PSYCHOPHARMACOLOGY | PSYCHOTHERAPY | PSYCHIATRIC EVALUATIONS

PSYCHOPHARMACOLOGY
 
Dr. Reives-Bright is a board certified psychiatrist who specializes in the assessment and treatment of children, adolescents, and adults suffering from a variety of psychiatric and behavioral disorders. One of her primary treatment expertise is psychopharmacology or medication management.

For children & adolescents who are usually sensitive to medication side effects, Dr. Reives-Bright’s usual practice is to “start low and go slow” with titration, unless extreme severity of symptoms warrants more aggressive treatment. For adults who often have a more complicated history, Dr. Reives-Bright’s usual practice is to analyze the symptom clusters to develop an individualized medication regimen. In either case, Dr. Reives-Bright always provides a comprehensive assessment and psychoeducation before prescribing medication.

When starting a new medication, Dr. Reives-Bright asks patients to schedule more frequent sessions to monitor tolerability and potential side effects while determining the optimal therapeutic dose. Once symptoms become more stable, session frequency can be extended to every 1-3 months depending on the medication regimen. In general, treatment duration and session frequency varies depending on severity of symptoms and medication profile.

PSYCHOTHERAPY
Individual Psychotherapy – Family & Couples/Marital Therapy

Through formal education, clinical training, and continuing education, Dr. Reives-Bright has earned proficiency in several types of individual psychotherapy with children, adolescents, and adults, as well as family and couples/marital psychotherapy.

Individual Psychotherapy

Dr. Reives-Bright uses individual psychotherapy to help children, adolescents, and adults who are experiencing difficulties with their emotions or behavior. This type of work focuses on communication as the basic tool for bringing about change in a person's feelings and behaviors. For adults, this is primarily accomplished via talking, while psychotherapy with children and adolescents tends to include playing, drawing, building, and pretending, as well as talking.

As part of the initial assessment, Dr. Reives-Bright will determine the need for psychotherapy. For children and adolescents, this decision will be based on such things as the patient’s current problems, history, level of development, ability to cooperate with treatment, and what interventions are most likely to help with the presenting concerns.  Psychotherapy is often used in combination with other treatments (medication, behavior management, or work with the school). The relationship that develops between Dr. Reives-Bright and the patient is very important. The child or adolescent must feel comfortable, safe and understood. This type of trusting environment makes it much easier for the child to express his/her thoughts and feelings and to use the therapy in a helpful way.

Psychotherapy helps children, adolescents, and adults in a variety of ways. They receive emotional support, resolve conflicts with people, try out new solutions to old problems, and gain insight about their thoughts, feelings, and behaviors. Goals for therapy may be specific (change in behavior, improved relations with friends, family, partners, or co-workers), or more general (improved mood, better self-esteem).  The length of psychotherapy depends on the complexity and severity of problems.

Dr. Reives-Bright is trained in the following types of individual psychotherapy:

• Cognitive-Behavioral Therapy (CBT) – is a structured and goal-directed type of psychotherapy that specifically focuses on increasing the patient’s awareness of and ability to modify their thoughts, feelings, and behaviors. Techniques commonly include keeping a diary of significant events and associated feelings, thoughts and behaviors; analyzing negative interactions or events; questioning and testing assumptions or habits of thoughts that might be unhelpful and unrealistic; gradually facing activities which may have been avoided; and trying out new ways of behaving and reacting. Relaxation and distraction techniques are also commonly included. CBT is widely accepted as an evidence-based, cost-effective psychotherapy for many disorders.
  
• Exposure/Response Prevention Therapy (ERPT) – is a specific behavioral technique for managing anxiety, phobias, obsessive-compulsive disorder, and other anxiety-based disorders. In ERPT, the patient is first exposed to the anxiety-producing stimuli (e.g., public speaking), then denied the ability to flee or avoid the situation. Over time and with repeated attempts, the patient learns to break the link between the anxiety and avoidance behavior.
  
• Interpersonal Psychotherapy (IPT) – is a brief (20 sessions or less) and highly structured manual-based psychotherapy that focuses on the impact of negative interpersonal relationships and events as reinforces of depression and other mood disorders.
  

Family & Couples/Marital Therapy

In addition to individual therapy, Dr. Reives-Bright also utilizes family and couples/marital therapy to improve the way family members interact with each other and resolve conflicts. Family therapy is particularly helpful as an adjunct modality for the treatment of childhood behavioral problems and for uncovering alliances, roles, rules, behavior patterns, and unhealthy relationships within the family that may be contributing to the identified patient’s difficulties. Dr. Reives-Bright employs couples/marital therapy to help individuals to resolve relationship and marriage difficulties. Like other psychotherapies, the ultimate goal of family and couples/marital therapy is the help family members and partners better understand their difficulties and communicate more effectively.

PSYCHIATRIC EVALUATIONS

In addition to psychopharmacology and psychotherapy, Dr. Reives-Bright performs comprehensive diagnostic evaluations of children, adolescents, and adults, which typically include the following procedures:

• Perform intake assessment of presenting problems and clinical history
• Interview collateral parties (parents/siblings, school psychologist, other healthcare professionals)
• Review any previous assessments and clinical reports
• Completion of behavioral checklists & rating scales
• Observe child/adolescent patient in school environment
• Write formal report if needed