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James J. Crist, Ph.D., CSAC                           Clinical Psychologist

Therapeutic Orientation

Many people ask about my therapeutic orientation--how I think about and understand people and what approach I use in psychotherapy.  I would call myself eclectic, which basically means I use a variety of approaches which include psychodynamic, family systems, and cognitive-behavioral.  In plain English, I do believe that we have unconscious motivations, often based on unresolved issues we had in our families, that can prevent us from living happily.  I also believe that members of a family can influence each other in ways that can cause problems.  However, not all problems are caused by such factors.  Sometimes, it can be as simple as thinking distorted thoughts or unknowingly reinforcing (rewarding) negative behavior that can cause problems such as depression or oppositional behavior in children.

At times, therapy alone may not be enough to resolve a problem.  For instance, some kids and teens with ADHD may be so disruptive in their behavior that they are alienating people and getting into frequent trouble in school.  Or they may be so unfocused that they are in danger of failing.  Some people are depressed to the point that they have significant difficulty functioning on a day to day basis.  Others are so anxious they rarely leave their homes.  In such cases, psychiatric medication may be helpful.  It is generally not my first choice and I refer only when the symptoms do not respond to therapy.  I generally recommend obtaining a complete physical examination first to rule out any underlying physical problems.  Thyroid problems, for instance, can cause depression.  Once this is done, I refer to psychiatrists in the area that I know and trust.  Renee Burdett, MD, is our medical director and she is an excellent psychiatrist.  Being in the same office allows us to share information quickly and effectively.

In working with children, I believe that parents need to be closely involved.  I usually meet privately with children for part of each session, and then include the parent later so that the child can share the important things we discussed.  Sometimes, I will meet with the parent first, especially if the child is not an accurate reporter of the problems that are occurring.  With some children, I will meet primarily with parent and child together.  It all depends on what people are comfortable with and what is most helpful.  As children get older, their sessions tend to be more private, but I still include the parents.    

Professional Affiliations

I am a member of the American Psychological Association, the Northern Virginia Society of Clinical Psychologists, the National Association for Alcohol and Drug Abuse Counselors, and the Virginia Association of Drug and Alcohol Counselors.  I abide by their ethical principles, which are available on their websites.      

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