Dr. Richard J. DioGuardi
Clinical & School Psychologist
Different issues require different solutions.
In providing individual therapy I integrate aspects of different treatment approaches based on the client’s needs, situations, and desires. This may include Cognitive Behavioral Therapy (CBT), Psychodynamic Therapy, Psychoeducation, and/or Family Systems Approaches in which family members may be invited to join us for one or several sessions.
Cognitive Behavioral Therapy (CBT) is a type of therapy that is also sometimes referred to as Rational Emotive Behavioral Therapy (REBT). It focuses on thinking, judging, deciding, analyzing, and doing. It assumes that cognition's, emotions, and behaviors interact and have a reciprocal cause-and-effect relationship. The therapy teaches that our emotions stem mainly from our beliefs, evaluations, interpretations and reactions to life situations.
The assumptions behind REBT are that people contribute to their own psychological problems and symptoms through the way that they interpret events and situations. One can reorganize their behaviors by reorganizing how they think. Behavioral modeling, rehearsal, and provision of reinforcement or rewards can be applied to thinking and changing it. The focus of the therapy is to change cognition's and therefore change behavior and emotions. Through this therapy - the client is to learn how to identify and dispute unhealthy, self-defeating beliefs and to replace ineffective ways of thinking with effective and rational thoughts. They are encouraged to stop absolutistic thinking, blaming and repeating false beliefs. In CBT or REBT, homework assignments are often given to enable the clients to work on their problems in between sessions and facilitate maximum functioning.
Psychodynamic Therapy aims to help clients become aware of and experience their vulnerable feelings which have been pushed out of conscious awareness. The Psychodynamic approach states that everyone has an unconscious which holds and harbors painful and vulnerable feelings which are too difficult for the person to be consciously aware of. In order to keep painful feelings, memories, and experiences in the unconscious, people tend to develop defense mechanisms, such as denial, repression, rationalization, and others. According to Psychodynamic theory, these defenses cause more harm than good and that once the vulnerable or painful feelings are processed the defense mechanisms reduce or resolve.
Many of the approaches used in Psychodynamic Therapy revolve around the idea that there is an element of maladaptive behavior in effect. Although it is unconscious at times, it is nevertheless still present. The assumption of maladaption is constructed and formed at a very early stage in a person’s life and ultimately causes disharmony in the experiences that they encounter on a daily basis. This form of therapy strives to uncover the underlying conflicts that are the catalysts for the disturbing and unhealthy symptoms. The first technique the therapist employs is that of the intervention in order to address the symptom that resulted from the maladaptive behavior. Once this has occurred, the therapist can then work with the client to devise and construct elements of change that can be implemented.
Psychoeducation is a specific form of education where the goal is for the client to understand and be better able to deal with the presented illness. Also, the client’s own strengths, resources and coping skills are reinforced, in order to avoid relapse and contribute to their own health and wellness on a long-term basis. The theory is, with better knowledge the client has of their illness, the better they can live with their condition. Through an improved view of the causes and the effects of the illness, psychoeducation frequently broadens the client’s view of their illness and this increased understanding can have a positive effect. The relapse risk is in this way lowered; clients and family members, who are more well-informed about the illness, feel less helpless.
Family Systems Therapy is based on the idea that individuals are best understood through assessing the entire family. Symptoms in individuals are seen as expressions of dysfunctions. The family is an interactional unit and a change in one member effects all members. Family therapists believe that an individual's relations have more impact in their lives than any one therapist could. The family therapist uses the systemic perspective, it believes that individuals may carry a symptom for the entire family, and an individuals functioning is a manifestation of the way a family functions. Individuals can have symptoms existing independently from the family members but these symptoms always have ramifications for family members. Therefore, family therapists will change the system in order to change the individuals. They do so by changing dysfunctional patterns or relating and creating functional ways of interacting.