Approach:
My approach to anger management is guided by a wide array of clinical interventions that include the following:

• The Four Choice Model of Anger Management: I devised this approach to treatment which is a Cognitive Behavioral Therapy (CBT)-based intervention that is designed to work with angry patients/students who struggle with learning challenges. 
• Change Theory: I integrate Prochaska and DiClimente's Transtheoretical Model of Change into every aspect of patient treatment in my practice. Change theory allows every team member to set reasonable expectations for treatment and allows the treatment to be perceived as a sequential process that makes sense and is predictable.
• Dialectical Behavior Therapy (DBT):  I support and integrate major aspects of Marsha Linehan's approach to treatment into my work with an emphasis on maintaining a non-pathologizing approach, focusing on skill acquisition, and emphasizing mindfulness and overall wellness.  
• Multi-Systemic Therapy: My approach to family treatment is to consider the patient as an integral part of the  larger family system, and the family as part of the larger community.  All aspects of these systems need to be healthy. This holistic approach requires constant phone/face contact with other treaters as well as communication with schools, teachers, and probation officers. Basic family therapy that is well-executed and results-focused is seen as one aspect of this larger systemic approach. 

I have worked with a wide range of patients who struggle with anger and impulsive behaviors, including:

• Patients who received treatment at one of the largest psychiatric teaching hospitals in the country
• College students who attend a range of college placements including local community colleges as well as Ivy League schools. 
• Students who have attended a variety of therapeutic school placements throughout the US
• Teenagers placed within the California & Massachusetts juvenile justice system
• Inmates who were incarcerated in medium security adult prisons and forensic psychiatric hospitals
• Patients placed within a range of psychiatric inpatient and day hospital settings throughout the country.
• Street kids found on the streets of Washington State

Anger Management Services Provided:

• Coordinated Multimodal Interventions
• Acute Assessment and Stabilization
• Medication referral (Often Required)
• Stabilization of legal concerns including coordination with legal team or probation officer/courts
• Evaluation of learning history/profile
• Review of previous testing
• Completion of a comprehensive Anger Testing Battery
• Referral for additional psychological and/or neuropsychological testing
• Referral for inpatient stay if required
• Assessment of substance use and its impact upon impulsive decision making/anger outbursts
• Evaluation of cognitive components to anger

​"I have found that all of the patients that I have worked with, in a variety of settings, are simply people who are trying to make sense out a world that at times can be cruel and chaotic."
​                          Dr. Perna
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