First, you will be treated, at all times, with concern, dignity and respect. This begins from the very first time you call to schedule your initial evaluation. I pride myself and my practice on a warm and empathic approach. Having a good therapeutic relationship also will involve challenging you to face difficult “truths” about yourself, your life, and your current situation. If you are not challenged to explore and question your assumptions of the world (and yourself), then you will not likely be able to grow and change.

My therapeutic methods are best described as eclectic, making use of both my psychodynamic and cognitive-behavioral therapy (CBT) training, and other therapeutic skills.

Please note that Dr. Mills does accept personal therapy patients; however, due to an (often) very full caseload, it is more likely that I will need to refer you to one of my trusted colleagues in my private practice for individual therapy, while I continue to provide medication consultation.

If psychotherapy is begun, each of our sessions will last 45 minutes. If you are taking psychiatric medications, or are interested in the adjunct use of medication in treating your condition, medication management will be incorporated into your therapy visits (usually at the very beginning of each visit). Psychotherapy sessions are usually scheduled one to two times a week; however, the frequency of our meetings will depend on your level of distress and personal availability.

In general, I do not recommend psychotherapy visits any less frequent than once per week (at least in the beginning stages of treatment), as this can often be counter-therapeutic (ie; causing you to become stagnant in therapy, rather than sustaining momentum toward progress).

The expected duration of psychotherapy is extremely variable, depending on the severity of factors leading to your need for treatment, your commitment to the therapeutic process, and the type of therapy utilized (Cognitive-Behavioral Therapy versus Psychodynamic Therapy, for instance). Some patients show significant improvement in just a few sessions, while others show more sustained benefit with continued psychotherapy over the process of several months, even years. Many patients choose to continue psychotherapy even when the severity of their situation wanes, because they feel the therapeutic process is so richly rewarding and intellectually compelling.

No problem. Your medication-management visits can be as frequent as weekly (in the initial weeks of medication treatment) or as infrequently as one visit every three to six months. In general, when a new medication is begun (or with a change in dosage), a follow-up medication visit should be scheduled within two to four weeks. When you are relatively stable and comfortable on your medication, the most common interval for medication visits is once per month.

Please note that, for many psychiatric disorders, the best treatment is combination of psychotherapy and medication management. If you are not interested in psychotherapy with me, I would recommend (in most instances) that you be in regular therapy with another provider.

Confidentiality: Some patients avoid using their health insurance altogether due to concern of keeping their personal information private. Almost universally, HMOs, managed health care and insurance companies will require your doctor, psychotherapist or counselor to give you a diagnosis, which then becomes a permanent part of your health record. More importantly, many HMOs, managed health care and insurance companies demand detailed, intimate and private information about your mental health history before they authorize payment.

Inadequate mental health benefits: Many people find that their mental health benefits are grossly inadequate. It would be unthinkable to deny coverage for needed heart surgery, yet millions of Americans with mental illnesses face similar discrimination when they seek private insurance coverage for necessary mental health services. They are routinely denied coverage for needed services because their private insurance plans fail to cover the services or promote inequities in co-payments and deductibles for mental health services. Insurance companies often impose strict limitations on the number of mental health visits you may have per year — regardless of the amount of distress you may be experiencing.

Long wait-lists for in-network providers: Patients often discover, much to their dismay, that insurance carriers often have “phantom networks” — lists of providers who are not taking any new patients, or who have long waiting lists for new appointments. Many patients are forced to wait weeks, sometimes months, before an in-network provider can see them. Again, this occurs regardless of the amount of distress you are experiencing.

Inadequate care when seeing in-network providers: Many patients find that, in addition to long waiting lists to see in-network providers, they experience substandard psychiatric care. Why does this happen? Due to insurance company policies that often make it difficult for your therapist to be reimbursed (or reimburse them at rates far less than their value), some therapists overbook their caseloads or shorten their session times to see more patients per day.

It is not uncommon for some psychiatrists, for example, to see 8-10 patients per hour for medication management! It is not difficult to imagine how little time you would have communicating your problems to your psychiatrist.  Please note that many mental health providers, despite the pitfalls of insurance reimbursement, remain ethical and committed to quality care.

Psychiatrists are medical doctors (M.D., Doctor of Medicine) who specialize in psychiatry. After undergraduate training, they attend medical school for four years, and then complete a medical internship and residency in psychiatry for four additional years. During residency, they receive supervised training in diagnosing and treating psychiatric illnesses with medications and psychotherapy, as well as diagnosing many medical disorders that can be confused with psychiatric illnesses (a common example would be hyperthyroidism manifesting as anxiety or panic). As physicians, psychiatrists can prescribe medications and order and evaluate lab tests or other exams such as CT scans or MRIs.

Contrary to popular misconception, psychiatrists can be excellent psychotherapists. Everything depends on the individual psychiatrist and the quality of his / her training background. I trained at the University of Illinois Medical Center, where there is a strong emphasis in the principles and practice of psychotherapy, including both traditional psychodynamic psychotherapy and cognitive-behavioral therapy. In fact, my residency had firm requirements for hours spent conducting (and being supervised in) psychotherapy for the 2nd, 3rd and 4th years. Residents could be disciplined (even suspended in rare cases) for failing to meet these requirements! In addition, I am a recent graduate of Chicago’s Institute for Psychoanalysis Fellowship Program.

Ph.D. (Doctor of Philosophy) therapists have a doctoral degree in psychology. They attend college and several years in graduate education training and research before receiving a doctoral degree. As part of their professional training, they must complete a supervised clinical internship in a hospital or organized health setting and at least one year of post-doctoral supervised experience before they can practice independently in any health care setting.

Psy.D. (Doctor of Psychology) therapists also have a doctoral degree in psychology. The main difference between a Psy.D. and Ph.D. is that, in many cases, the Psy.D. requirements do not include the research toward and the writing of a dissertation. The Psy.D. is often thought of as a more clinically oriented degree, that is, more geared toward the practice of clinical psychotherapy than the Ph.D. degree. The Ph.D. is often viewed as the degree with more emphasis on research.

Both the Psy.D. and Ph.D. degree require a great deal of training towards the assessment and treatment of mental disorders. And both can make outstanding psychotherapists. It depends on the individual therapist and the quality of his/her training background.