Dr. Buchanan treats many different problems using individual psychotherapy, couples therapy and family therapy. Having received excellent training, he has more than 30 years of experience working with children, adolescents, adults, couples and families on such issues as:
Dr. Buchanan's orientation to treatment is an "eclectic" approach, drawing from a variety of schools of therapy and integrating the best methods to address the particular problem for that person at that time. He uses the most effective elements of Cognitive-Behavior Therapy (CBT), Dialectical Behavior Therapy (DBT), family systems therapy, structural-strategic family therapy, interpersonal psychotherapy, behavior modification and the Gottman approach to marital therapy. Dr. Buchanan employs evidence-based treatments; i.e., treatments that have scientific research demonstrating effectiveness.
If you feel that your religious beliefs and spiritual practices are important for your therapy, please bring it up for discussion. Dr. Buchanan loves helping people live an integrated life.
Being in therapy requires a commitment of your time and effort, not only for attending therapy sessions but also for working on things between sessions. This often means practicing new behaviors, reading, researching something on the internet, etc. At other times, it might mean to think about something or make a decision before the next session.
It is important that you make attending therapy a high priority and that you attend sessions regularly, missing appointments only when it cannot be avoided. The frequency of your sessions can be adjusted to whatever makes the most sense for you and your situation. Some people meet twice a week, while others may meet once every two to three weeks. If appropriate, there may be an occasional session of two hours or longer.
At the start of therapy, sessions are typically scheduled for once a week, gradually tapering the frequency to less often toward the end. Once you have met your goals, sessions may be scheduled once every two to eight weeks for a while to enhance the maintenance of your success.
The length of therapy varies greatly, depending on the nature of the problem(s), your emotional strengths and weaknesses, your social support system and the goals of therapy. The goal should be to satisfactorily resolve the targeted problem and improve your coping skills. Patients often report that they experience considerable relief of their presenting problems in 6-10 sessions. To make more significant changes in lifestyle and personality functioning, more time is sometimes needed. Some people end therapy after 6-10 weeks, while others continue on for a while longer. It depends on your goals and how you feel about the process of the therapy. You are, of course, free to end therapy any time you desire.
Engaging in psychotherapy presents both benefits and risks. A great deal of research over the last half-century has demonstrated that counseling and psychotherapy for mental health issues are generally effective. Several large-scale studies have found that most people in counseling and psychotherapy experienced significant relief of their symptoms and had a high level of patient satisfaction. However, no therapist can guarantee a cure or promise improvement, as all people and circumstances are unique.
Potential risks of therapy include experiencing such uncomfortable feelings as sadness, anxiety, depression, guilt, anger and frustration. You may also experience uncomfortable memories, question your relationships and/or have difficulty adjusting to a change in lifestyle. It is important to view such experiences as a normal part of the counseling process and that “things often get worse before they get better.” (Some clichés are really true!). It is very important that we talk about these experiences in therapy.
One of the most important things you can do in any type of therapy is to be open and honest with your therapist. If Dr. Buchanan says or does something you do not understand, you disagree with or are concerned about, you are strongly encouraged to bring it up for discussion. This cannot be emphasized strongly enough.
Dr. Buchanan uses a family psychology model of practice, similar to the family practice model of medicine. The idea is that over the course of your life different issues will come up, and it is useful to work with a practitioner with whom you have an established relationship and who already knows your history. He wants to keep an open door so that if you need his services at a later time, he will be available to you. The advantage is that you don’t have to start over with a new therapist.
Dr. Buchanan has seen former patients return for additional services after periods of months, years or even decades. These are sometimes very short-term consultations (often only a session or two) but are long enough to get advice on a new twist or development. Other people may return for more intensive therapy than they had the first time.
Psychological treatment for most mental and emotional disorders is as effective, and often more effective, than medication. Even if one is on medication for an emotional
issue, the medication generally treats symptoms without addressing the deeper problem. Depending on the problem, psychological therapy can sometimes help people either reduce medication or get off medication entirely.
Individual Counseling and Psychotherapy
Though people tend to use the terms “counseling,” “psychotherapy” and “therapy” interchangeably, “counseling” is actually a more general term, usually referring to professional advice or guidance provided for a variety of personal issues. “Psychotherapy” describes the treatment of an emotional or mental condition or disorder with more in-depth resolution of the emotional issues that have a tendency to reoccur over time.
For individual psychotherapy to be effective, you must focus on YOUR issues, YOUR contribution to a dysfunctional relationship, YOUR misinterpretations and YOUR inappropriate behaviors. “Therapy” that basically focuses on another person who isn’t in the room is not real therapy at all. The focus of individual psychotherapy is you taking control of your life.
Research indicates that when someone goes to individual therapy for a marital problem, that individual therapy increases the likelihood of divorce when compared to not being in therapy at all. Under most circumstances, if you have marital or relationship problems, the treatment best suited to address those problems is marital or couples therapy, not individual psychotherapy.
The Serenity Prayer by theologian Dr. Reinhold Niebuhr sums up the goals of individual psychotherapy very well:
God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.
If most of your time in therapy is learning to consistently do the three things in the Serenity Prayer, your individual psychotherapy will be very effective. Having greater serenity, courage and wisdom would be considered a very good outcome for virtually any therapy.
Couple or Marital Therapy
Couple or Marital therapy could include several different situations:
The common theme to all the above situations is that the Couples or Marital Therapy will be focused on improving a relationship between you and another individual. Thus, the relationship itself is the target of treatment.
Unless otherwise agreed in advance or in certain circumstances, Dr. Buchanan expects both individuals to attend all therapy sessions. He tries very hard to not take sides when working with a couple but will provide feedback to promote fairness, openness and consideration of both individuals. Though he may appear to take a side on a particular topic or during a particular session, he will generally do the same thing for both individuals on a fairly routine basis.
Dr. Buchanan knows that you have probably had a great deal of hurt and pain in the relationship, or you wouldn’t be seeking the services of a therapist. Because both of you have been through enough hurt already, he may interrupt if he thinks you are saying something destructive to the relationship or the therapy process. When you get loud, he may ask that you both take a break. At such times, Dr. Buchanan may teach some self-soothing exercises.
Just as therapy is not effective if someone is drunk on alcohol, therapy cannot succeed if you are “drunk” with anger, rage, jealousy, scorn, disdain, etc. One major goal is for the two of you talk about issues in a productive manner. This means being able to discuss very emotional issues in a calm, well-regulated manner. Dr. Buchanan will be a coach to both of you, helping each of you stay calm and well-regulated with each other.
Dr. Buchanan believes that Family Therapy is the most powerful and efficient treatment for childhood problems, typically far superior to individual child therapy and play therapy. Much of the family therapy will include coaching the parents as to how to handle many situations related to the child(ren). Having the parents involved as part of the therapy greatly enhances a positive outcome of therapy.
Although Dr. Buchanan likes having family members attend the sessions, therapy can sometimes become like “musical chairs,” depending on who is present. He may spend some of the session with the parent(s) without the child, some time with the child without the parent(s) and some of the session with everyone who attended. This may also change from week to week, depending on his assessment of what needs to be accomplished.
Parents often want to speak to Dr. Buchanan before he sees their child, and this can be very helpful. Other sessions may be just for the parents, teaching them a specific intervention to implement at home.
A major goal is for family members to talk about important issues in a productive manner and not just vent. This means being able to discuss these very emotional issues in a calm, well-regulated manner. Dr. Buchanan will be a coach to all, helping each individual remain calm and well-regulated as you communicate with each other.