What is your approach to therapy? What can I expect if we work together for therapy?

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 our selves that we cannot see or understand without some outside help, and 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 do your best to share whatever is going through your mind 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.

What is your approach to prescribing? What can I expect if we are primarily working together on medications?

I believe that good psychiatric care begins with a thorough history, and it is very important to me that I understand your experiences in depth in order to begin to develop a diagnostic formulation and treatment plan. We may be able to achieve the necessary understanding by the end of the initial consultation, or it may take a few consultation session for us to get a clear sense of what is going on. 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.

I strive to provide 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. While I endeavor to make recommendations that are data-driven and supported by evidence-based guidelines, I do not ascribe to a one-size-fits-all approach to treatment.

I prefer to avoid prescribing multiple medications when a single medication may suffice, and I am happy to de-prescribe when a medication is not helping or is actively causing harm. It is never my wish to numb emotions or change someone’s personality with medications. I view medications as tools that may ideally reduce symptoms to the point that you can do the personal work that will enable you to live a more fulfilling and enjoyable life.

How often will we meet?

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 meet anywhere from 2-3 times per week to 2-3 times per month. 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 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.

Do you see couples or families?

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 therapy, I will be glad to refer you to a trusted colleague with expertise in these types of therapy.

Why is your practice out of network with insurance?

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 time with my patients. Second, I can offer a higher degree of privacy and confidentiality, since insurers generally cannot compel me to share progress notes or treatment records. Third, being "out of network" keeps patients in control of their treatment by limiting insurers’ ability to inappropriately influence or dictate care by way of 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." By setting a self-pay rate that I believe represents fair compensation for my time, I can offer each patient the time they deserve rather than cramming as many appointments as possibe into every hour of the day.