Richard Heafey

Psychologist

2860 Laguna St. Unit C San Francisco CA, 94123 Show map

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Dr. Richard Heafey is a psychologist practicing in San Francisco, CA. Dr. Heafey specializes in the treatment of mental health problems, and helps people to cope with their mental illnesses. As a psychologist, Dr. Heafey evaluates and treats patients through a variety of methods, most typically being psychotherapy or talk therapy. Patients usually visit Dr. Heafey because they have been experiencing depression, anxiety, stress or anger for a significant period of time and are seeking help. Psychologists may perform a variety of exams and assessments to diagnose a mental condition.

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Richard Heafey

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What is the leading treatment for depression?
Currently, we have a number of options. The best treatment is the combination of two: Psychopharmacology and cognitive Behavioral Therapy (CBT) focus on Depressive symptoms. This topic has been studied in depth. If you adhere to your clinician's directions and participate (fill out) the identified interventions thoroughly, then it has been shown to be relatively equally effective as SSRIs (selective serotonin reuptake inhibitors.) CBT treatments have been shown to have less recidivism (fewer participants relapsed.) All of our current studies indicate taking an anti-depressant and undergoing CBT therapy is the most efficacious treatment for depression. READ MORE
How do you help a child with anger?
Supporting a child who lashes out and expresses a great deal of anger is a relatively simple process; when the child is younger. When we approach the age of 7 and 8, and the child is still exhibiting a significant amount of anger, then addressing the feelings is not as straightforward. It is more challenging to identify the source of the child's anger and to achieve the goal (managing the anger) the child often needs to have a desire to manage their feelings. A quick cheat sheet - ignore the behavior. Younger children are often receptive to 'operant conditioning.' Examples: "positive reinforcement, negative reinforcement, positive punishment, and negative punishment." Ignore the words together - positive means ADDING something to the situation, and NEGATIVE means taking something away from the situation. REINFORCEMENT means you want the behavior to continue, and PUNISHMENT means you want the behavior to stop. To engage a child with anxiety (or anger), it is important to consider their situation and consider if would like the child's behavior to stop (anxiety/anger), and whether you want to add something to the situation (an incentive, for example) or if you want to remove something. With anger and tantrums, you should remove yourself from the environment so the child does not have an audience. Children's anger is typically related to frustration over a sense of 'injustice.' It's not fair that I am not getting... Focus on 'why' the child feels things are unfair, acknowledge how it may feel unfair, and it does not mean the child can act in any way. This is when you should consider operant conditioning; what in the environment can be added or subtracted, and what behaviors you want to continue and what behaviors you want to stop. READ MORE
Can therapy cause more anxiety?
If your anxiety increases, you really want to communicate this with your doctor. Anxiety can increase, and often does, because therapy often involves looking at events and relationships in your life, but exploring them with another person - to improve, expand and garner added insights. The goal - at least my goal - is to improve my patients quality of life. I do not like it when my patients leave more anxious then when they come in the door, but I have certainly received text messages the day after a particularly intense session where my patients report feeling a bit "off" or "raw." We schedule a time to speak, and explore what they have been ruminating on. The aspects of the session they are replaying, and not finding a sufficient answer. With a well structured treatment plan, and well planned out sessions (so that the session does not end abruptly), anxiety can be greatly reduced. READ MORE
At what age can a child start behavioral therapy?
In my clinical experience, behavioral therapy can have a significant impact on the child - even at 5 years old. If I had a 5 year old patient, diagnosed with ADHD, I would want to initiate a multimodal approach. I would treat them using behavioral therapy, as well as having them work with an executive functioning coach - to establish a strong baseline the child can grow from. When clinicians are able to work in unison, you create a 1 + 1 = 3, synergistic phenomena. It is not common to find offices which offer several services, but it is recommended parents seek the ones who can facilitate this service. Depending on the severity of the diagnosis, and how activated they are, we might also utilize direct CBT interventions, or even a more 'unique' methodology in which the child will dictate - out loud - what they are doing, in order not to forget or become distracted. Being able to focus and also not become overly focused are equally challenging at this age. If the child is watching TV, or doing something they really love - ensuring this is time based, rather than "episode" or "feelings" driven, will teach them the cognitive flexibility necessary to accomodate future situations in which they are required to switch topics rapidly. (example - 1 hour of screen time, at the hour, the game is taken away, the tv is turned off, the tablet is gently removed from the child's hands.) Lastly, ADHD is not simply a diagnosis related to focus or concentration. Kiddos with ADHD are terribly sensitive. They miss social cues, are often misaligned with their friends goals and ways of playing, and will often verbalize how they cannot tell if "billy" is there friend or not (on the other hand, you can see children of this age become obsessed with just 1 person, often times someone younger, because they are easier to communicate with, easier to relate to - while easier, it is not conducive to the youths over all growth. Peer to peer interactions is what you want.) Setting up play groups, ensuring the child understands the natural give and take which occurs when you play (that other kids are allowed to win, that cheating in order to win is not the 'point). You will often see a 'parallel process' when working with children of this age. For parents, take out a simple game and see how your child plays it with you... Are they playing or "playing." "Playing" refers to when children have another's attention and they want to ensure they keep the attention, and something like a game is highly controlled, new 'rules' are created, and several additional obstacles are created to ensure there will be only one winner (guess who...?) There is much, much more, and I hope this was helpful. If you would like to hear more about how I would treat a young child diagnosed with ADHD, I encourage you to reach out to austin@unfoldpsychology.com, or give me a call at 650-993-9321. We welcome all inquiries! Unfold Psychology's offices can be found in the Bay Area (San Francisco, Oakland, Marin etc.) - Dr. Heafey READ MORE
What psychotherapy is best for PTSD?
PTSD - post traumatic stress disorder - is a phenomenon which may occur, following a significant life event, or when an individual has been exposed to a particularly unwelcomed event, experience, something that has occured to a loved one: put simply, when we do not properly contextualize a series of disturbing stimuli, they are processed [coded into our thoughts/memories] through/using our "fight/flight" response (specifically the Amygdala), rather than the normal processing pathway, which utilizes the hippocampus and frontal lobes contained in the brain. There are a number of treatment options available for patients suffering with PTSD. The most common, and most evidence based approach, is for behavioral treatment which simultaneously utilizes the core features of cognition, specifically, the ones which impact our behaviors the most. This approach, referred to as Cognitive Behavioral Theory (CBT), is evidence-based, requires the patient to engage in work in between sessions, and is highly interactive. (Unlike the paradigm of lying on the couch, a CBT therapy approach puts a great deal of responsibility on the patient to report on past, present and future events in life, as well as understand the connection between a patient's thoughts and their behaviors. When a patient is able to appropriately understand, and thus contextualize the traumatic event, victims living with PTSD report a significant reduction in the symptoms associated with PTSD. There are a number of other treatment paradigms which are designed to highlight and directly treat the symptoms, and underlying source of maladaptive coping skills which lead the patient to experience an event traumatically as opposed to objectively, or appropriately subjectively. EMDR (eye movement desensitization reprocessing) is another option, some clinicians say is the best option, to treat PTSD. Eye movement desensitization and reprocessing (EMDR) is a fairly new, nontraditional type of psychotherapy . It's growing in popularity, particularly for treating post-traumatic stress disorder (PTSD ). PTSD often occurs after experiences such as military combat, physical assault, rape, or car accidents. Although research continues, EMDR remains controversial among some healthcare professionals. At first glance, EMDR appears to approach psychological issues in an unusual way. It does not rely on talk therapy or medications . Instead, EMDR uses a patient's own rapid, rhythmic eye movements. These eye movements dampen the power of emotionally charged memories of past traumatic events. (https://www.ptsd.va.gov/understand_tx/emdr.asp) Traditional Psychotherapy is effective, but not as effective as CBT therapy or Narrative Therapy. However, current research has identified a brand new technique - termed Ketamine Assisted Psychotherapy - which has been shown to be especially effective. Ketamine Assisted Psychotherapy (KAP), combines the cathartic experiences of psychotherapy with the naturally "broadening" components of Ketamine medication. Ketamine has been found to be 1) very safe, 2) highly effective for several treatments, and 3) is a short term treatment which provides long term benefits. In my practice, I recommend either KAP or a form of narrative therapy, combined with aspects of CBT and psycho-education. It is important to understand the symptoms of PTSD can be easily 'tended to.' The real challenge is finding the source, the "root" of why a patient was unable to utilize their inherent coping strategies. The old adage used with weeds in any garden, in which the gardener is only able to completely rid themselves of a weed is if they "pull it up, root and stem." This is how this clinician conceptualizes PTSD. 1. identifying the source (what happened?) 2. naming and then tracking the extent of the symptoms associated with the diagnosis of PTSD. 3. Ensuring the patient was appropriately diagnosed (it is not uncommon for a clinician with less experience to mis-identify a patient's symptoms and simply assume they are consistent with PTSD, rather than the diagnosis now left unattended.) 4. Working with the patient, providing psycho-educational information, in order to determine which treatment approach would be a) most indicated, and b) agreed upon by both patient and clinician. 5. Initiate the treatment 6. track the progress of the treatment, using the symptoms of PTSD as a rubric 7. When the symptoms have been reduced by 70%, exploring coping mechanisms and the patients natural defences 8. Finally, guiding the patient through 'recovery' and working with them to develop the cognitive features necessary to face any future triggers or deleterious exposures. 9. Ensuring the patient understands early identification of pre-trauma 10. Tapering treatment frequency and duration down (1x a week, to bimonthly, to monthly, to just checking in with the patient every 2 or so months. READ MORE