For many patients, it is important that their expectations and beliefs about how they would like to get better or improve their life are in sync with their psychiatrist’s. Although, you will likely get a sense of this after our first meeting, I would like to provide you with a brief summary of my treatment philosophy. Hopefully, this will give you an idea of how well we might work together in treatment.
I believe that the most important ingredient in treatment is the “therapeutic alliance” between a doctor and patient. What does this mean? There are three components of the therapeutic alliance: 1) agreed upon goals between doctor and patient, 2) agreed upon ways of accomplishing those goals (therapy, medication, etc.), and most importantly 3) the bond between the doctor and patient. The ability to form a bond is a function of both the doctor and the patient and is related to many factors including past relationships, personality, adaptability, trust, and general goodness of fit. The importance of a good treatment alliance is corroborated in research studies, where outcomes of the plethora of treatment modalities (psychodynamic, CBT, DBT, interpersonal) are correlated with a stronger alliance.
Nature and Nurture
Next, I feel strongly that most psychiatric symptoms (depression, anxiety, behavioral issues) are a result of a combination of genetic vulnerability, environmental influences, and an individual’s way of handling stress and conflict. As a psychiatrist with an M.D., I am experienced in prescribing medications to help alleviate suffering, however, in the majority of cases I have seen sustained improvements in functioning and self-understanding only when psychotherapy (talk therapy) is an integral part of the treatment, in addition to the medication. Research upholds this belief, as most studies show that therapy in addition to medication and often therapy alone is superior to medication alone.
As a medically-trained psychiatrist, I have extensive training in a variety of medical areas including internal medicine, adult and pediatric neurology and consultation-liaison psychiatry. When I assess and treat a patient, I explore all possible reasons for psychiatric symptoms, including medical, medication-related and developmental causes. I will often request labs, other medical studies, and recommend referrals to other medical specialties if I think there might be a chance that other, non-psychiatric, conditions are possibly contributing.