you a few proven tools that may help reduce your symptoms. Or we might evaluate, diagnose, and focus on a specific mental health issue, which may be as unique as you are.

Adjustment Disorder

Typical causes are stressors and situations that may cause adjustment disorder symptoms: End of a significant relationship, Business difficulties, Marriage problems, Unfulfilled sexual relationship, Seasonal business downturn, New illness (yours or a loved one’s), Persistent illness, Natural disaster, Job loss, Career change, Leaving home, Getting married, Becoming a parent, Retirement, Death of a loved one, anything that, to you, represents a major change in lifestyle, comfort, security, relationship, career, health.

Symptoms are: 1. Marked distress that is out of proportion to the severity or intensity of the stressor, taking into account the external context and the cultural factors that might influence symptom severity and presentation. 2. Significant impairment in social, occupational, or other important areas of functioning.

Anxiety

We are programmed for survival and to respond to potential dangers on every level, physical, psychological and emotional. When our threat-detection mechanisms misfire we can become hypervigilant, always alert for real or perceived dangers, and respond exaggeratedly. Anxiety and stress arise from a perception that our resources are inadequate to meet the challenges we may face, and inadequate to face their consequences. This may or may not be the case, however to the anxious or stressed individual there is no logic that can effectively counter this dysfunctional way of thinking.

Psychotherapy, and more specifically CBT has been proven very effective in treating anxiety disorders that stem from a a maladaptive way of perceiving and managing life’s challenges. The treatment also includes mindfulness and diaphragmatic breathing training, and relaxation techniques.

The most typical anxiety disorders are: Generalized anxiety disorder (GAD); Separation anxiety disorder (children and adults); Social anxiety disorder (social phobia); Panic disorder, with or without panic attacks; Selective mutism (in children); Specific phobia: illness (hypochondria), animal, natural environment; Blood-injection-injury: fear of blood, fear of injections and transfusions, fear of other medical care, fear of injury; Situational: agoraphobia (open spaces, enclosed spaces, crowds), acrophobia (heights); Substance/medication-induced anxiety disorder (provoked by illicit drugs or alcohol).

PTSD

Traumatic memories (abuse, assault, rape, combat, natural disaster) and all memories in general are processed by the brain and stored in different ways. Even mildly traumatic experiences can sometimes become etched or “burned-in” with a high degree of detail. In these cases, it is not only the memory of the fact that is preserved, but also the intense emotional experience of it.

When a significant event is moderate in emotional intensity, it is usually stored in long-term memory. The long-term memory process works as it should and the memory of significant events is stored and remains retrievable throughout our lifespan. Traumatic events, on the other hand, can disrupt this process and cause the brain to store memories almost entirely as emotions or sensations rather than as a nearly emotion-free recollection of facts.

Bipolar

Bipolar Disorder (formerly known as manic-depressive disorder) describes the two polar opposite manifestations of the illness: a depressive stage which is either preceded or followed by a manic, hyperactive stage.  The name for this serious mental health condition also reflects the bipolarity (cycling through) of the symptoms, that is, the radically different emotions that can be experienced and the contradictory behaviors that can be exhibited by the same individual.

It is a disorder that requires specialized treatment, often with a combination of psychotherapy (primarily cognitive-behavioral therapy) and appropriate medication.

The major types of bipolar disorder are: Bipolar I Disorder (cycles from deep depression to full mania), Bipolar II Disorder (cycles from full depression to hypomania–lower level of mania), Cyclothymic Disorder, Substance/medication-induced Bipolar and related disorder, or Bipolar and related disorder due to another medical condition.

Why Solution Focused Brief Therapy?

Solution Focused Brief Therapy (SFBT) is a cost-effective psychotherapy model due to its emphasis on rapid, goal-oriented change, typically requiring only 5 to 10 sessions. Dr. Z offers a six session intensive that will work well in most cases. By focusing on solutions rather than the origins of problems, SFBT minimizes time spent in treatment, resulting in lower cost. Its adaptability across various issues allows for broad application in individual, couple, and family contexts. Additionally, SFBT enhances  efficiency and reduces system-wide expenses, making it an economically sustainable alternative to longer-term therapies.

Other Available Therapies

Hundreds of clients from all walks of life have worked with Dr. Z. SFBT is Dr. Z’s first line of intervention to provide immediate help. An initial diagnostic interview will determine if SFBT or another therapy (CBT, EMDR, CPT) is appropriate for your case. Solution -Focused Brief Therapy (SFBT), Cognitive Behavioral Therapy (CBT), Eye Movement Desensitization and Reprocessing (EMDR), Cognitive Processing Therapy (CPT), as well as Spiritually Integrated Counseling (Christ-centered), will be chosen as appropriate after a thorough assessment.

Depression

Depression has a very high incidence in all strata of society and affects the functioning and well-being of people of all ages, socio-economic status, and gender. Cognitive Behavioral Therapy (better if paired with appropriate medication prescribed by a physician) has been proven very effective in treating depressive disorders. The major types of depression are: Disruptive Mood Dysregulation Disorder, Major Depressive Disorder (Single episode or Recurrent episode), Persistent Depressive Disorder (Dysthymia), Premenstrual Dysphoric Disorder, Substance/Medication-Induced Depressive Disorder, Depressive Disorder Due to Another Medical Condition.

How do you know if you are clinically depressed? Five (or more) of the following symptoms may be present during the same 2-week period and represent a change from previous functioning: at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. (1) Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, hopeless) or observation made by others (e.g., appears tearful). (Note: In children and adolescents, can be irritable mood.) (2) Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation). (3) Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month) or decrease or increase in appetite nearly every day. (Note: In children, consider failure to make expected weight gain.) (4) Insomnia or hypersomnia nearly every day. (5) Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down). (6) Fatigue or loss of energy nearly every day. (7) Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick). (8) Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others). (9) Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

ADD/ADHD

Attention Deficit Disorder (ADD) in adults often includes hyperactivity, in which case it is commonly referred to as Attention Deficit/Hyperactivity Disorder (ADHD). Adults suffering from ADHD may be characterized by a high degree of restlessness and lack of focus that are not only a problem for the sufferer, but also noticeable by and bothersome to others. Adult ADHD may include impulsivity, which is the tendency to make quick decisions and act without thought for the consequences. This degree of impulsivity can be harmful to the individual (e.g., crossing the street without looking) and bothersome to others, especially in relationships. High impulsivity may be motivated by a quest for immediate rewards and the inability to delay gratification.

This can manifest itself in social intrusiveness (e.g., interrupting others excessively) and in making important decisions without proper planning or understanding of their implications (e.g., making an investment without adequate information, quitting a job for trivial reasons). In all cases, the essential feature of adult ADHD is a a pervasive, noticeable pattern of inattention, hyperactivity, and impulsivity that interferes with functioning and may cause severe distress. It is a severe disorder that will not resolve itself without treatment. Cognitive-behavioral therapy (CBT) coupled with medication (prescribed by a physician) is the approach that has been shown to produce the best results.

OCD

Obsessive-Compulsive Disorder is part of the anxiety disorders spectrum. It is a more severe manifestation of a concern, a fear, or a preoccupation with something physical or psychological or situational, or with a relationship, whose symptoms rise to the level of pathology. What makes it pathological is the severity of the symptoms, i.e., the persistence and intrusiveness of the obsessions, and the frequency and intensity of the compulsions. It is not a disorder that will disappear by itself if left untreated.  If you or someone you love appears to suffer from OCD, it will be necessary to confirm the diagnosis through specific testing and a diagnostic interview, and then seek treatment with a recommended approach such as CBT (possibly combined with medication.)

According to the expert’s definition, Mild OCD (Yale-Brown Obsessive-Compulsive Scale 10-18) causes distress but not necessarily dysfunction; help from others is usually not required to get through the day. Moderate OCD (YBOCS 18 -29) causes both distress and functional impairment. Severe OCD (YBOCS = 30 or above) causes serious functional impairment requiring significant help from others.

Grief & Loss

Individuals who must live through significant losses at any moment in their life (i.e., deaths, major illness, debilitating accidents, divorces, job loss) almost invariably experience severe depression and discouragement, and exhibit strong, uncharacteristic emotional responses that can be cause of concern. Intrusive, recurring thoughts centering around or dominated by the loss often cause the grieving person to experience poor concentration, sudden or prolonged tearful spells, and confusion about the future. In a sense, the individual’s future is temporarily “lost” after the experience of a significant loss.

Eventually, if the severe grief does not resolve itself into a painful but bearable acceptance of the loss within a few weeks, or at most four to six months (depending on the severity of the loss), the grief becomes more problematic (Complicated Grief) and requires more intensive professional help. Among these strong emotional or psycho-somatic responses there can be a diminished appetite, weight loss, insomnia, despair, loss of self-esteem and moments of suicidal ideation.  In many cases, the feelings of guilt that not enough was done to prevent the loss from occurring, or an unreasonable belief of having contributed to the loss can become quite overwhelming.

Your 6-session Solution-Focused Therapy Journey

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