My Approach to Treatment | DevelopingMindsandFutures

Treatment Framework

Throughout my practice, I have collected data and researched the transdiagnostic variables, those distal and proximal risk and protective factors that influence a range of similar symptoms expressed in emotional, behavioral, and informational processing disorders. A breakthrough occurred when observing the high co-occurrence rates of depressive, anxiety, and externalizing disorders that were no longer the exception, but the norm: particularly when working with clients living with Attention-Deficit/Hyperactivity Disorder (ADHD).

After years of closely monitoring client progression with unidirectional focus on one disorder, I was able to identify consistent patterns of emotional, neuro-anatomical, biological predispositions, and environmental stressors that facilitate idiosyncratic expression and disturbance in an individual's cognitive processing. Ultimately, what I learned during my comprehensive studies and training as a Clinically Certified Service Provider (CSSP), is an intimate link between ADHD and executive function impairments, to such an extent that ADHD is more aptly considered Executive Function Deficiency Disorder (EFDD) by the most prominent scholars in the field of mental health & ADHD.

Assuming a transdiagnostic perspective: ADHD, executive function impairments, and the extremely high rates of co-occurring externalizing and internalizing pathologies all share common features; namely, the inability to access higher-order cognitive capacities required for self-regulation of primary emotional and behavioral states over time in the performance of goal-directed tasks. Over a seventeen year period, I developed an executive function-focused, cognitive-behavioral, transdiagnostic, multi-modal, empirically-based treatment design that works particularly well for children, adolescents, & adults and is adapted for working with the family system.

The Treatment: individualized to meet the needs of each client, allowing for self-regulation of behavior and emotion over time, during the performance of goal-directed tasks.

The drive and desire I have for each of my clients is focused on achieving access, and generalizing tools created in session, which are necessary for executive control over behavioral and emotional states when faced with external stimuli and/or internal prompts that would otherwise trigger primary prepotent response patterns.

By modifying general treatment models to meet the unique personality & temperamental profiles of each client, I create novel templates and exercises designed to provide a client with ability to decouple dominate responses to stimuli in the environment. This allows the client to guide their lives with executive top-down regulation and control of their thoughts, behaviors, and emotions, while contemplating future hypothetical outcomes of their actions.

In order to ensure I am providing clients with the most effective tools to date, I remain current on all theoretical trends across multiple modalities of research and treatment, as well as cutting edge evidence based intervention models;

Member of both Children & Adults with Attention Deficit Disorder (CHADD) and the Autism Society,
Yearly subscriptions;
- The ADHD Report - published by Dr. Russell Barkley
- The Journal of Social & Clinical Psychology
- Child & Adolescent Psychopharmacology News
- The International Journal of Cognitive Therapy
- The Journal of Personality Disorders
- The Journal of Systemic Therapies
- The Journal of Social Cognition

Access to this wealth of information during assessments occurring within the context of a developmental-systemic approach, has given me the ability throughout the years, to find convergence points between multi-modal evidence-based treatment approaches, all specifically geared toward identifying executive function impairments, which are commonplace with a diagnosed case of ADHD and other neurodevelopmental disorders.

Implementation of evidence-based assessment tools allow me to create a comprehensive multi-modal intervention model that addresses the greatest degrees of impairment in daily life functioning caused by ADHD and/or the corresponding client-to-client specific executive impairments seen with this disorder. Through the use of these multi-systemic evidence-based approaches to assessment and intervention, my clients are able to achieve an intrinsically defined level of control that meets the standards of executive control over their disorders as defined by their loved ones and themselves.

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FOR THOSE NOT DIAGNOSED WITH ADHD

Other Disorders

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Mindfulness-Based Techniques

Transdiagnostic evidence-based methodologies allow for case conceptualization and integration of bi-directional, transactionally influencing domains of life, within a unified framework. Sub-threshold symptom expression that does not meet diagnostic criterion for a specific disorder, often illustrates the concept of multi-finality, thereby necessitating an ability to coalesce common cognitive, behavioral, and emotional processes that serve as the etiological source of distress.

Independent of presenting with a psychopathology, adolescents and adults are welcomed to schedule a session if they desire to build a context of understanding regarding the potential unifying themes in the onset, development, and maintenance of distress, depressionogenic thought processing, anxious beliefs & cognitions, and intrafamilial/interpersonal conflicts.

Through a process of identifying consistent themes that generalize cross-situationally to multiple domains of life, we then focus on implementing the necessary structures and provide in-vivo support plans that facilitate the ability to gain control in each respective domain of life.

Scaffolding and modeling in-vivo top-down regulation of primary prepotent emotional responses, once decoupled from proximal and distal risk factors for impulsive responding, the transactional and bi-directional nature of these newly developed skills with the environment facilitates the generalization and accessibility of higher order cognitive capacities in the development of diverse social support networks.

Clients become fully engaged with self-awareness, experiencing emotions fully to create coherent self narratives, which are critical component pieces of the counseling process I provide to clients seeking help outside of my ADHD work.

I also provide Executive Function training, which specifically deals with emotion regulation, self-esteem & motivation, organization, and time management, which everyone can benefit from, independent of being ADHD or not.