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Treatment Approach with Dr. Alicia Salzer

When You or a Family Member Are Struggling, You Want the Very Best Psychiatrist or Therapist

My clients tend to be high functioning, ambitious, hardworking professionals and their families. Typically, they are people who have aimed high and had success. But something has happened that keeps them from feeling they are able to have the life they are meant for. That’s when they decide to make an appointment with a Psychiatrist or Therapist.

Usually the process begins with looking for a Psychiatrist whose credentials generate confidence that they will be in good hands. My clients want treatment from someone who went to the best college and the best medical school. Then they search for someone with 5 star reviews, who is both responsive and caring. Above all, you want to have faith that you are in good hands. After all, it’s not every day that you decide to share your problems, your secrets or your struggles with a complete stranger.

The Importance of Connection

I know that taking that first step to make an appointment with a psychiatrist or therapist is one that you don’t take lightly. That’s why I strive to spend the first session listening, supporting, exploring and connecting.

While my clients universally seem reassured by seeing that I have been in practice over 20 years, it is not until we meet, and you see that I hear you and I “get you”, that we begin our working relationship. The good news, is that there’s nothing in the world of Psychiatry that is beyond help. Whatever brings you here, there is reason to feel optimistic that with treatment, things will get better.

We Can’t Achieve Goals Without First Carefully Identifying What They Are

In subsequent sessions, we will work together to establish treatment goals, to decide on a focus for treatment, or perhaps a few focuses. This helps us stay on target and have the satisfaction of seeing improvement.

I know my clients are busy and I appreciate the investment of time and money that my clients make when they commit to treatment with me. Therefore it’s important to me that in each session you feel you made some tangible progress, gained some insight, learned a new coping skill or communication skill or found some way to move bit by bit in the direction of increased mastery, increased efficacy and the satisfaction and happiness that come with it.

A Collaborative Approach to Medication Management

If Psychiatric medications for anxiety, depression, panic, sleep, OCD, or ADHD are desired and indicated, I will conduct a thorough history of the symptoms you have had, for how long, how they have impacted your life, what has helped, and what has not helped. We will review any medications you have already tried in detail, because this can offer valuable information about the psychiatric medication choices we make going forward.

Finding Solutions and Hope When Treatment Has Failed in the Past

Often my clients feel that past treatment hasn’t helped. But I notice that often they weren’t taught what to look for in order to know if medications were helping them get better or not. I am often surprised that, although my clients are smart and highly educated people, no one has explained to them their diagnosis, it’s characteristics, the prognosis, how their medications work, what time frame to expect a result, or what we do about side effects if they occur. No one has explained the algorithms we use to determine not only the first steps of medication management of psychiatric illness, but also, what the subsequent steps will be.

Sharing Expertise, So You Can Be Part of the Plan and the Solution

I am deeply invested in pulling back the curtain of mystery behind what we as Psychiatrists do, to make transparent the process of how medications work, and how therapy works. I often tell my patient that I am a consultant who works for them. I bring my expertise to the table, I teach, I answer questions, I share information from scholarly journals and from the world of research to teach you what the evidence shows. But in the end YOU decide if and when you feel comfortable taking those steps.

I am a big fan of sharing stories with my clients about other patient’s experiences. Of course no names are revealed, but my clients find it helpful to hear what someone else was going through, what it was like for them to start medications, and what it feels like when those medications start to work. It’s really important to know what to look for as we wait for medications to start working. Doing so helps my clients have hope that they will be feeling better soon, and helps them have realistic goals about what medications can and can’t do.

The Formula for Feeling Better

Learning the names and characteristics of the symptoms you are experiencing is an empowering way of realizing that these symptoms are part of a constellation of problems that are typical of your diagnosis…not a shortcoming or failure on your part.

Tracking progress really helps patients see that their struggle with depression, anxiety, OCD, ADHD, panic or sleep problems are treatable, that they can be mastered. That they have reason to feel hopeful that they can get back to being themselves and back to their life and goals and plans.

Did You Ever Wonder if Your Diagnosis Might Not Be Right?

Are Other Issues like Substance Use, Eating Disorder, a History of Trauma or a Significant Life Stressor Contributing to Your Struggles?

I especially like working with people who have a complicated history. I approach these clients with a drive to go the extra mile to figure out what is needed for them to feel better. Often I find that those who have gone before me simply kept prescribing an additional medication or kept changing medications. I like to revisit things from the bottom up.

As a master diagnostician I always question the diagnoses my patients come in with. Often history or details have been overlooked that could have predicted why a certain medication or treatment approach was not going to work. Or perhaps other issues that have not been addressed are at the heart of it. That’s why I always do a full screening for things that can complicate and undermine you getting better. Things like substance use or abuse, eating disorders, history of sexual trauma or physical or emotional abuse, unhealthy coping strategies, and unhelpful outlooks.

Beyond Just Feeling Better

You may have been to a Psychiatrist or therapist in the past who only spent 15 minutes, wrote a new prescription and sent you on your way. I don’t believe in that kind of treatment. I believe my clients deserve better. I know that I cannot just treat an illness or medicate away a diagnosis. I need to understand my clients as a whole. My goal is not just to make symptoms go away. My goal is to teach my clients about what they are dealing with, collaborate on a plan to master it, and focus on having a full, satisfying, life.

What Happens Once Patients are Feeling Better?

For too long the fields of Psychiatry and Psychology have focused on helping people’s mood go from a -10 to a zero, that is, symptom free. But what about getting to a +10? I have a personal interest in those positive numbers. That’s why I have extensively studied the field of Positive Psychology. I even wrote a book about the habits and practices of highly resilient people.

For highly motivated patients Interested in making significant changes, the real magic of therapy begins once severe symptoms remit. Not everyone wants to do this kind of work, but if you do, we will talk about your goals, your values, the health of your relationships, the strength of your communication skills, your sense of efficacy and agency, how empowered you feel, how capable you feel to set a goal and achieve it. And if not, what stands in the way. These are the elements that help people be not just symptom free, but back on track.

Comprehensive Treatment for the Whole Person

There are few of us who wouldn’t benefit from gaining insight into some of the ways we get in our own way, why we are that way, and what can be done about it. I’m referring to things like: learning to advocate for ourselves better, learning to control our temper better, learning to identify what we want or need and communicate it to our partners better, understanding being a people pleaser, understanding why we make the poor relationship choices we sometimes do, committing to not making the mistakes our parents made as we raise our own kids, etc.

I believe treatment should be a place where once a week we pause to remember the big picture, to take a 30,000 foot view, to get perspective, to make a long term plan. To be mindful of where we want to be heading. As I always say, you can’t make your goal if you can’t see the target. I’m all about helping you identify the target.

The best treatment is not just about medication management and therapy targeted at symptom reduction. At its best, Psychiatric treatment is a relationship with a person who helps you envision the person you want to be and the life you want to have, and considers it their responsibility to be in your corner as you identify and pursue those goals. We are all the product of our pasts, our histories and our families of origins. But we are capable of transcending the habits and patterns that hold us back.

I consider it a privilege to be entrusted with these challenges and to walk with you as you find your way towards the life you want. You can be sure that I will be tireless in helping you find solutions and relief from the psychiatric symptoms that brought you here. But also to partner with you in the vision that there is so much more in store for you than to be merely symptom free.