Treatment
Therapy
Medication can quiet symptoms; therapy is where patterns change. Dr. Giddens offers psychotherapy in its own right and alongside medication, choosing the approach that fits the problem and the person.
Approaches offered
- Cognitive behavioral therapy (CBT)
- Structured, practical, and time-limited. CBT works on the link between thoughts, feelings, and behavior, and is the best-studied psychotherapy for anxiety, depression, OCD, and many adolescent problems. Sessions include work to do between visits, and progress is measured. More on CBT from the American Psychological Association.
- CBT for insomnia (CBT-I)
- The first-line treatment for chronic insomnia, recommended ahead of sleep medication by the American Academy of Sleep Medicine. Over four to eight sessions it resets the sleep schedule, rebuilds the bed–sleep connection, and addresses the worry that keeps people awake. It is adapted for adolescents with delayed sleep phase.
- Interpersonal psychotherapy (IPT)
- A time-limited therapy, usually 12 to 16 sessions, built on a simple observation: depression and relationships shape each other. IPT focuses on one of four areas, grief, a role change such as a new baby or a new job, a conflict with someone important, or isolation, and works to resolve it. It has strong evidence for depression in adolescents and adults, and for depression in pregnancy and after birth, where it is often preferred to medication. More from the International Society of Interpersonal Psychotherapy.
- Psychodynamic psychotherapy
- For patterns that keep repeating despite good intentions: in relationships, in mood, in the way a person treats themselves. Psychodynamic work looks at where those patterns come from, including the parts that operate outside awareness, so that they can change at the root rather than at the surface. Dr. Giddens practices psychodynamic psychotherapy with ongoing psychodynamic supervision, the discipline's standard for keeping this depth of work rigorous.
- Motivational interviewing
- A collaborative, non-judgmental way of working with ambivalence, developed for substance use and now used far more widely. It is the backbone of the early stages of addiction treatment here and of work with teenagers who did not choose to come.
- Supportive psychotherapy
- Steady, practical support through a crisis, a loss, a diagnosis, or a stretch of life that is simply hard. Often the right choice during medication changes or early recovery.
- Parent guidance and family sessions
- For children and adolescents, the most powerful lever is often the adults around them. Parent sessions cover how to respond to anxiety, defiance, screen and sleep battles, and substance use in ways that help rather than escalate, and family sessions bring everyone into the same conversation.
How therapy fits with the rest of your care
- Therapy and medication are planned together, by one physician, rather than handed between offices.
- If you already have a therapist, we do not replace them; we coordinate so that both treatments pull in the same direction.
- Progress is tracked with the same brief rating scales used for medication, so you can see change rather than take it on faith.
- Therapy sessions are 45 to 50 minutes and are available in New York, in Washington, DC, and by video for established patients.
Is therapy right for you?
Not every problem needs it, and not every person wants it. The first evaluation is where we decide together: sometimes medication alone is the right start, sometimes therapy alone, and often the two together do more than either does apart. If you are unsure, book an evaluation and we will talk it through.