My primary approach to treatment is psychodynamic psychotherapy.  There are a few guiding tenets that are common among psychotherapists practicing from this orientation: 

• Children and parents are not always fully aware of why they do what they do because some things are outside of their awareness.  Sometimes this is because some things are painful and our mind works hard to defend against that pain.  

• People can feel more than one way about some things, even conflicted.  For example, we might feel both excited about our child trying new things and sad that they're growing up so quickly.   

• The past influences the present.  Your child's prior experiences will influence how they view themselves, others and the world.  You as a caregiver also bring in your own past experiences and this influences who you are (or who you definitely don't want to be) as a parent.  It's important to consider the past to understand the present.

• There is a reason for psychological distress.  How we feel, think and behave is not random, and a simple strategy, homework assignment, or a well-timed recommendation for a meditation app will not be enough to alleviate distress in the long run because they don't help us understand why we're doing what we're doing.  

Want to learn more about psychodynamic psychotherapy as an evidence-based practice?  Click here to access Dr. Jonathan Shedler's seminal 2010 paper "The Efficacy of Psychodynamic Psychotherapy".   

In addition to a psychodynamic orientation, I view the caregiver-child relationship through an attachment lens.  From the first few hours of life, infants are social beings driven to connect to their caregivers.  Attachment security builds over time during every caretaking moment, no matter how seemingly small or mundane.  Children depend on their caregivers to keep them safe from harm and comfort them.  Every baby, toddler and preschooler is a little explorer, and their caregivers are their "base camp" from where they set out to climb their next mountain, and then return for comfort, nourishment and recovery.  It would be impossible to work with young children and their caregivers without using an attachment lens to orient our work together and support the parent-child relationship.

You and any other caregiver in your child's life will be seen alone for a few sessions (the consultation and assessment period) to understand what your concerns are and what you'd like to get out of therapy.  These sessions will also focus on your child's developmental history, and any strengths and areas of challenge.  After we have gotten to know each other better, your child will join us in later sessions and we will either play or do an activity that you and your child typically enjoy doing at home.  Only after the consultation and assessment period can we have a conversation about how treatment may be helpful.  

Once treatment begins, sessions may be held with both of you together (dyadic sessions), individually with your child (individual sessions), or a combination of the two.  Play is the way that babies and young children communicate what's going on in their inner world, and it's also the way in which they try to understand what goes on around them.  It may seem like all you do in therapy is play with your child, but remember that the building blocks of attachment and relationships are created in those small moments.  This can also give me a glimpse into what you are seeing at home and provides me with an opportunity to help you and your child understand what is going on.  

In addition, sessions alone with you (parent guidance sessions) will be scheduled consistently to openly discuss your worries, your hopes, and your own experiences that may be influencing your parenting style and your relationship with your child.  It's important for me to get to know you really well, and this is best done through parent guidance sessions.  

Please know that this type of treatment does not include the creation of sticker charts, homework, or one-size-fits-all strategies.  As needed, we will talk about child development, the common anxieties of early childhood, and how to recognize your child's attachment bids or behaviors.  However, this is only done to help you be more curious and reflective about what might be going on in your own child's mind or what is happening between the two (or three, or four) of you.  This type of parent work will help you create a parenting style that is uniquely your own, one that both honors and respects your family values, your child's unique psychological and developmental needs, and what you'd like your child to learn from their experience of being parented by you.