Anxiety Disorders
We provide state of the art treatments for all complaints involving fears and phobias. Common symptoms that we successfully treat include:
- Panic
- Social anxiety
- Fears of flying
- Illness fears
- Simple phobias (e.g. animals, insects)
- Public speaking/test anxiety
- Obsessive compulsive and related disorders
- Post traumatic stress disorders
Example of specific therapies:
- breathing training for panickers whose physiological symptoms are related to hyperventilation
- cognitive therapy for panic to address fears of losing control, going crazy, having a heart attack
- cognitive therapy for social anxiety to deal with fears of negative evaluation and embarrassment
- social skills training
- relaxation and biofeedback
- exposure and response prevention for OCD
- EMDR for post traumatic disorders
Depression
Depressed mood represents the most common psychological complaint presented to mental health clinicians. Its chief symptoms include
a) a "down" mood,
b) self critical thoughts and feelings of despair or hopelessness,
c) changes in one's sleep and or eating habits,
d) reduction in activity level,
e) problems concentrating.
Unfortunately, the incidence of depression has been increasing almost exponentially. Recent studies point to an alarming rise in certain sub-groups such as adolescents and the elderly. Mood disorders have been extensively studied for many years and fortunately most individuals can benefit considerably from CBT (sometimes in conjunction with other methods).
Bipolar mood disorders are also increasingly being detected and effectively treated by qualified clinicians. Bipolar spectrum conditions often present with symptoms of irritability, grandiosity, paranoia, agitation, impulsivity and disturbed sleep. Activity scheduling, light therapy, cognitive therapy to challenge negative thinking and assertiveness are just a few of the methods we employ with depression.
OCD
There has been a dramatic increase in interest and research on Obsessive Compulsive Disorder (OCD) in the past few years. OCD is an illness characterized by persistent, unwanted thoughts or feelings and an overwhelming need to perform certain behaviors or think particular thoughts. Recent advances in diagnosis and treatment have reduced the stigma associated with this medical condition and prompted more individuals to seek help. Research studies have determined that cognitive behavior therapy is effective with a majority of sufferers and that the results are often long lasting.
| Symptoms of OCD vary but often include anxieties about the following: |
Common compulsions include: |
- Contamination
- Checking
- Sexual impulses
- Ordering
- Aggressive thoughts
|
- Repeating actions
- Generalized doubts
- Washing
- Illness
- Asking for reassurance
- Hoarding
|
| In addition, many individuals suffer with what have been termed "OCD-related" complains. These include: |
- Hair pulling
- Jealousy
- Hypochondriasis
- Body dysmorphic (imagined ugliness)
- Compulsive sex
- Gambling
- Self-injurious behavior
- Tics
|
Additional difficulties involve perfectionism, social anxiety, guilt, depression and preoccupation with detail.
Attention Deficit Disorders (ADD)
Learning difficulties are diagnosed by our Educational specialist, Dr. David Gottesfeld through a process that includes interview data and standardized testing procedures. A treatment plan is then provided that can help individuals identify and achieve realistic educational and professional goals.
Test anxiety is a common problem in many schools. Individuals are taught to manage this form of performance anxiety which untreated can interfere with academic success. Imaginal desensitization methods are often an invaluable component of a comprehensive treatment which may include study skills training, memory enhancement strategies, etc. We work with elementary school age children to adults taking the bar exam.
Chronic Stress Related Medical Problems
Most illness is influenced by lifestyle behaviors (
e.g. diet, exercise) and our ability to deal with stressful circumstance. Chronic illness can also wear us down resulting in depression. We employ a comprehensive approach to helping individuals identify and successfully change their behavior. This more holistic model has been shown to be extremely helpful with enhancing quality of life and increasing life expectancy. Our HHA program (
see treatments) is an example of one of our flagship programs. We also treat headache, IBS, pain and other maladies in conjunction with other medical providers.
Eating Disorders
In the last 10 years America has witnessed both a staggering increase in eating disorders (especially among young women) and a major public health epidemic in the form of obesity (starting in childhood). A number of eating disorders have been delineated and include:
- Restricted eating patterns (e.g. anorexia)
- Binge purge syndromes
- Binge disorders
- Obesity
Recent research has highlighted the necessity of treatment. Fortunately treatments have become increasingly comprehensive and address multiple dimensions including body image. We work closely with nutritionists.
Alcohol and Substance Abuse
Research in these areas has focused on the objective and thorough evaluation of individuals with drinking or drug problems. The majority of this population often have additional problems such as social phobia, ADD, or mood complaints which urgently need to be addressed. Research studies in the last 25 years have supported the notion that some drinkers can be taught to drink moderately with clinically meaningful reductions in risk. These and other outpatient therapies have demonstrated to be extremely successful when compared with inpatient programs and 12 step programs. We provide individualized treatment plans after doing a functional analysis of one’s alcohol or substance abuse pattern. These can also be a powerful adjunct to other therapies (e.g. AA, Rx)
Smoking
Smoking is the single most preventable cause of death in the United States. It costs the nation almost 75 billion dollars annually. Smoking involves both nicotine addiction and a powerful habit which both need to be aggressively treated. Our treatment includes behavior modification, hypnosis, craving control and relapse prevention. We collaborate with physicians when nicotine replacement or psychoactive medications are deemed necessary and safe.
Pain
CBT has been used for years to reduce both acute and chronic pain. Specific strategies include learning to shift attention away from painful sensations and reduce fear and depression as a response to the pain. Hypnosis and related methods are particularly helpful in pain management. In addition, CBT can help increase activity and reduce suffering by promoting acceptance of the pain as well as reducing dependence on pain medication.
Sleep
Sleep complaints have become almost epidemic and include individuals who don’t sleep as well or as much as they would like (insomnias) as well as individuals who sleep excessively (hypersomnias). In addition, many people have sleep habit complaints such as teeth grinding, snoring, bed wetting, sleep walking, sleep talking and restless leg syndrome. We employ specific treatment methods such as stimulus control procedures, sleep restriction therapies, sleep hygiene training, relaxation training and desensitization. Referrals to sleep labs and/or psychopharmacologists are made when appropriate.
Sexual Complaints
Most individuals suffer with sexual complaints at some time in their life. These include problems with arousal, orgasm, premature or delayed ejaculation and libido deficits. After a comprehensive evaluation and psychoeducational phase, individuals with or without their partners can receive specific instructions about therapeutic assignments to be done at home.
Relationship Discord
Many individuals experience significant conflict and communication difficulties with loved ones. Specific methods for communicating more effectively and managing conflict can be extremely helpful. Separation counseling is available as well when one or both individuals prefer that goal.
Divorce
Going through a divorce is universally stressful and we can all benefit from concrete, supportive treatments to facilitate coping. Specific symptoms which are often experienced include anger, depression and profound feelings of loss.
Family Business Conflict
Family businesses are commonly plagued by interpersonal conflict. Individual and group meetings allow for problem identification and management.
Childhood/Adolescent Disorders
Many children and adolescents struggle with anxiety and mood disorders. They can often benefit from specific treatments such as social skills training for shyness and desensitization for test anxiety. In addition we also teach young people how to be more optimistic which has been shown to reduce depression in the future. Young people often need counseling regarding safe sexual behavior, communication and relationship skills as well as dealing with the ever present risk of alcohol and substance abuse. Specific topics such as ADD and LD are addressed elsewhere on this site. We also help young people make decisions regarding college and vocational choices.
Impulse Disorders
Many individuals struggle with problematic, self defeating behaviors such as nail biting, hair pulling, gambling. These behavioral conditions may be extremely difficult to resist. New research has given people with often years of frustrating and treatment resistant symptoms cause for optimism. Habit reversal is one of several methods that we often use successfully with many individuals.
Anger
Significant irritability and a tendency to get overly angry or aggressive can be divisive in one’s relationships and present health complications over time. A complete functional analysis of one’s tendency to get angry, frustrated or enraged will often reveal negative interpretations of people and/or events and a lack of more appropriate assertive skills. Anger management training attempts to reduce the frequency, severity and duration of anger episodes while emphasizing more adaptive expressions of conflict.
Sports Performance Enhancement Therapies
Individuals whose athletic performance appears compromised by anxiety or distracting negative thoughts can learn attention enhancement methods and strategies for controlling negative thoughts. Research has confirmed that these methods, including hypnosis, can be extremely helpful.
Women’s Issues
Mood complaints are common at times of hormonal disturbance. Specific and powerful psychological complaints are often experienced during pregnancy, premenstrually, in the post partum phase and perimenopausally. Our therapists are knowledgeable about these problems and have specific suggestions to make which can be invaluable.
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