Therapy Services.
What is an LCSW? An LCSW is a Licensed Clinical Social Worker. The licensing board in the State of California for an LCSW is the same board as the MFT license. The difference between the licenses is small and primarily in the education. LCSW's are educated with a more "macro" view in mind. They are exposed to a "systems" approach to treatment.
LCSWs are not psychologists or psychiatrists. Many people get these professions confused. A psychiatrist has been trained in medicine and is a medical doctor (MD) with a specialty in psychiatry. They diagnosis mental conditions and are licensed to prescribed medications. A psychologist has a Ph.D., a doctorate in Psychology. Psychologists are trained in providing psychological testing and have a longer education requirement.
The field of counseling and psychotherapy consists of many orientations. Most therapists use a combination of modalities. I have included the orientations that underscore my clinical approach and a brief description of each. Also, I have included a brief case example of each.
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- Intersubjective Psychotherapy = The main feature of this approach is to create a "shared" environment between the therapist and the patient whereby the interactions provide a new, hopefully positive experience. There is some focus on "family of origin" issues and integration of personal history. Trauma, whether shock trauma or developmental (or both) can become a vehicle for insight.
Case Example: A newly sober person has never trusted another person with shameful experiences. Drinking and using drugs was a way to self medicate the overwhelming feelings of anxiety. The intersubjective process offers a "relational home" for sharing these experiences, over time building trust, decreasing anxiety and shame with the goal of creating a new more positive and lasting relational experience.
- Intersubjective Psychotherapy = The main feature of this approach is to create a "shared" environment between the therapist and the patient whereby the interactions provide a new, hopefully positive experience. There is some focus on "family of origin" issues and integration of personal history. Trauma, whether shock trauma or developmental (or both) can become a vehicle for insight.
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- Cognitive Behavioral (CBT) = The focus of CBT is the identification of thoughts, assumptions, beliefs and behaviors that cause debilitating negative emotions and dysfunctional behaviors with the goal of unpacking and rebuilding a more positive and functional lifestyle.
Case Example: A substance abuser cannot seem to get their life on track. They keep repeating cycles of substance abuse, sobering up and then wondering why their life has stagnated or become more chaotic. The focus of the therapist would be to identify the dysfunctional behavior of substance abuse and the subsequent negative consequences. At the same time through education, the therapist would explore the person's distorted belief systems and perceptions. The goal of treatment would be to restructure a life style that the individual could actualize their life goals.
- Cognitive Behavioral (CBT) = The focus of CBT is the identification of thoughts, assumptions, beliefs and behaviors that cause debilitating negative emotions and dysfunctional behaviors with the goal of unpacking and rebuilding a more positive and functional lifestyle.
- Somatic Therapy = Integrating into the work a focus on bodily sensations (felt sense) in an effort to help a person "renegotiate" activated states in the body's nervous system such as, anxiety, anger and sadness. The goal is to allow for highly aroused energies in the body to be experienced safely and gradually without re-traumatization.
Case Example: A person grew up with an abusive alcoholic parent. They find themselves disassociating during specific stressful times, i.e. conflict in a relationship. They are "hyper vigilant" with most relationships. By focusing on the "felt sense" in the body, the therapist can help the person unlock trauma in their nervous system, slowly, utilizing the person's own resources to calm and discharge the activation, i.e., anxiety. The goal of the treatment would be for the person to experience decreased stress and anxiety in relationships and the ability to tolerate conflict.