My Approach

  • What to Expect

    People usually call me seeking help with anxiety that is getting in the way of their functioning their best at home or at work.

    For example, people call for help with really specific anxieties like panic attacks; fears of flying, riding the subways or elevators;  fears about speaking in meetings; as well as more general stress and anxieties like being overwhelmed at work, having insomnia, chronic worry, “a nervous stomach,” or extreme shyness.

    Once we start working together and my clients quickly gain some tools and start feeling better, they often ask if I can help them with something else! That’s a sign of a great working relationship, and I’m glad to broaden the work to other areas besides anxiety. So sometimes clients extend their sessions a while longer to sort out some relationship issues, work stress, or career goals.

Sophisticated CBT
I provide effective Cognitive Behavioral Therapy for anxiety and other issues. My approach is clinically sophisticated, so I tailor the work to help you get relief from current symptoms, but also to shift longstanding patterns and create lasting change.
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  • The initial consultation

    My agenda for the first session is to do a thorough assessment of the current issues and your background, give feedback on diagnosis and treatment options, and provide a sense of how I would approach your concerns.  It’s also a chance for us to see how the dialogue feels, and if it seems like a good match.

    At the end of the consultation, if either of us thinks you would be better served by some other professional or approach, I will try to provide an appropriate referral.  But assuming we agree to work together, my aim is to begin working right in the first session, and for you to start to feel better right away.

  • Making the most of it

    My clients are often surprised when they find that changing their perspective really does lead to better relationships with a partner or co-worker, to alleviating anxiety that is restricting their ability to interact comfortably with others, or to being able to change dysfunctional eating habits.

    But changing your perspective really does take practice, so I encourage my clients to do between-session assignments.   At first, these are cognitive therapy exercises that I will tailor to you.  But as we proceed, and you’ve mastered the basic tools, then we’ll be creative in tailoring the assignments together so they are most relevant for the specific changes you want to see.

  • How we know it’s working

    This work is really energizing, for my clients and for me, too.  One of the best parts is witnessing the shift when a client starts to notice the change in a thought pattern, and is surprised to find themselves not having the panic attack when they usually would, or being able to fly comfortably for a business trip or family vacation, or being able to speak up in a meeting where they usually would have avoided it.  Seeing that kind of progress is a great moment for them, and it propels people forward in the work, to consolidate their gains and to keep building on their success.

  • Length of therapy

    Cognitive therapy is designed to be short-term and focused, and my being a fast-paced New Yorker who likes to move apace, that works well for my practice!  CBT textbooks usually recommend 12 – 20 sessions to treat a specific anxiety disorder, but my clients usually report they are starting to feel better in the first few sessions, and often we move quicker than the textbooks say. To be safe, count on a few weeks to a few months of weekly therapy sessions to do the main work, followed by a number of sessions spaced at greater intervals, so that we can consolidate the gains that were made and prepare for post-therapy maintenance.  Bottom line:  there is a range;  some very focused problems require only a handful of sessions, while making lasting changes in core issues does take longer.

  • Open door policy

    Some of my clients finish up a piece of therapy work, like getting subway panic attacks in check, and may return at a later point for a brief “tune-up” or to focus on another issue, say relationship or career concerns. Others work on their main issue, and then decide to extend the sessions in order to focus on another area. Given the nature of my approach, it must be obvious that my aim is not to conduct lifelong, ongoing psychotherapy.  I define the project and the time frame jointly with my clients, and I am flexible about when and how to proceed with sessions.

  • Use of psychiatric medications

    While cognitive therapy often has a powerful effect on its own, clinical research, plus my professional experience, indicates that in some cases cognitive therapy plus medication is a more effective combination for mental health care.  As a result, while I tend to be conservative in recommending medication, I absolutely do make evaluation referrals when appropriate.  I stay in contact with a number of psychiatrists who specialize in psychopharmacology, and when I do refer to one of these colleagues, we work together to coordinate our treatment efforts.