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Clinical Practice

Areas to check out

Articles

 

Yes, it's true, Dr. Gale wound up on Geraldo At Large on May 4, 2006... and survived.  I was discussing the new film Normal People Scare MeThe film includes some the technology used by Dr. Gale to help with individuals diagnosed with Autistic Spectrum Disorders.


Introduction

I have been in private clinical practice in California since 1988. Prior to that I practiced in Boston (providing services to children with special needs while working in geriatrics, an interesting practice, to say the least!).  About two years ago I moved to a new office located in Encino (San Fernando Valley) right next door to Gelsons Market.  I searched quite a bit before coming up with this location.  It is on the ground floor of what I like to think of as a low-key garden-style building. 

As you read below, realize that the businesses near my office provide a wonderful extended therapeutic environment for addressing many of the types of problems for which clients are seeking help.  Generalizing gains which occur in the office is a paramount concern for effective treatment.  With Gelsons market, Office Depot, numerous types of restaurants and other stores, clients can practice assertive skills, work on social anxiety, improve attentional and executive functioning, and rehearse a variety of social and impulse control skills.

My primary specialties include working in individual or group treatment with children, adolescents, and adults who experience difficulties with social skills, attentional and impulse control problems, or problems with interfering anxiety (see below for more details)

Therapeutic Focus

My primary therapeutic orientation is a cognitive-behavioral therapy or a more traditional behavioral therapy approach.  You can read more about cognitive therapy by clicking on the link below:

Tracking Progress:  I am a strong believer in developing some form of data mechanism in my work with clients to help them track progress.  Some of the systems I have developed have been fairly sophisticated (see Dec/Jan 06 newsletter for a case example, but others have been quite simple.  I like developing secure online forms for clients since it allows them to keep me abreast of their progress or difficulties in between sessions.  I have been doing so since 2002 and have experienced no problems with this technology.

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Areas of Clinical Practice

Populations Served

Most individuals who see me are experiencing significant problems with anxiety and/or corresponding social skill difficulties.  My most common referrals are for individuals diagnosed with Asperger's Syndrome or High Functioning Autism; Anxiety Disorders (Social Anxiety Disorder; Generalized Anxiety, Panic Disorder, OCD, and Phobias); and Attentional and Impulse Control problems, including executive functioning deficits.

Currently, I have two ongoing adult groups at my Brentwood location which meet on Mondays and an anxiety disorders group (social anxiety disorder clients) which meets every other Tuesday.

Typical diagnoses of the individuals I see include the following:

  • spectrum anxiety disorders, including panic disorder, OCD, generalized anxiety, phobias, social anxiety disorder/extreme shyness
  • social skill challenges related to ADHD, learning disabilities, developmental disorders, autism, Asperger's Syndrome, and nonverbal learning disabilities
  • trouble controlling anger, oppositional behavior.

Clients with Attention Problems:  I often make use of digital video or computer animation as a treatment adjunct.  In working with clients who have attentional problems, it can be helpful to have them make their own tutorials which they can take on a DVD to play and rehearse or have it available on a protected portion of my web server.  The other helpful aspect of this is that, with a digital recording, you can easily "take out" the irrelevant parts of interactions, allowing clients to see more functional representations of themselves during activities or interactions.  This provides a model for them to practice in between sessions.  We can also easily print out "scripts" for them to take home.

Socially Shy Clients:  Including computer animation as part of the session and letting clients create and practice conversations between cartoon characters can much less threatening than role playing or sustained face to face interactions.  Like the client tutorials, they can take these with them and view the interactions.  The simple animation programs I use allow them to choose between animal and human-type characters and add what I refer to as the "bells and whistles" as easily as one might use a word processor.  I recently added the ability for them to use "Avatars," which clients are responding to positively.  As with client experiencing attention problems, scripts can be generated for them to take with them.

 

How I Stay Current

I read journals, attend conferences, and talk with colleagues.  Additionally, I volunteer time with the California Diagnostic Center (leadership position in PENT program, research team, and serve as technology advisor); Westside Regional Center (Autism Learning Collaborative); Jewish Family Service ("J" in JFS Committe); and serve on the editorial board for the journal Cyberpsychology and Behavior.  I am qualified as a Sponsoring organization through the American Psychological Association and the California Board of Behavioral Science to offer CE credits to psychologists, social workers, and MFTs.  There's no better way to stay abreast than having to teach others.  I also am called for expert testimony at times, usually in the areas of developmentally disabilities.

Research Interests

  • Using technology to enhance assessment and treatment efficacy
  • Development of online assessment tools and methodologies
  • Creating valid and reliable methods of behavior observation

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Types of Assessments Conducted

I conduct assessments for children and adolescents aged 5-18 and adults 18 and older.  My most frequent referrals generally concern autistic spectrum disorders, which include Asperger's Syndrome, High-Functioning Autism, ADHD/ADD, Anxiety Disorders (phobias, panic disorder, OCD, social anxiety, generalized anxiety, avoidant personality), and anger or impulse control disorders.

Functional Behavior Assessment - as opposed to determination of diagnosis, FBA is generally more concerned with developing an understanding of what behaviors or symptoms are producing or maintaining behaviors.  This can be more useful for problems such as anger or aggression, social skill deficits, oppositional behavior, anxiety, and attention deficits.  FBAs involve 1) determining the frequency and severity of behaviors; 2) understanding of the context in which these behaviors are more likely to occur; 3) factors maintaining the occurrence of behaviors.

This generally leads to the development of a comprehensive treatment which may include behavior management techniques, medications, if indicated, coping strategies, and possible changes in environmental conditions.

Psychoeducational Assessment - evaluation of cognitive, academic functioning, social-emotional functioning, adaptive behavior, and vocational interests.  Very similar to Psychodiagnostic Assessment, except the focus is on eligibility for special education, recommendations for IEPs and/or Section 504 Plans.  Click here for more information.   You will be taken to the school section for more details.

Psychodiagnostic Assessment - determination of diagnosis.  Generally involves a blend of cognitive testing, personality assessment, assessment of adaptive and social emotional functioning.  May include neuropsychological tests assessing memory, processing speed, and related areas, plus detailed history and background.  Use to establish diagnoses leading to specific treatment recommendations.

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