Topics and Practice Areas

Common Topics in Couples Therapy

• Preparing for marriage – building a foundation for marriage, establishing positive communication styles, managing expectations
• Unproductive or unhealthy communication – having the same arguments over and over, not resolving issues, insulting, demeaning, or sarcastic statements, aggression
• Difficulty working together – differing expectations, feeling unappreciated, lack of shared goals, lingering resentments
• Talking about feelings – expressing emotions, communicating one’s needs
• Infidelity – emotional affairs, sexual indiscretions, cheating
• Technology’s impact on the relationship – interference with shared quality time, feeling ignored, internet addiction
• Parenting disagreements – discordant parenting styles, discipline, developmental expectations, lack of role models
• Time management – mismatch in perception or importance of time, interpretation of differences
• Blended family adjustment – dealing with stepchildren and ex-spouses, clarification of roles, merging households
• Forgiveness – self and others, being stuck in recriminations
• One or both partners’ mental health problems including addiction – understanding partner’s illness, changes in emotional functioning, battling addiction, enabling maladaptive behaviors, supporting recovery, self-care
• One or both partners’ physical health problems – understanding partner’s illness, changes in mobility or other physical functioning, enabling maladaptive behaviors, supporting health, self-care
• Life events – new job/career change, moving to a new area, birth or death of family member
• Money – attitudes about saving and spending, dealing with financial strain
• Intimacy – loss of emotional closeness, lack of sexual relationship, shifting emotional focus to another family member
• Extended family – dealing with in-laws, unhealthy family of origin
• Ending the relationship on best possible terms – deciding it’s over and what that really means, how to talk to family members and children about divorce, managing grief

Common Topics in Individual Therapy

• Depression – Depression is a condition when someone feels sad, hopeless, unmotivated, or lack of pleasure for two weeks or more and when these feeling interfere with daily functioning. Depression affects the way a person thinks, feels, behaves, and interacts with others. It is treatable and can usually be classified as mild, moderate, or severe. Therapy alone can be sufficient for many individuals, but treatment may need to include medications for severe cases and those involving impaired perceptions of reality (psychosis). In some cases, a brief period of hospitalization may be necessary when there are safety concerns or a need for stabilization. I will be happy to collaborate with your medication provider to make sure you are receiving quality coordinated care.
• Chronic Pain – The American Academy of Pain Medicine (AAPM) estimates that at least 100 million Americans (about a third of the population, including children) are affected by chronic pain – more than diabetes, heart disease and cancer combined. Whether your pain is rooted in an injury, fibromyalgia, arthritis, or other condition, chronic pain can affect many aspects of your life. Your relationships, leisure activities, self-esteem, sex life, professional identity, sleep, finances, and of course your mood can all be affected. Cognitive behavioral therapy methods are an important component of a comprehensive treatment strategy that addresses the “whole person with pain” rather than just the pain itself. For this reason, the AAPM has included CBT in its practice management guidelines. Through mindfulness, relaxation skills, and other CBT techniques, we can reduce your experience of pain, restore functioning, and improve your overall quality of life. This can be done in an individual or group setting. I will be happy to collaborate with your medication provider to make sure you are receiving quality coordinated care.
• Sleep Problems – According to the National Sleep Foundation, roughly 40 million Americans experience sleep difficulties. Many people have problem falling or staying asleep, or have disrupted sleep/wake cycles. I can help you improve your sleep using cognitive behavioral techniques to address both the thoughts and behaviors associated with sleep. Numerous studies have found that CBT is an effective treatment with long term benefits for most people.
• Anxiety – Anxiety is normal and is experienced by everyone from time to time. Anxiety is not just an emotion. Besides feeling worry or tension, anxiety also may include thoughts like dread or helplessness, and physical symptoms such as increased heart rate, sweaty palms, and temperature changes. Sometimes this trio of emotions, thoughts, and physiological symptoms is so overwhelming that a sense of panic sets in or certain situations/things are avoided to the point that it interferes with regular life. CBT is recognized as a highly effective treatment for anxiety disorders, with and without medication. I can help you learn the tools to combat anxiety and cope in a more effective way.
• PTSD and other trauma-related problems – Symptoms related to trauma include sleep problems, difficulty trusting others, avoidance of situations and other reminders of the trauma, feeling on edge or on guard all the time, memories or thoughts that interfere with other tasks, social withdrawal, feeling emotionally numb or indifferent to loved ones, excessive guilt, and difficulty concentrating. Sometimes individuals feel embarrassed or weak because the effects of trauma are still bothering them, even after a lot of time has passed. They (or others) think they should just “get over it.” If only it was that easy! Some worry that a diagnosis of PTSD means they’re crazy, or that they will be bothered by trauma for the rest of their lives. Trauma-focused CBT and EMDR are evidence-based approaches to treatment that can be very effective in helping you feel better, reducing the interference of intrusive thoughts/images, and becoming more connected with family.
• Military Specific Problems – I can help with issues such as transitioning to civilian life, after effects of combat trauma, military sexual assault, and establishing work-life balance.

Common Topics in Court Related Services

• Court ordered psychological evaluation (individual) – A psychological evaluation can provide information for a judge or probation officer regarding the educational, emotional, and social needs of a youth or adult defendant/litigant. A psychological assessment can serve to augment other data the court has regarding disposition of a case, rehabilitation potential, treatment needs, as well as parenting and family functioning. A standard psychological evaluation includes a comprehensive record review, clinical interview(s), psychological testing, and empirically guided structured checklists of static and dynamic risk factors. In many cases, an evaluation will also include collateral interviews with other significant parties (e.g., caregivers, service providers, teachers). The results of an evaluation are presented in a comprehensive report which includes a summary of relevant findings, a clinical formulation, and recommendations when appropriate.
• Custody Evaluations/ Home & Background Study (family) – The goal of a custody evaluation is to provide information that will be helpful to a legal decision-maker when he or she is deciding on custody/visitation arrangements that afford give each involved child access to the best skills, talents, and resources each parent has to offer. Dr. Warren follows the guidelines suggested by the American Psychological Association that multiple sources of information be gathered and independently generated convergent lines of data be sought. A comprehensive study typically involves: interviewing a substantial number of individuals (including, but not limited to children and parents); observing each child with each parent, and perhaps each child with his or her siblings all together or with both parents; home observation, the administration of paper and pencil measures to key participants; and the review of relevant legal, medical, educational, and mental health documents.
• Consultation – Dr. Warren can provide telephone consultation on mental health questions to be explored, or help identify other service providers who may have relevant expertise. Telephone or teleconference consultation may occur in one or more calls as a case requires.
• Litigation Support Services – Dr. Warren can aid in preparing a client for emotionally trying litigation and provide ongoing therapeutic support, assist an attorney in understanding psychological material presented by opposing counsel, and may offer alternative opinion or perspective.
• Work Product Review – Dr. Warren will review available legal, medical (including psychological and psychiatric), employment (including military), and school documents and provide a summary of findings and recommendations, usually by phone. Findings and opinions can be offered on issues such as standards of care and issues for further inquiry.