The majority of people who come to my practice begin by describing specific life problems and emotional issues. These difficulties are often circumstantially caused—rooted in (the ‘Person in Environment’ Model). These challenges are layered on top of someone’s past experiences and personality characteristics (the Bio-Psycho-Social Model). In turn, these all sit top of genetics, brain biochemistry, and neuronal connectivity (the Medical Psychopathology Model).

• Person in Environment Model: This model iews your challenges in the context of your current life circumstances that involve family and personal relationships, work and career pressures, as well as a person’s social environment. These can induce emotional problems (commonly anxiety, stress, depression), and trigger behavioral problems (including alcohol and substance abuse, disturbed interpersonal relationships, eating disorders and anger). Usually they are all inter-mixed and mutually magnifying.
• Bio-Psycho-Social Model: This model considers the interplay of life circumstance with past experiences and traumas, resulting in PTSD, despondency and social anxiety. These are influenced by biological factors, including psychological makeup and personality.
• Medical Psychopathology Model– Focuses on genetics, brain biochemistry, and neural connectivity as potential contributors to emotional and behavioral difficulties. These factors can result in personality disorders, autism spectrum disorder, Down syndrome and schizophrenia. Individualy with these disorders can be particularly vulnerable to environmental challenges.

Treatment Approaches

Welcome to therapy. Usually, I start with the person in environment model because almost invariably something needs to be changed about a person’s situation. What’s happening in your relationships? Your work environment? Your living situation? Your community? Often, the roots of distress lie in these external circumstances and how you’re navigating them. Understanding these factors opens up immediate opportunities for meaningful change.

As our therapeutic relationship develops, we then fold into the treatment considerations psycho-social components —your past experiences, personality and responsiveness. How do you typically respond to stress? What patterns have you developed over time? What strengths do you bring? This psychological dimension is where much of our therapeutic work happens—building new skills, examining old patterns, and creating new ways of understanding and responding to your experiences.

If there are questions about biological factors—such as whether certain symptoms might have a physiological component—you can also consult with a psychiatrist for assessment. The biological dimension is one piece of the puzzle, but it’s the psychological and social dimensions where the greatest opportunities for lasting change typically exist.

Evidence-Based Therapy That Works

Evidence-based treatment modalities like Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) have been proven to be as equally, if not more effective than medication for many psychological conditions. These aren’t alternative approaches—they’re gold-standard treatments backed by decades of evidence-based research.

CBT helps you identify and change thought patterns and behaviors that keep you stuck. DBT combines cognitive-behavioral techniques with mindfulness and acceptance strategies, teaching you skills for emotional regulation, distress tolerance, and interpersonal effectiveness. Both approaches are action-oriented and focused on creating measurable, lasting change.

These modalities work precisely because they address what medication cannot: the learned patterns, environmental factors, relationship dynamics, and cognitive frameworks that maintain your difficulties. Many psychological and behavioral problems simply don’t have a specific medication to treat them. Issues like personality patterns, relationship difficulties, trauma responses, and maladaptive coping strategies require therapeutic interventions.

The Power of Constructs and Targets for Therapy

One of the most important additional concepts in understanding how therapy creates lasting change is the idea of ‘Constructs’. These are assumptions you’ve created based on your experiences—the mental frameworks through which you interpret the world, yourself, and others.

Here’s a simple truth: different experiences create different constructs. If you grew up in an environment where expressing emotions was punished, you likely developed constructs about emotional expression being dangerous or unwelcome. If early relationships taught you that people leave, you may have constructed beliefs about your own worthiness or the reliability of others.

These constructs aren’t just thoughts—they’re deeply embedded patterns that guide your emotional responses and behaviors, often outside of conscious awareness. They feel like truth, even when they’re no longer serving you well.

My approach to therapy focuses on creating new constructs—not just understanding the old ones, but actively building new frameworks for interpreting and responding to your experiences. This is work that happens in the present, with the explicit goal of making changes that last long-term, well beyond our time together.

Yes, insight matters. Understanding where your patterns come from provides important context. But insight alone isn’t enough. Therapy with me is action-oriented. We work together to:

• Identify the constructs that are keeping you stuck
• Examine how these assumptions were formed and whether they still fit your reality
• Actively practice new ways of thinking, feeling, and behaving
• Build new constructs based on current reality rather than past experience
• Create lasting change through repeated practice and integration

This work proceeds at a comfortable pace that respects where you are in your journey. Momentum builds naturally as you acquire new skills, explore new considerations, and integrate new concepts. There’s no rush—sustainable change happens through consistent practice and gradual incorporation of new ways of being.

A Personalized Approach

I recognize that everyone brings a unique combination of biological tendencies, personality traits, formative experiences, and current circumstances to therapy. There’s no one-size-fits-all approach. Together, we’ll explore what specific constructs and patterns are affecting you, and we’ll develop strategies tailored to your particular situation and goals.

The changes we create in therapy are designed to be permanent because they’re built on new understanding, new skills, and new ways of being that become part of who you are—not dependent on an external intervention like medication.

Ready to Begin?

If you’re looking for more than temporary relief—if you’re ready to create lasting change through insight and action—I invite you to reach out. Let’s talk about your particular challenges and how we can work together to build new constructs that serve you better.

Call 410-970-4917 or email edgewaterpsychotherapy@gmail.com to schedule a consultation. I look forward to hearing from you