Practical Tools, Individualized Treatment, and a Whole-Person Perspective
My approach to psychiatric care combines established therapeutic methods, individualized treatment planning, and a genuine interest in understanding each person as an individual. Depending on your needs and circumstances, our work may incorporate solution-focused therapy, cognitive behavioral therapy (CBT), practical exercises between appointments, exploration of personality patterns, and psychiatric medication when appropriate.
My goal is not simply to help you understand your difficulties, but to help you discover practical ways to address them and move toward a more satisfying life.
Solution-Focused Therapy: Discovering What Works
One approach I use is Solution-Focused Therapy, which emphasizes practical solutions, personal strengths, and the steps that can move you toward your goals.
Rather than concentrating exclusively on why a problem developed, we might explore questions such as:
- If this situation were improving, what would you be doing differently?
- What is already working, even if only a little?
- What would be the first small step in the direction you want to go?
These questions can help shift our attention from the problem alone to the possibilities for change.
I believe people often possess more strengths, resources, and potential solutions than they initially recognize. Sometimes, the answers are already there, at least in part, waiting to be discovered. My role is to help you identify those resources and put them to practical use.
Like Dorothy discovering what she needed in The Wizard of Oz, you may find that some of the resources you need are closer than you think. So get ready to tap your heels together three times.
Cognitive Behavioral Therapy (CBT): Changing Patterns of Thought
Another approach I use is Cognitive Behavioral Therapy (CBT). CBT examines the relationships among our thoughts, feelings, physical responses, and behaviors.
Anxious or depressed moods can sometimes be reinforced by habitual patterns of thinking—for example, assuming the worst, viewing a setback as a complete failure, or treating an uncertain outcome as a certainty.
CBT offers practical methods for recognizing these patterns, examining the evidence behind them, and developing more balanced and useful ways of thinking. Changes in how we interpret a situation can, in turn, influence how we feel and respond to it.
This is not about pretending that problems do not exist or forcing yourself to think positively. It is about learning to recognize when your thinking may be making a difficult situation harder and developing more effective ways to respond.
The goal is greater flexibility in how you think, feel, and act.
The Solution-Focus Notebook: Putting Ideas into Practice
Many patients benefit from a practical tool I developed called the Solution-Focus Notebook. It brings together exercises inspired by solution-focused methods and cognitive behavioral therapy to help you apply what we discuss in our sessions to everyday life.
The notebook has five sections:
- Goals and Mission Statement: Clarifying what matters to you and what you want to work toward.
- Strengths and Resources: Identifying the abilities, relationships, experiences, and other resources you can draw upon.
- Gratitude List: Noticing and recording things you appreciate, including small everyday experiences.
- Cognitive Behavioral Therapy: Identifying and examining thought patterns that may contribute to anxiety, depression, or other difficulties.
- Solution-Focused Exceptions: Recognizing occasions when a problem is less severe, absent, or more manageable, and exploring what is different about those moments.
I encourage patients to set aside a little time for this work several days a week when appropriate. I sometimes call it “changework” rather than homework, because the purpose is to help you make meaningful changes in your daily life.
The exercises need not be complicated. You might write down one or two things you appreciate that day—even something as simple as the smell of cinnamon. Or you might examine an anxious thought, consider the evidence for and against it, and develop a more balanced interpretation.
Small exercises, practiced consistently, can help reinforce what we work on together.
Understanding Personality and Individual Differences
Personality influences how we interpret experiences, relate to others, respond to stress, and navigate relationships. Understanding recurring patterns can sometimes help explain why certain difficulties arise or why familiar situations lead to familiar reactions.
One framework I use to explore personality is the Enneagram, which describes nine broad personality types, each associated with characteristic strengths and potential limitations.
I use this framework as a way to stimulate self-reflection and discussion, not as a psychiatric diagnosis or a substitute for scientifically validated psychological assessment. It may help us consider recurring patterns without necessarily undertaking an extensive exploration of every event in your past.
Some patients benefit from deeper exploratory psychotherapy. When that is appropriate, I can refer them to experienced colleagues who specialize in this work.
When a more detailed assessment of cognitive functioning is indicated, I also collaborate with an experienced Ph.D. neuropsychologist who provides comprehensive neuropsychological testing.
Psychiatric Medication: An Individualized Approach
Psychotherapy and practical strategies are important components of treatment, but many patients also benefit from psychiatric medication.
Medication decisions require careful consideration of your symptoms, history, previous treatment responses, medical circumstances, preferences, and treatment goals. A medication that works well for one person may not be the best choice for another.
I have worked with patients who continued to struggle despite previous medication trials. In some cases, a careful reassessment of the diagnosis, treatment history, and available options can identify a different approach worth considering.
My aim is to develop an individualized treatment plan, monitor how you respond, and make adjustments when clinically appropriate. Medication is neither automatically necessary nor something to dismiss; the question is whether it is likely to be helpful for you.
Dr. Kirsner has no current financial relationships with pharmaceutical or nutritional supplement companies. I receive no commissions, referral fees or other compensation for prescribing medications or recommending supplements. My treatment recommendations are based on clinical evidence, professional judgement, and what I believe will best serve each individual patient.
Taking Mental Health Seriously—and Making Room for Humor
Psychiatric difficulties can be painful and disruptive, and I take them seriously. At the same time, I believe humor can sometimes provide perspective, relieve tension, and help people see a difficult situation in a new light.
When appropriate to the person and circumstances, a little well-timed humor can make a challenging moment more manageable. It may help loosen the grip of a rigid pattern or allow someone to approach a familiar conflict differently.
Humor is not appropriate in every situation, and it never substitutes for addressing serious problems. Used sensitively and collaboratively, however, it can be another useful resource in the therapeutic process.
I want our work together to be thoughtful and productive, but also human. There should be room for warmth, spontaneity, and the occasional laugh.
Making Therapy a Collaborative Process
Psychotherapy is a collaborative undertaking. Meaningful progress generally requires participation from both of us, along with reasonable consistency, communication, and respect for the boundaries that make treatment productive.
Depending on our work together, that may include arriving on time, attending sessions consistently, and practicing skills or completing exercises between appointments. These activities help carry what we discuss in our meetings into the situations where you actually live, work, and relate to other people.
Therapy does not always produce every change a person hopes for, and progress can take time. But with a shared understanding of your goals, a willingness to work together, and a treatment approach suited to your needs, we can work toward meaningful and lasting improvement.
My aim is to provide thoughtful, individualized psychiatric care that combines clinical experience, practical therapeutic tools, and respect for the person behind the symptoms.