Center for Emotion and Behavior Integration
The Center for Emotion and Behavior Integration provides intensive, time-limited outpatient treatment for adolescents and young adults (17-45 years of age) suffering from complex behavioral problems. The Center encompasses a variety of treatment approaches based upon the most up-to-date neurocognitive and psychosocial understanding of the causes for these problems. Specific services that are available include comprehensive prescreening testing, diagnostic evaluation, individual psychotherapies, group therapies, family consultation, and medication management. The specific treatment package is tailored to the needs of the individual patient.
Robert J Gregory, MD
Psychiatry; Borderline Personality Disorder; Dynamic Deconstructive Psychotherapy; Psychodynamic Psychotherapy; Psychopharmacology
Jean Shook, NP
Psychiatry; Borderline Personality Disorder; Dialectical Behavior Therapy
What are complex behavioral problems?
Complex behavioral problems are maladaptive sets of behaviors that are used to cope with negative emotions and interpersonal stresses. Patients who suffer from self-harm, eating disorders, addictions, recurrent suicide attempts, and/or borderline personality disorder may be eligible for treatment at the Center. Because of the affected brain regions involved in these conditions, they often are accompanied by anxiety, depression, mood instability, and poor interpersonal functioning.
What causes complex behavioral problems?
Recent neuroscience research is pointing the way toward a better understanding of complex behavioral problems. Neuroimaging studies suggest that individuals who suffer from these behaviors react to emotional stress in a different way from most other people. There is a relative deactivation of certain prefrontal regions of the brain, which are responsible for helping us to be aware of our emotional experiences and adaptively manage them. On the other hand, there is relative hyper-activation of certain other brain regions (amygdala and ventral striatum), which can account for much of the mood reactivity, anxiety, and distress that patients with complex behavior problems suffer from. The ventral striatum triggers pleasure seeking behaviors (such as drug addiction, bingeing, compulsive gambling), as well as attachment seeking behaviors, which can contribute to rejection sensitivity.
If the brain is functioning abnormally, is there anything that can be done?
YES! Multiple neuroimaging studies suggest that specific kinds of psychotherapy and medication interventions can remediate the neural networks in the brain to normalize activity of the various regions. This is not an easy process, but with the right combination of treatment and with hard work and determination on the part of the patient, success can be achieved!
What treatments are offered at the Center?
- Outpatient Medical Detoxification. This program is run by our addiction specialist, Dr. Brian Johnson, a Harvard trained psychiatrist. It is only the second outpatient detoxification program in NYS and promotes access and continuity of care.
- Dialectical Behavior Therapy. This program is directed by Jean Shook, RN, PNP, a practitioner with extensive DBT training and experience. DBT is an evidence-based treatment that has been shown to reduce maladaptive behaviors by teaching alternative skills for managing negative emotions and interpersonal stresses.
- Dynamic Deconstructive Psychotherapy. The Center is the only location in NYS where this treatment is offered. DDP is an evidence-based treatment for complex behavior problems that has been shown to improve symptoms and restore functioning in treatment-resistant patients. The DDP program is run by Drs. Evan Deranja, Robert Gregory, and Georgian Mustata.
- Eating Disorders Program. This program is run by Kathleen Deters Hayes, LCSW-R, a Menninger-trained therapist. Initial focus of the program is on medical stability. Through both individual and group psychotherapy, patients will learn how to express emotions, develop a solid "sense of self", manage trauma, and develop healthy relationships.
- Family Therapy. This program is run by Dr. Rebecca King, a psychiatrist specializing in family therapy. She employs Carl Whitaker's pioneering approach to family systems and is available for consultation or on-going treatment.
- Group Therapy. Two kinds of group therapies are offered at the Center: Dialectical Behavior Therapy and Systems Centered Therapy. The former focuses on learning new coping skills and the latter focuses in improving interpersonal relationships. Both treatments often complement individual therapies for complex behavior problems.
- Medication Management. Although medications tend to have more modest effects for complex behavioral problems, they can be an important component of the overall treatment plan.