I can only provide rough guidelines as to what you may expect in session — no two treatments are alike, and our work together will inevitably reflect your own individuality.

That said, I work from a contemporary psychoanalytic lens. This simply means that I believe that we all have aspects of ourselves that we cannot see or understand without some outside help, and that it is often helpful to get to know these parts. It is my hope that by deepening your insight into your experiences, past and present, you will discover novel, creative solutions to the challenges you face. Therapy is a conversation, and I view my role as that of a companion or guide who can provide a safe environment and offer questions and reflections to support your process of self-discovery.

I will typically ask that you try to share whatever enters your mind in session and to follow your thoughts wherever they lead you, with some special attention to strong emotions, fantasies, dreams, memories, and thoughts or feelings that you find yourself wanting to censor or avoid. We may also examine your thoughts and feelings about me and our relationship to help us understand how you tend to experience yourself in relation to others.

I believe that good psychiatric care begins with a thorough history, and want to understand your experiences in depth before offering a diagnostic formulation or treatment plan. I offer longer sessions than many other psychiatrists because I want to make sure we have the time and space to fully explore your concerns, goals, and treatment options.

For most patients, there is a great deal more to healing and psychological wellness than simply establishing a diagnosis and an effective medication regimen. To this end, I offer brief supportive and insight-oriented therapeutic interventions during most appointments even if we are not formally working together for therapy. I am also happy to explore non-pharmacological treatments including nutrition, physical activity, lifestyle, mindfulness, and complementary/alternative medicine approaches.

When it comes to making treatment decisions, I value a thorough informed consent process. We will discuss the indications, risks, benefits, and alternatives to any proposed course of treatment so that you have the information you need to make a thoughtful decision about what will be best for you. The right medications can sometimes make a world of difference, but no medication is without its own unique risks and drawbacks, and it is important that we monitor carefully for adverse effects.

I prefer to avoid prescribing multiple medications when a single medication might suffice, and I am happy to de-prescribe when a medication has proven to be ineffective or harmful. It is never my wish to numb emotions or change someone’s personality with medications.

While I endeavor to make recommendations that are data-driven and supported by evidence-based guidelines, I do not believe in a one-size-fits-all approach. I feel strongly that treatment plans should be carefully tailored to each individual’s unique needs. I welcome patients who are curious, informed, and seeking to work collaboratively.

The short answer: it depends! The frequency of our meetings is determined entirely by your individual situation, taking into account a number of factors including the severity of your symptoms, guidelines around appropriate treatment monitoring, and your personal treatment goals and preferences.

For those interested in psychotherapy, we may start by meeting anywhere from 2-3 times per week to 2-3 times per month. In general, the more frequently we meet, the more depth and continuity we can maintain between sessions.

For patients who are interested in obtaining diagnostic clarification and/or starting medications, we may meet once for an initial consultation, with perhaps another 1-2 shorter consultation sessions within the span of a few weeks to establish an initial diagnostic formulation and treatment plan. We may then follow up after 1-4 weeks to assess your response to the treatment.

If we are able to achieve a good response on a stable treatment plan, we may gradually decrease the frequency of our meetings during the “maintenance” phase of treatment.

I am happy to involve partners or family members in your treatment when appropriate, but I do not currently offer couples therapy or family therapy on a regular basis. If you are interested in couples or family work, I will be glad to refer you to a trusted colleague with expertise in these types of therapy.

I believe going "out of network" enables me to provide higher quality care for several reasons:

First, I spend less time on paperwork, documentation, and billing, so I can spend more of that time with my patients.

Second, I can offer a higher degree of privacy and confidentiality because I do not have a contract with insurers that would obligate me to me to share progress notes or other treatment records with them or their third-party affiliates.

Third, being "out of network" keeps patients in control of their treatment by limiting insurers’ ability to inappropriately influence or dictate care with formulary exclusions, restrictive provider networks, session limits, stepped treatment algorithms, and delay tactics such as prior authorizations and utilization reviews.

Finally, insurance reimbursement models incentivize shorter appointment times, leading to the unfortunate phenomenon of the "15-minute med check" as providers attempt to maximize reimbursement by seeing as many patients as possible every hour of the day. By setting a self-pay fee structure that I believe represents fair compensation for my time, I can offer each patient the time and attention they deserve.