Mary V. Cunningham, Ph.D. - Psychologist - Assessment, Therapy - Austin, Texas

 

My practice is divided between therapy and psychological assessment. I enjoy each, and feel privileged to be able to do both. (See Therapy Practice and Psychological Assessment Practice below.) I am a licensed psychologist.

 

Some Background

I have a B.S. in Biology from the University of Santa Clara, an M.P.A. from George Washington University. My Ph.D. is from the University of Texas.

 

Prior professional history includes teaching as adjunct faculty in the UT Department of Educational Psychology. Before moving to Austin in 1983, I lived in Washington, D.C. where I was an LBJ Congressional intern, worked on several political campaigns, and for the Overseas Private Investment Corporation -- putting together joint ventures between U.S. businesses and counterparts in developing countries. I've done lots of event planning, was a resident counselor at a girls' boarding school, and I like to write. I founded The National Organization to Treat A-T, a public charity that funds treatment research for a rare childhood disease that my son had. My greatest privilege has been to be Mom to my three children.

 

My research has included a published outcome study on the appropriateness and cost-effectiveness of residential placement of emotionally disturbed youth by Texas school districts. My dissertation research addressed the effects of trace alcohols (present, but not labeled, in many processed foods,) on children's attentional abilities.

 

My practice is different from many others, in that I do not file insurance for clients. I do provide statements, which clients can file on their own. Running my practice this way reduces the amount of paperwork, helps me keep my rates down, and allows more time for keeping up with the psychological literature, as well as fiction and non-fiction books relevant to my practice and to individual clients.

 

Therapy Practice

Most of my therapy clients are adults or adolescents, although I also see school-aged children and their families.

 

I specialize in treating relationship issues, anxiety, depression, family functioning, adult child issues, sexual issues, and trauma - including assault, abuse, date-rape, and loss by death, fire and abandonment. I draw from a number of therapeutic approaches including cognitive-behavioral, psychodynamic, interpersonal, and exposure therapy. For families, I draw on family systems therapy, strategic family therapy and structural family therapy. I often make recommendations to clients for relevant outside reading.

 

I may use EMDR (Eye Movement Desensitization and Reprocessing) to address "stuck" cognitive beliefs or the effects of trauma. I hold in mind, and incorporate, as needed, applications from attachment theory, the Myers-Briggs, assertiveness training, systems theory and theories of identity development. I also focus on strengths -- on what works. I do not provide treatment for alcohol or drug abuse, or for eating disorders.

 

While we do not wallow in the adult client's childhood history, I do believe it is important to identify early/old patterns of relating and problem solving that may be getting in the way as an adult. Presumably, as children and adolescents, we developed patterns of responding (to conflict, to others, to disappointment, to stress) that made sense at that time. But for many of us, some of these patterns and associated cognitive beliefs may not make sense in our current relationships, and in fact, may underlie our anxiety, depression, avoidance, irritability, etc.

 

Psychological Assessment Practice

 

What is the difference between psychological testing and psychological assessment?

Assessment is more than testing. Psychological testing (e.g., an intelligence test, personality test, or mental health test) occurs as part of the process of psychological assessment.  The results of a psychological test are rarely used on their own.

 

Psychological assessment is essentially a judgmental process whereby a broad range of information, including the results of psychological tests, is integrated into a meaningful understanding of a particular person. Psychological assessment is an extremely complex process of solving problems (answering questions), in which psychological tests are often used as one of the methods of collecting relevant data.

 

In addition to standardized tests, psychological assessment usually also includes interview, record review, demographic information, medical information, personal history, and where appropriate and feasible, gathering information from others about the client via interview or checklists.

 

My Philosophy of Assessment

My philosophy of assessment considers the whole person, from sensory-motor to cognitive functioning, to interpersonal and emotional functioning, as needed; to gather data from multiple measures across multiple environments before reaching conclusions; and to provide comprehensive feedback including a written report, face-to-face feedback, assessment of strengths, opportunity for discussion, and recommendations for treatment. When salient, legal rights to accommodations and assistive technologies are delineated.   Reports and feedback focus on diagnostics and real-world interventions. I have a sizeable referral network including schools, tutoring, occupational, physical & speech therapies; psychotherapy; psychiatry/medication evaluations; support groups.   My assessment practice is different from most others in that I schedule assessments across 3-4 separate appointments, from 2 to 4 hours each. While assessments are interesting and can be fun, I believe the most valid results are obtained by limiting sessions to a half-day at a time, at the most. Scheduling over several sessions also allows for a sense of trust to develop, which impacts disclosure. For younger children, I may use 1-2 hour sessions, depending on attention span.   Also different from many others, I personally conduct all interviews, observations and administer all tests - I do not use students, interns or paraprofessionals, or Masters level diagnosticians.

 

 

Areas of Assessment

Anxiety disorders	Temperament
Affective and mood disorders	Dyslexia
Post-traumatic stress	Dysgraphia (handwriting)
Attention deficit - child to adult*	Asperger's/Autism spectrum
Executive functioning	Cognitive processing factors**
Attachment and relational issues	Language
Family systems assessment	Intelligence
Personality disorders	Academic/learning disabilities
Emotional functioning

 

I have also conducted assessments for less usual situations, including assessments of children and adults who have been difficult-to-diagnose under a medical model; a pilot for FAA review; to determine the best rehab placement for a parolee with learning disabilities; of older children adopted from other countries; of individuals with Cerebral Palsy and other neurological differences.

        _________

* ADD/ADHD should be distinguished from situational stressors, anxiety, auditory processing disorder, &/or learning disabilities. Therefore, assessment for ADHD includes assessment of these areas.

**Processing speed, memory/retrieval, acquired knowledge, auditory and visual processing, reasoning/novel thinking

Assessment Methods

While certain aspects of assessments are fairly standard, each assessment is individually designed. As the assessment progresses, I remain flexible to new information that emerges. Methods include standardized tests, a complete history, interviews, self-report measures, projective tests, and sometimes, record review (e.g. previous testing, medical) and/or standardized reports completed by relevant others (i.e. parents, teachers, grandparents, significant others).

Emotional assessment includes a cognitive battery and selected methods including clinical interview, standardized self-reports and projectives, including the Rorschach, apperception tests, drawings and /or others.

 

As part of the assessment, I screen, and refer as necessary, for speech, sensory integration and gross motor functioning. I am a licensed psychologist, not a neuropsychologist, however I am trained in, and use, neuropsychological tests.

 

Where do referrals come from?

Clients are referred from several sources - relatives, friends and colleagues of former clients; psychiatrists, family practitioners, internists, pediatricians; psycho-therapists, speech/language therapists; public and private schools and universities; the internet. Many adults self-refer. Reasons for referral include:

 

Children:

School problems -- the obvious (e.g. reading problems) and the not-so-obvious (e.g. memory, behavior, etc.)

Emotional issues

Anxiety or depression, despite medical treatment, therapy

School refusal

Anger, social problems, stealing, lying

Underachievement

Problems turning in homework, participating in class

Family conflict

Parent-child relational problem inc. step- & blended families

Separation anxiety

Adults:

For the adult, an assessment can shed light on what has been a lifelong history of confusion or distress about school performance, personal achievement and/or continuing emotional distress. Getting an assessment as an adult often makes sense of the past and marks a new beginning in terms of insight, understanding and relief. If an adult has an intuitive sense that his academic achievement does not match his true potential, or if she takes extraordinary time to complete ordinary academic tasks such as reading, an educational assessment may be warranted.