Knowing the exact nature of a problem is critical in selecting the appropriate treatment. A careful history taking is important in the process of accurately identifying a problem. The use of standardized tests can also be useful. This information gathering process can take 2 to 4 sessions. The appropriate treatment plan can then be mutually determined and agreed upon.
Causes of depression vary. Clinical depression can occur following a loss, prolonged period of stress, or traumatic event. This is referred to as a reactive depression. Learned or acquired negative thinking patterns can also cause depression. In addition, some medications or medical illnesses can result in a clinical depression (e.g., hypothyroidism, heart attack, brain trauma, etc.). Regardless of the cause, depression can be successfully treated through psychotherapy or medication. However, a combination of the two results in the best outcome; of the two (psychotherapy or medication), psychotherapy tends to be the preferred treatment because there is less of a chance of relapse. A cognitive approach is considered to be the most effective non-medication treatment. However, when biochemical changes are at the root of a depression, which is the case with a bipolar depression, then pharmacotherapy is a necessary adjunct to treatment. The treatment of choice for depression is cognitive-behavior therapy.
Anxiety is one of the most common reasons that people seek treatment. There are various kinds of anxiety disorders within the anxiety “family” and it is extremely common for two or more to occur together (e.g., generalized anxiety disorder and panic disorder or social anxiety and a specific phobia, etc.). In extreme cases, medication can be helpful, at least for a brief period of time, until strategies for management of the anxiety can be learned, but in most cases, it can be successfully treated without medication. Cognitive-behavior therapy is the treatment of choice for anxiety disorders.
Autism Spectrum Disorders (including what was previously known as Asperger Syndrome)
Unfortunately, a lack of understanding of Autism Spectrum Disorders (ASDs) still exists among the majority of healthcare professionals (and that includes psychologists, counselors, and other types of therapists), physicians, and educators who work with individuals with this particular neurological difference. As a result, the presence of an ASD is often completely missed and some even question the diagnosis altogether after it has been diagnosed, especially in the case of the more subtle forms of ASD. Moreover, of those professionals who do have some understanding of ASDs, their level of knowledge, training, and experience is still often insufficient and they themselves may be unaware that they are ill-equipped to be of any real help. Due to the complexity level of ASDs and the vast range of variation in presentation, a superficial knowledge and limited training and/or treatment experience can only go so far. This is an unfortunate state of affairs for those seeking to be accurately diagnosed and helped. Dr. Miller has over 15 years of specialized training in the diagnosis and treatment of individuals with ASD and she has evaluated and/or treated over 1,000 individuals.
Attention Deficit/Hyperactivity Disorder (ADHD)
ADHD is often a misdiagnosed, especially in children, because there are other conditions that can present similarly such as an auditory processing, learning, or bipolar disorder. However, by conducting a more comprehensive evaluation versus utilizing solely ADHD questionnaires, an accurate differential diagnosis can be made. This can also eliminate the possibility of an unnecessary use of medication.