Our Approach to Assessment and Treatment

We have both had the privilege of training with some of the top clinical and scientific minds in our respective fields of specialization.  Our training experiences have strongly shaped our approach to the assessment, diagnosis, and treatment of psychological issues. 

Our training history and experience in an academic medical setting has prepared us to be true scientist-practitioners, conducting scientific research and utilizing evidence-based strategies to treat psychological problems .  Below is an overview of our approach to assessment and treatment.

Our Foundation:  The Biopsychosocial Model of Health

Recent advances in psychological, medical, and physiological research have led to new ways of thinking about health (including psychological and behavioral health) and illness. This conceptualization, labeled the biopsychosocial model, views health and illness as the product of a combination of factors, including the biology of the individual (e.g., genetic predispositions, chemical imbalances), behavioral factors (e.g., lifestyle, stress, health beliefs), and social conditions (e.g., cultural influences, family relationships, social support).  The model and its relationship to health is depicted in the figure below.

Tailored Assessment Approach

Our adoption of the biopsychosocial model of health means that we are committed to  providing a tailored approach to identifying the many possible contributors to life problems and health.  We utilize a technique called case formulation that carefully details the specific problems you are encountering, the predisposing factors that have led to your problems, the perpetuating factors that serve to maintain your problems over time, and the protective factors that influence your health status and problems.  Taken together, this approach allows us to carefully detail your problems and why they are occurring, and assists us in outlining the steps that need to be taken in order to improve your quality of life.

We use a variety of assessment strategies to gather complete and accurate information about your particular problems, including a clinical interview of you and your loved ones, psychological testing, and self-monitoring of your thoughts and behaviors over time.  In addition, you can expect to receive a comprehensive explanation of your case formulation which will assist you in understanding the nature of your particular difficulties and will help prevent their re-occurrence in the future.

Treatment Strategies

Once we have detailed the problems you are experiencing, we work with you to prioritize your treatment goals and employ evidence based treatment strategies.  A commonly accepted definition of evidence-based practice is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. This involves integrating individual clinical experience with the best available external clinical evidence available from scientific research.” The primary evidence-based treatment strategies we use are cognitive-behavioral in nature.

What is Cognitive-Behavioral Treatment?

Cognitive-Behavioral Treatment, or CBT, is an approach to treatment that focuses on identifying the problems that an individual is having, examining the causes that maintain these problems, and generating alternative approaches that decrease problems.  All people, even those who are not encountering emotional distress, tend to think in ways that are subjective which results in filtering out a good deal of information about what is going on around them. This tendency becomes more extreme during periods of emotional turmoil, and can often create or maintain anxiety, depression or other psychological difficulties. For example, research suggests that some people overestimate the probability that negative events will occur, while underestimating their ability to cope with them. CBT challenges our thoughts about ourselves, the world, and the future by collecting objective evidence to more clearly evaluate current beliefs.  Individuals first practice becoming aware of negative thoughts (which are often automatic and almost subconscious in nature), and then look at constructive ways to challenge these thoughts and beliefs.

The behavioral component of CBT starts with self-monitoring of behaviors that either directly or indirectly cause life problems, followed by specific techniques to both reduce the frequency and intensity of maladaptive behavior and increasing functional behaviors and coping skills.  It takes a skilled clinician to be able to help you identify those thoughts and behaviors that contribute to your problems and help you to correct them.

Of particular importance is the fact that research clearly demonstrates that most, if not all, psychological and life difficulties include a component of ineffective or inaccurate thinking that exacerbates an already difficult problem.  In the vast majority of cases, the individual is completely unaware of the counterproductive nature of their thinking until a highly skilled clinician provides assistance.

For most life problems that include a psychological component, CBT has been shown to be as effective or more effective than either medication or other forms of psychotherapy.