Clinical Services

Therapies: Individual, Couples, Family, Group, Biofeedback

Psychoeducation: Group
Evaluation: Presurgical, Intelligence, Personality, Academic, Personnel and Employment, Disability

Q: How is psychotherapy different from psychoeducation?

A: Although learning and change occur in both processes, psychotherapy is a process of guided inquiry where the individual seeks to identify processes and dynamics that impact behavior, thought and emotions, seeks to identify the causes and to effect change. The therapist serves to focus inquiry and point out, or direct attention to, elements you may have missed. Sometimes, the process of psychotherapy can evoke emotional experiences that re-create and re-work old hurts. Psychoeducation, on the other hand, serves to impart knowledge in an educator/learner process, serving to share information gathered from the study of the mind (psychology) to improve specific conditions with knowledge, skills and strategies.

Q: How is evaluation different from therapy or psychoeducation?

A: Evaluation is focused on a brief, yet detailed, assessment of what exists now for the examinee. This is typically done to answer a specific question, or for a specific purpose. For example, many insurance companies require a mental status examination prior to surgery to rule out problems that may serve as complicating factors. The purpose is to answer specific questions and seek a detailed understanding of conditions that exist right now; but the work with the psychologist typically ends there. Therapy or psychoeducation, however, both focus on intervention with change as a desired goal, and the psychologist is integrally involved in the process.


Women’s Issues — Women make up the largest portion of my practice.This is partly a reflection of women’s greater receptivity to and awareness of the powerful change element of psychotherapy in our society. I have also formed alliances with several OB/GYN physicians in San Antonio and receive many referrals from them. I am sensitive to the demands on the women in our society, and appreciate the unique conditions faced by women.  For those who prefer to work with a female clinician, I have maintained this option on staff.  For more information on issues commonly faced by women, see this page.

Pain — I have had significant experience with persons experiencing chronic pain (see Dr. Villanueva), having developed two chronic pain programs in San Antonio. I also work with physician pain practitioners and their patients, both pre-and postsurgery. I use a comprehensive approach to understanding factors that impact pain, and offer interventions that place you, my client, in greater control of your experience of pain and the impact pain has on daily living. Many of the resources developed within my practice were specifically designed to decrease pain.

PTSD — Posttraumatic stress disorder is a cluster of symptoms that sometimes occur after a significant stressor, threat or traumatic experience. These symptoms are characterized by strong reactions to reminders of the event, attempts to avoid reminders of the event, and reduced ability to enjoy many aspects of living because of the event. This condition can limit functioning in many areas of daily living, including work, family and recreation. The impact of this condition on your functioning can be dramatically improved with a combination of insight and cognitive behavioral therapies.

“Stress and anxiety have significant cumulative and acute impacts on your heart health…”
Heart Health — I hold hospital privileges at the TexSAnHeart hospital and within the Baptist Health System and rely on the competent staff and facilities of those systems to comprehensively integrate treatment from a psychological perspective with my clients experiencing heart issues. I am an avid supporter of the local American Heart Association and have close professional ties with local, reputable cardiac physicians and pulmonary physicians. Stress and anxiety have significant cumulative and acute impacts on your heart health (see Stress and Your Heart), and I use a range of treatments, including cognitive behavioral interventions and Biofeedback, to improve the conditions that affect your body and your heart.

Pre-/Postsurgery — Surgeries are often difficult on the psyche, as well as on the body. But few people know you can learn ways to reduce the impact on the mind and, importantly, on the body.This aspect of my practice is beneficial when preparing for planned surgeries, e.g. bariatric, stimulator or pump implants, or cardiac surgeries.

Depression — Depression is a common presenting condition with many of my clients. Factors that can contribute to depression include grief/loss, situational stressors (e.g. birth of a child [post-partum depression], marriage, marital conflict or divorce, job stress or dissatisfaction), or long-standing hurts from the family of origin. I understand the significance of these conditions, and help my clients learn ways to alleviate symptoms of depression while seeking the creation of desired change, understanding or peace.

Serious Mental Illness — I have worked closely with clients and their families when serious mental illness, including such symptoms as auditory and visual hallucinations, are present (see Dr. Villanueva). These clients and their families require special, long-view support and guidance, often on a cyclical basis between periods of relative stability, and with direction towards comprehensive community services. Because of my clinical skills, history of work and awareness of community resources, I am able to help my clients and their families in these unique conditions.

Anxiety — The fast pace of our society and a range of daily stressors combine to make anxiety one of the primary concerns of my clients. I know that many factors contribute to anxiety, and I help my clients address these issues in therapy. Yet I also know that certain tools are almost universally beneficial for alleviating anxiety (see Free Tools/Store). In addition to helping my clients navigate change that impacts anxiety, I also share those tools which will help create immediate relief.

Insomnia — Difficulty sleeping can be a side effect of daily life stressors, or can be a primary presenting issue in the absence of any precipitating stressor. I work closely with pulmonary physicians in San Antonio to address the needs of their patients experiencing insomnia, and have developed an eight week psychoeducational group to address insomnia. Some of my resources on this website were developed to address issues related to insomnia (see Free Tools/Store).

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