Functional Approach to Mental Health

At AO-Counseling, I utilize a functional, systems-oriented approach to mental health. Interventions across clients and diagnoses focus on restoring function by enhancing resilience and adaptive capacity and targeting root causes and underlying mechanism rather than mere symptom suppression.

Within this model, optimizing physiology is critical, as biological issues often manifest as cognitive, emotional, motivational, and behavioral disturbance.
If the body is broken, the mind suffers. In my clinical experience, psychological issues frequently become far more manageable—or disappear entirely—when the pillars of sleep, nutrition, exercise, and biological function are restored.

Implementing this treatment model requires collaboration with physicians who can rectify the body—so the mind can mend.

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why my clients need you:

Engaging an unhealthy client in therapy is an arduous and inefficient process. In addition to ruling out underlying pathology, I rely on medical providers to improve the effectiveness of my work and improve client outcomes.

I frequently refer clients for assessment and treatment of:

Chronic fatigue, brain fog, and cognitive dysfunction
Hormonal and endocrine dysfunction — including thyroid, parathyroid, adrenal, reproductive hormones, and insulin resistance
Nutrient imbalances — such as B₁₂, folate, vitamin D, iron, magnesium, and other deficiencies
Genetic contributors — including relevant polymorphisms (e.g., MTHFR, COMT) that may impact cognition, mood, or detoxification
Mitochondrial and metabolic dysfunction — involving insulin resistance, mitochondrial inefficiency, oxidative stress, and impaired energy production
Medication management — prescription, side effect mitigation, dosage titration, or adjunctive strategies to support overall mental and physical well-being

These referrals are routine, not rare—and ensure clients aren’t trying to “therapy their way through” a biologically driven issue.

I highly value physicians who:

Look beyond surface symptoms

Value integrative, lifestyle-based approaches

Understand the impact of mitochondrial and metabolic function on mental health

Connect

Functional Mental Health

Functional Approach to Mental Health

At AO-Counseling, I utilize a functional, systems-oriented approach to mental health. Interventions across clients and diagnoses focus on restoring function by enhancing resilience and adaptive capacity and targeting root causes and underlying mechanism rather than mere symptom suppression.

Within this model, optimizing physiology is critical, as biological issues often manifest as cognitive, emotional, motivational, and behavioral disturbance.
If the body is broken, the mind suffers. In my clinical experience, psychological issues frequently become far more manageable—or disappear entirely—when the pillars of sleep, nutrition, exercise, and biological function are restored.

Implementing this treatment model requires collaboration with physicians who can rectify the body—so the mind can mend.

Why My Clients Need You

Physiology Often Dictates Psychological Functioning

Engaging an unhealthy client in therapy is an arduous and inefficient process. In addition to ruling out underlying pathology, I utilize medical providers to improve the effectiveness of my work and improve client outcomes.

I frequently refer clients for assessment and treatment of:

Chronic fatigue, brain fog, and cognitive dysfunction
Hormonal and endocrine function — including thyroid, parathyroid, adrenal, reproductive hormones, and insulin resistance
Nutrient imbalances — such as B₁₂, folate, vitamin D, ferritin/iron, magnesium, and other deficiencies
Genetic contributors — including relevant polymorphisms (e.g., MTHFR, COMT) that may impact cognition, mood, or detoxification
Mitochondrial and metabolic dysfunction — involving insulin resistance, mitochondrial inefficiency, oxidative stress, and impaired energy production
Medication management — prescription, side effect mitigation, dosage titration, or adjunctive strategies to support overall mental and physical well-being

These referrals are routine, not rare—and ensure clients aren’t trying to “therapy their way through” a biologically driven issue.

I highly value physicians who:

Look beyond surface symptoms
Leverage integrative, lifestyle-based approaches
Understand the impact of mitochondrial and metabolic function on mental health
Respect the pace of behavioral change

If you’re practicing this kind of thoughtful, root-cause-informed care, I’d be honored to collaborate in improving patient outcomes.

What I Offer Clinicians

How I Can Help

Medical professionals are tasked with establishing the correct diagnosis and recommending appropriate treatment within an exceedingly brief window—an astonishing feat requiring extensive training, cognitive precision, and clinical acumen.

Regardless of the clinician’s brilliance, insight is of little value without patient follow-through.

That’s where I come in…

My model leveraging physiology to improve psychological function reinforces your recommendations via:

Connecting lifestyle choices to physical and psychological symptoms
Reconditioning clients to prioritize physical health
Realigning behavior with values
Reconstructing limiting beliefs and building motivation
Strengthening consistency and follow-through
Promoting agency and providing accountability

Using CBT, ACT, and Motivational Interviewing, we’ll address:

Behavioral patterns
Emotional regulation
Decision-making
Resistance to change

Result: Clients become more consistent in following medical recommendations—making dietary changes, reducing alcohol intake, and taking medications reliably.

Bonus: Optimizing lifestyle and behavioral factors (sleep, diet, exercise, and substance use), permits minimum effective doses of medications to be established at lower thresholds—and with fewer side effects.

Case Study

A Counselor and Client in Need of a Good Clinician

A client in their mid 30s, previously diagnosed with Bipolar II disorder, had been on Wellbutrin, Lamotrigine, Oxybutynin, and Metoprolol for nearly five years. Despite a relatively stable mood, they continued to report persistent fatigue, cognitive issues, and poor motivation—and were insistent that they pursue ADHD assessment and stimulant treatment.

While in session helping the client determine whether a little bit of speed would indeed prove to be the answer to all their ails, I privately began reviewing the side-effect profiles of the litany of drugs they were taking, some of which were at their upper dosing limits. I started with the most recently prescribed medication, Metoprolol, and worked backward. I was well aware of its downregulating effects on the sympathetic nervous system and suspected this might account for a number of their symptoms. The Metoprolol had been prescribed to manage “idiopathic” tachycardia, which I discovered emerged shortly after initiation of Oxybutynin for hyperhidrosis.

Realizing Oxybutynin‘s mechanism of action was anticholinergic, I quickly found research supporting its potential role in elevating heart rate due to inhibitory effects on vagal tone, as well as its apparently well-established impact on cognitive function. I was relieved that most—if not all—of the client’s symptoms could be explained by Metoprolol and Oxybutynin, and their psychiatric medications could be excluded entirely from our discussion. The last thing I wanted to put into their head was the idea that maybe they should stop taking their Bipolar medication or any medication for that matter—these were explorations to be done with their doctor.

Quite fortunately they had just found a new PCP with whom they were going to discuss their symptoms and potential screening and treatment for ADHD. In our next session, I provided them with the manufacturer data on Metoprolol and Oxybutynin, several studies detailing Oxybutynin’s cognitive side effects, an explanation of the potential mechanisms at play, and a quick primer on how to provide their new PCP the necessary information to make well-informed clinical recommendations.

We specifically covered:

Asking their PCP about alternative treatments for hyperhidrosis or potentially switching from Oxybutynin to Glycopyrrolate, which is less likely to cross the BBB.
Tapering Metoprolol under medical supervision after being off Oxybutynin for a sufficient period.
Requesting targeted lab tests evaluating TSH, FT3, FT4, 25(OH)D, iron, and B12 (the client adhered to a predominantly vegan diet).

The client’s PCP gladly made the requested medication change to Glycopyrrolate, agreed to monitor Metoprolol tapering after an appropriate interval, and discovered a significant B12 deficiency.

Within a couple of weeks following these changes, the client reported a “miraculous” improvement in cognitive clarity, motivation, and overall mood—with the real-world effect of presenting as a far more engaged, cognizant, adaptive, and happy individual. I have the privilege of continuing to work with them and witnessing continued improvement in functioning across multiple domains. In the context of pursuing their therapeutic goals, it no longer feels as if we are pushing a car up the hill; we are driving it!

As a mental health clinician, I am well aware that much of what was required to ensure my client’s wellbeing in this situation was beyond the scope of counseling. Medicine is not my field of expertise by any means.

However, given the tremendous overlap between what have been traditionally designated psychological and physiological systems—likely a false dichotomy obscuring the discernment of both cause and solution—developing a collaborative care system between specialists is critical to effectively managing all aspects of patient health.

This is why I am seeking an established referral network of trusted, highly skilled medical providers—with superior training and superior intellect (yes, I said that)—to assume responsibility for overseeing my clients’ physical health, and the motivation behind me reaching out to you and your practice specifically.

What I offer clinicians:

Medical professionals are tasked with establishing the correct diagnosis and recommending appropriate treatment within an exceedingly brief window—an astonishing feat requiring extensive training, cognitive precision, and clinical acumen.

Regardless of the clinician’s brilliance, insight is of little value without patient follow-through.

That’s where I come in…

My model leveraging physiology to improve psychological function reinforces your recommendations via:

Connecting lifestyle choices to physical and psychological symptoms
Reconditioning clients to prioritize physical health
Realigning behavior with values
Reconstructing limiting beliefs and building motivation
Strengthening consistency and follow-through
Promoting agency and providing accountability

Using CBT, ACT, and Motivational Interviewing, we’ll address:

Behavioral patterns
Emotional regulation
Decision-making
Resistance to change

Result: Clients become more consistent in following medical recommendations—making dietary changes, moving more, reducing alcohol intake, and taking medications reliably.

Bonus: Optimizing lifestyle and behavioral factors (sleep, diet, exercise, and substance use), permits minimum effective doses of medications to be established at lower thresholds—and with fewer side effects.

Case Study

A Counselor and Client in Need of a Good Clinician

A client in their mid 30s, previously diagnosed with Bipolar II disorder, had been on Wellbutrin, Lamotrigine, Oxybutynin, and Metoprolol for nearly five years. Despite a relatively stable mood, they continued to report persistent fatigue, cognitive issues, and poor motivation—and were insistent that they pursue ADHD assessment and stimulant treatment.

While in session helping the client determine whether a little bit of speed would indeed prove to be the answer to all their ails, I privately began reviewing the side-effect profiles of the litany of drugs they were taking, some of which were at their upper dosing limits. I started with the most recently prescribed medication, Metoprolol, and worked backward. I was well aware of its downregulating effects on the sympathetic nervous system and suspected this might account for a number of their symptoms. The Metoprolol had been prescribed to manage “idiopathic” tachycardia, which I discovered emerged shortly after initiation of Oxybutynin for hyperhidrosis.

Realizing Oxybutynin‘s mechanism of action was anticholinergic, I quickly found research supporting its potential role in elevating heart rate due to inhibitory effects on vagal tone, as well as its apparently well-established impact on cognitive function. I was relieved that most—if not all—of the client’s symptoms could be explained by Metoprolol and Oxybutynin, and their psychiatric medications could be excluded entirely from our discussion. The last thing I wanted to put into their head was the idea that maybe they should stop taking their Bipolar medication or any medication for that matter—these were explorations to be done with their doctor.

Quite fortunately they had just found a new PCP with whom they were going to discuss their symptoms and potential screening and treatment for ADHD. In our next session, I provided them with the manufacturer data on Metoprolol and Oxybutynin, several studies detailing Oxybutynin’s cognitive side effects, an explanation of the potential mechanisms at play, and a quick primer on how to provide their new PCP the necessary information to make well-informed clinical recommendations.

We specifically covered:

Asking their PCP about alternative treatments for hyperhidrosis or potentially switching from Oxybutynin to Glycopyrrolate, which is less likely to cross the BBB.
Tapering Metoprolol under medical supervision after being off Oxybutynin for a sufficient period.
Requesting targeted lab tests evaluating TSH, FT3, FT4, 25(OH)D, iron, and B12 (the client adhered to a predominantly vegan diet).

The client’s PCP gladly made the requested medication change to Glycopyrrolate, agreed to monitor Metoprolol tapering after an appropriate interval, and discovered a significant B12 deficiency.

Within a couple of weeks following these changes, the client reported a “miraculous” improvement in cognitive clarity, motivation, and overall mood—with the real-world effect of presenting as a far more engaged, cognizant, adaptive, and happy individual. I have the privilege of continuing to work with them and witnessing continued improvement in functioning across multiple domains. In the context of pursuing their therapeutic goals, it no longer feels as if we are pushing a car up the hill; we are driving it!

As a mental health clinician, I am well aware that much of what was required to ensure my client’s wellbeing in this situation was beyond the scope of counseling. Medicine is not my field of expertise by any means.

However, given the tremendous overlap between what have been traditionally designated psychological and physiological systems—likely a false dichotomy obscuring the discernment of both cause and solution—developing a collaborative care system between specialists is critical to effectively managing all aspects of patient health.

This is why I am seeking an established referral network of trusted, highly skilled medical providers—with superior training and superior intellect (yes, I said that)—to assume responsibility for overseeing my clients’ physical health, and the motivation behind me reaching out to you and your practice specifically.

How I Work

Clients are referred to medical professionals for medical treatment, medication management, preventative care, health optimization, or when symptoms warrant further diagnostic evaluation.
Brief consults available prior to referral if needed.

Fees & Insurance

Direct-Pay: $100/hr individuals, $110/hr couples

Discounts available for direct-pay clients

Accepted Insurances:

➤ Blue Cross Blue Shield
➤ United Health Care UHC / UBH
➤ Cigna and Evernorth
➤ Aetna

Ideal Clients for Referral

Individuals (9+) with Anxiety, Depression, Bipolar Disorder, ADHD, Substance Use issues or anything stress-related
(see FAQ on Homepage for a comprehensive list)
Patients struggling to implement lifestyle recommendations
Clients resistant to medication or seeking skills-based support
Medically stable clients who need behavioral scaffolding to function well
Couples Counseling (Gottman Method—Level 2)