Mental illness remains one of our society's greatest stigmas.  The fact of the matter is that mental illness - conditions such as schizophrenia and bipolar disorder - are brain illnesses with biological and genetic causes.

Our understanding of mental illness has evolved greatly over the past two decades with the advent of the brain scan.  Along with this understanding has come the development of newer medications which improve the prognosis for persons suffering with major mental illness.

With this new understanding of the illness has come a new understanding of the treatment.  Major mental illness requires specialized treatment.  Just as you would seek out a cardiologist for a heart condition, you need to seek out a mental health professional trained in this specific area to receive the best help.

The Four Pillars of Treatment

Treatment for major mental illness generally involves four components - medication, psychosocial rehabilitation & therapy, family support and skills, and healthy lifestyle.
 

1. Medication.  Biological illnesses require biological treatments.  Medication alone is not enough, but it is the foundation.  The goal of medication management is to stabilize the debilitating symptoms of the illness so that the person is back in the driver’s seat and able to pursue their life's goals and dreams.  Advances in medication now provide more options than ever.
    
2. Psychosocial Rehabilitation and Therapy.   The psychosocial rehabilitation model is one based on a person's strengths, focusing on their self-determined goals and helping them live better in the world.  It contrasts from the traditional medical model which focuses only on symptoms and pathology.  Individual therapy from this model works with the person to identify goals, develop strategies to achieve the goals, and address barriers to reaching them.  Critical in this model is the role of peer support.  Connecting with others who understand the condition and face similar challenges in moving forward instills greater hope, reduces stigma and alienation, and provides a social network.
   
   The most effective therapy for persons with severe and persistent mental illness is cognitive behavior therapy (CBT). CBT focuses on the thought process, helping persons understand their problems in a healthier, more adaptive manner. Further , CBT helps the person develop specific techniques and skills to manage their illness, cope with symptoms, and problem solve. In line with the psychosocial model, all of this is done with a focus on helping the person pursue their goals and dreams.
    
3. Family Support and Skills.  Mental illnesses are family illnesses.  While the person experiences the symptoms, it is the entire family which experiences the trauma.  As such, families need to be involved.  Further, they are viewed as an asset to treatment - not a hindrance, not as the cause of the illness.  Families play a great role in the recovery process by providing the helpful factors in recovery.  Family treatment includes crisis management, providing education, and practicing the research proven skills effective in promoting recovery.
    
4. Healthy Lifestyle.  The more we learn about mental illness, the more we know that healthy lifestyle activities play an important role in recovery. While helpful for everyone, these become necessary given the demands mental illness poses on the person. Activities which have been shown helpful include: healthy diet, supplements, exercise, prayer and meditation, yoga, breath training, muscle relaxation, social support, and spirituality.

How it works in my practice

There is no one way in which this works in practice, but there are some general patterns depending on who is asking for the help.

If the family seeks help...  I often consult initially with the family (without the mentally ill relative).  Families can benefit greatly from the education, problem solving, and support provided through this work.  Even if their relative will not become a part of treatment, there are many families for whom I provide ongoing consultation on a regular or as needed basis.

Over time, families may be able to invite their relative into the process.  At this point, I will see the person individually and with their family.  It becomes a case by case decision - depending upon the particular needs of that person and their family - how treatment then proceeds.

If the person seeks help...  When persons with a severe and persistent mental illness seek help, they're accustomed to more traditional forms of treatment.  I try to give them a sense that my approach is different - focusing on strengths and goals, trying to understand their unique experience with their illness, identifying practical coping strategies.

A key point I discuss is the importance of incorporating the family (or other support system) into the process.  Helping the significant others in their life better understand them can be an important aspect in their recovery efforts.  Once the family is involved, again it becomes a case by case decision how treatment then proceeds.

If the person & family are willingly seeking help… If everyone is willing, then an initial consultation with the entire family is preferred. During this consultation, we will start with the entire family, then may spend some time with the just the person and/or the family without the person.

The Bottom Line... in this work is that everyone - individual, family, and professional - is on the same page, working toward shared goals.
 

Getting Started

The fee is $150- for a standard 50 minute session.  Fees are collected at the time of service. 

The initial session is 1 hour and 45 minutes long to provide time to more fully assess the individual and/or family's presenting concerns and background, and address initial questions that you may have.  The fee for the initial session is $300 (based on my $150/hour fee).

For the initial session, I ask that you complete a few forms that will help us begin our work together.  You may download and complete each form (attached below in Adobe Acrobat).  Completing these will give you time to reflect upon the concerns that have led you to seek help and provide me with some background information about you.  If for any reason you cannot download these forms, you may come to my office 30 minutes prior to your initial appointment and complete them there.

Forms you can download and complete:

• Consent for Services - Family (person & family member sign)
• Admission Form - Individual (person completes)
• Lifestyle Self-Assessment (person completes)
• Admission Form - Family Report (family member completes)

Please contact me directly via phone or e-mail for further information or to set up an initial consultation.