1979: BSE, Princeton University, Basic Engineering, Graduated with High Honors, Senior Thesis: “A Parametric Time Series Approach to Electrocardiographic Data.” Three Varsity Letters in Rowing.
1984: MD, University of Texas Health Science Center at Dallas, Southwestern Medical School.
1988: Residency in Psychiatry, University of Texas Health Science Center at Dallas, Southwestern Medical Center, Department of Psychiatry.
1987-2004: Dallas Psychoanalytic Institute- graduate Psychoanalyst. This included five years of classes, four control cases with the associated supervision, preparation of six month summaries and full case reports on the completion of the psychoanalysis, and a training psychoanalysis.
1990: Board Certified in Adult Psychiatry.
2004-2005: Fellowship in Forensic Psychiatry, University of Massachusetts Medical School Program in Psychiatry and the Law.
2007: Board Certified in Forensic Psychiatry.
Dallas Psychiatric Associates, Staff Psychiatrist working on an inpatient unit specializing in long term treatment of severe character disorders and severe psychiatric disorders including individual work as well as group therapy. Also provided consult liaison work at Brookhaven Hospital on the medical services.
Assistant Clinical Professor at UT Southwestern providing ongoing psychotherapy supervision of third and fourth year psychiatric residents as well as being a preceptor for first and second year medical students especially learning how to interview patients with a variety of backgrounds.
Director of Adult Psychiatric Services at the Charter Hospital at Grapevine supervising locked and open psychiatric units, day hospital, community outreach, staff and program development. I also provided consult liaison services at two community hospitals in Grapevine and Irving Texas as well as providing talks on mental health subjects to a community college and other groups on request.
9/1988-9/1998: Private Practice in Psychiatry with a mix of consultation liaison work in medical hospitals, psychoanalysis, long and short-term psychotherapies, psychopharmacology, and supervision on difficult psychiatric cases. I participated in an ongoing psychoanalytic book study groups and movie groups to promote ongoing interest in psychoanalytic theory and understanding the community.
Staff Psychiatrist at the Catawba Hospital, Catawba, Virginia working on a short term acute adult unit and a longer term adult unit including supervision and training of residents and medical students in both settings. I served on a number of committees including the hospital executive board, pharmacy and therapeutics, ethics and performance improvement teams. This has included providing the psychiatric input for a multi-year project, setting up “Active Treatment Mall” program for psychosocial rehabilitation of patients with severe mental illness. This also included a FMEA team looking at suicide prevention including developing policies and procedures to implement the improvements. Other duties have included acting as the lead psychiatrist for the forensic population of NGRI patients including difficult patients who have not done well at other facilities or patients who requested to be treated at a different facility for a variety of reasons. The broader forensic work has included reports and court testimony as well as providing other forensic services including Competence to Stand trial evaluations, Restoration of Competence, Custody Evaluations, Emergency treatment, Mental Status at the time of the Offense Evaluations and providing independent Forensic Evaluations at other state facilities as well as the associated Court Testimony. As part of my work with residents I established an ongoing psychotherapy continuous case conference for the University of Virginia Roanoke/Salem Residency Program’s third year residents. I interviewed patience for the third year residents and then also worked with them on formulating a psychodynamic understanding of the patient as well as a complete biopsychosocial formulation. I have also been continuing to provide ongoing psychotherapy supervision of residents as part of the Clinical faculty of the University of Virginia. Other programs I started included establishing an ongoing Psychoanalytic Film Society to promote Psychoanalytic interest and understanding in the community. I have Prepared and given Grand Round topics including Psychoanalytic Dream theory with examples from clinical practice, Psychotherapy approaches to Borderline Personality Disorder, and participated in symposiums on Psychosocial Rehabilitation for the Roanoke area mental health community including organizations such as NAMI. I also provided medical staff leadership as Acting Chief of Staff and served on the state level on the DMHMRSAS Peer Review Committee. I also was involved with the recent “reinvestment” initiative in state mental health treatment.
Attending psychiatrist at Worcester State Hospital, clinical faculty at the University of Massachusetts Medical School, Department of Psychiatry.
Director of Forensic Psychiatric Services and President of the Medical Staff at the Catawba Hospital with duties similar to those described above. During our 2006 Joint Commission Inspection, I was the acting Chief of Staff and escorted the examiners and worked closely with the Facility Director and hospital leadership throughout that inspection. In addition, I was also engaged in private practice limited to Psychoanalysis and Forensic Psychiatry.
Attending psychiatrist at Bridgewater State Hospital (BSH), Bridgewater, MA. BSH is an all male maximum security forensic psychiatric hospital serving both DOC and DMH patients. This included being the attending psychiatrist on the Max-1 unit where those persons who needed the highest level of security due to aggressive or challenging behaviors were treated. I also was the lead psychiatrist in the Intensive Treatment Unit (ITU) comprised of fourteen seclusion cells for those persons not stable enough for any of the regular units. In addition, I provided forensic evaluation on other units (i.e. Competence to stand trial, criminal responsibility, aid in sentencing reports) and provided courtroom testimony. I had a clinical faculty affiliation with UMass and supervised fellows in forensic psychiatry in their rotations through the Max-1 unit.
Attending Psychiatrist at Central State Hospital (CSH), Virginia’s maximum security forensic psychiatric hospital. This included starting the new ‘Restoration Unit,’ a unit specializing in working with patients who have severe and persistent mental illnesses and legal problems who have been found incompetent to stand trial and who have been committed by the court for restoration of competence to stand trial. This has reduced the waiting time for admission of persons needing evaluations and restoration of CST from six months to no waiting time at present. It has also reduced the overall forensic census at the facility by more efficiently treating patients with treatment resistant psychotic illnesses. Chair of the CSH Pharmacy and Therapeutics Committee with a focus on improving treatment while reducing costs. In the past year the spending on atypical antipsychotics has been reduced by 42% with an annual savings of $600,000.00. The use of multiple antipsychotics has been reduced by 29% and the use of multiple atypical antipsychotics has been reduced by 56%. This has occurred with no negative impact on patient care. In addition we have improved the informed consent process, and improved monitoring for metabolic side effects of the atypical antipsychotic medications. Recently Nursing has adopted a weight and metabolic side effect flow sheet that the P&T committee tasked with looking to improve the efficacy and safety of prescribing across the state.
Attending Psychiatrist at Atascadero State Hospital, Atascadero, CA working on a unit treating mentally disordered offenders. I also perform Competence to Stand Trial and other Forensic assessments. In addition I helped the facility design a new unit to treat the most aggressive patients.
Attending Psychiatrist at California Psychiatric Transitions, Delhi, CA. I currently run three units. One is for dual diagnosis patients with a combination of intellectual disability, major mental illness, personality disorders and serious behavioral problems. Another is the Reentry unit for those patients who are more stable and in the phase of their treatment where they are more actively going out with transitioning to the community. I run a forensic unit for persons with intellectual disability and serious mental illness who are here for restoration of competence to stand trial or court diversion. In addition, I perform forensic evaluations including evaluations of competence to stand trial and provide consultation and management of overall programming at CPT.
Forensic Psychiatry consulting services to Contra Costa County Mental Health, assisted in starting a forensic mental health program and outpatient restoration of competence to stand trial program, conservatorship evaluations and testimony, risk assessments, utilization review of difficult to manage patients.
Forensic Psychiatry consulting services to Contra Costa and Solano County Conrep programs.
APA Institute, Atlanta Meeting: Approaches to Inpatient Suicide Risk Assessment in State Psychiatric Hospitals.
AAPL, Montreal Meeting, Research in Progress Presentation: Physician’s Documentation of Suicide Risk Assessment.
AAPL, Seattle Meeting, Panel Presentation: Being the Victim: Beyond Sadism in Serial Sexual Murderers.
Carilion-University of Virginia Roanoke/Salem Psychiatry Residency Program: 2006-2007 Attending Teacher of the Year.