Treatment Areas

Explore a range of specialized treatment areas tailored by Dr. Fishburne to address diverse psychological challenges and foster lasting positive change in your life.

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Anxiety

Anxiety consists of various disorders such as generalized anxiety disorder (GAD), panic disorder, social anxiety (i.e., excessive shyness), specific phobias, and various forms of trauma (PTSD). Symptoms vary widely but commonly include physical signs (increased heart rate, sweating, trembling), cognitive impairments (excessive worrying, difficulty concentrating, pessimism), and functional problems (avoidance behaviors, impaired work performance,
social withdrawal).

Anxiety disorders remain among the most prevalent mental health conditions in the US. According to the Anxiety and Depression Association of America (ADAA), anxiety disorders affect 40 million adults in the U.S. aged 18 and older, or 18.1% of the population every year. Despite being highly treatable, only about 36.9% of those suffering receive treatment.

Dr. Fishburne uses a combination of several empirically supported strategies for effectively treating anxiety, to include Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (A.C.T.), and mindfulness-based strategies.

Depression

Depression is a widespread mental disorder in the United States, marked by persistent sadness, loss of interest in activities, and a range of physical and emotional problems. It can cause significant impairments in daily functioning and is one of the most common mental health
disorders in the country.

In 2021, an estimated 21.0 million adults in the United States experienced at least one major depressive episode, representing about 8.3% of all U.S. adults. The prevalence was higher  among adult females (10.3%) than males (6.2%) and was most prevalent among individuals aged 18-25 (18.6%).

Despite its high prevalence, many individuals with depression do not receive adequate treatment. In 2021, around 61.0% of U.S. adults with a major depressive episode received treatment, indicating a significant treatment gap. This gap is even more pronounced among adolescents, where about 60% of those with a major depressive episode did not receive treatment.

Cognitive Behavioral Therapy (CBT) is highly effective for the treatment of depression, with numerous studies supporting its efficacy. CBT involves identifying and challenging the negative and irrational thoughts, beliefs, and attitudes that fuel depression. By replacing these thought patterns with more accurate and positive ones, individuals can significantly reduce depressive symptoms. Concurrently, behavioral changes, such as increasing engagement in enjoyable or meaningful activities, can disrupt the cycle of depression by enhancing mood and reducing withdrawal and avoidance behaviors. Together, these changes in thought and behavior create a powerful mechanism for alleviating depression and promoting mental health recovery.

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Marriage / Relationships

In the United States, divorce rates have shown a nuanced trend over the past few decades. While the commonly cited statistic from the 1980s suggested that around 50%  of marriages ended in divorce, more recent analyses indicate a decline, with rates hovering around 40-45%. This change is partly attributed to shifting societal norms, with younger generations marrying later or choosing not to marry at all. There’;s also an increasing trend towards long-term committed relationships without formal marriage, reflecting changing attitudes towards commitment and cohabitation. This shift underscores a reevaluation of traditional marriage as the sole framework for long-term partnerships.

Committed relationships, whether formalized through marriage or not, have been shown to confer numerous benefits on individuals' well-being. Mentally, they can provide emotional support, reduce stress, and contribute to greater overall happiness. Physically, being in a committed relationship has been linked to lower rates of heart disease, improved immune function, and longer lifespan. Financially, shared resources and dual incomes can lead to improved economic stability and opportunities for wealth accumulation. Moreover, having a partner to share life’s burdens can foster a sense of security and mutual growth, contributing to a more fulfilling life. These benefits underscore the profound impact of committed relationships on various aspects of health and well-being.

Couple’s therapy offers significant benefits by addressing relationship issues, improving communication, and fostering a deeper understanding between partners. It provides a structured environment for resolving conflicts and exploring sensitive topics that might be difficult to address without professional guidance. By learning effective communication strategies and conflict resolution skills, couples can enhance their relationship satisfaction and emotional intimacy. Additionally, couple’s therapy can help partners navigate transitions, heal from infidelities, and rekindle romance and passion. The benefits extend beyond the relationship itself, often leading to improved mental health, stress reduction, and greater overall happiness for both individuals. Couple’s therapy not only aids in resolving current issues but also equips couples with the tools to face future challenges together, strengthening the bond and durability of their relationship.

Post-Traumatic Stress Disorder

Prolonged Exposure (PE) therapy for Post-Traumatic Stress Disorder (PTSD) can indeed be a difficult and challenging process, as it requires individuals to bravely face and engage with memories and stimuli that they have likely spent a long time (often years) trying to avoid. This process of deliberate, repeated confrontation with traumatic experiences is understandably daunting and can evoke significant emotional distress initially. However, it’s precisely through this courageous willingness to face one’s fears that the therapy finds its effectiveness. These therapeutic techniques (usually through writing exercises, imagining traumatic experiences in session, etc.), operate on the principle of habituation. By gradually and repeatedly exposing individuals to trauma-related cues, thoughts, and feelings without actual danger, they learn to decrease their emotional response and diminish the power of the traumatic memories. This process helps to break the cycle of avoidance and fear that characterizes PTSD, enabling clients to regain control over their emotional reactions and reduce symptoms of the disorder, promoting healing and resilience.

Dr. Fishburne approaches this therapy with a foundation of compassion and professional guidance, aiming not just to confront trauma but to empower individuals with a sense of control over their lives again.  The effectiveness of PE therapy in treating PTSD has been robustly supported by empirical evidence, including a significant study by Foa et al. (2005), which demonstrated substantial reductions in PTSD symptoms among participants undergoing PE, with many patients maintaining their gains over time. This study, among others, underscores PE therapy’s role in enabling individuals with PTSD to confront and assimilate their traumatic experiences, leading to improved functioning and quality of life

Substance Use

Deciding on the best approach to manage or modify alcohol use can be somewhat confusing, in part due to the tendency of people to support the option that worked best for them. The choice between pursuing treatment strategies like Mindfulness-Based Cognitive Therapy (MBCT), Cognitive Behavioral Therapy (CBT), and Motivational Interviewing (MI), or opting for complete abstinence, hinges on a variety of individual factors. Understanding these can guide you to the treatment best aligned with your needs and goals. Here’s a look at some key considerations that might help you determine the most effective approach for your needs.

  • Severity of Alcohol Use Disorder (AUD): The severity of AUD—mild, moderate, or severe—is a crucial determinant. Those with severe AUD are generally recommended to pursue abstinence, as moderation can pose significant risks and challenges. Mild to moderate levels might be more amenable to moderation approaches such as CBT or MI.
  • Psychological Factors: Personal mental health conditions play a significant role. For individuals with co-occurring disorders such as anxiety or depression, MBCT might be particularly beneficial to address both the mental health condition and the drinking by promoting mindfulness and stress reduction.
  • Drinking Triggers: Identifying what prompts your drinking—stress, social environments, negative emotions—can also guide the choice of treatment. CBT is effective in teaching how to cope with these triggers through healthier behaviors and thought patterns.
  • Willingness to Abstain: Personal readiness and willingness to abstain from alcohol entirely vs. a desire to reduce drinking to a safer level can influence treatment choice. Motivational Interviewing can be particularly useful in resolving ambivalence towards drinking and supporting a commitment to change, whether towards moderation or abstinence.
  • Social and Support Systems: The strength and nature of your social networks and support systems also weigh heavily. For example, individuals with strong, supportive networks might find AA or similar support groups beneficial, while others may prefer the privacy and individual focus offered by one-on-one therapy sessions.
  • Lifestyle Considerations: Your daily routines, responsibilities, and stress levels should also be considered. Those with highly stressful or unstructured lifestyles might find structured therapies like CBT helpful in establishing routines that discourage impulsive drinking.
  • Research and Evidence: It’s also important to consider the evidence supporting different treatments for AUD. CBT and MBCT have robust support for effectively reducing harmful drinking patterns and promoting better coping mechanisms, while MI is noted for its effectiveness in building motivation and readiness for change.

Choosing between moderation and abstinence doesn’t have to be a one-size-fits-all decision. By understanding your specific circumstances and combining that knowledge with professional advice, you can select a treatment strategy that offers the best chance for success and sustainability. Remember, the journey to managing alcohol use is personal and evolving; what works for one individual may not work for another. Let’s explore what can work for you.

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