ACC funds psychologists, psychiatrists and psychotherapists to undertake a variety of tasks in assessment and rehabilitation. At Practice 92 psychologists and psychiatrists are available to undertake general and neuro-psychological (child and adult) assessments for clients who have had mental stress associated with an accident. Psychologists and psychotherapists at Practice 92 are also registered with ACC to undertake assessment and therapy both for clients with general injuries and for those with a Sensitive Claim (Sexual Abuse). Clients and their referrers are asked to ensure that the receptionist is aware that a client may be seeking assessment or treatment through ACC when making an appointment.

We all feel some anxiety at some time or other. Anxiety may serve as an alerting signal, warning us of external /internal threats and consequently acting as a prompt to take appropriate action. When anxiety is very severe and present even when there is no threat of any kind, then it interferes with our functioning and can become an illness. In this circumstance, anxiety becomes a disorder characterised by an unpleasant emotion with feelings of fear, threat and impending danger and can be associated with numerous bodily symptoms like breathlessness, trembling, tightness in throat, dry mouth, racing heart and nausea/vomiting. There are varieties of anxiety disorders like panic attacks, phobias (unhealthy fear of something), agoraphobia (fear of open spaces), social anxiety, post-traumatic disorder and obsessive compulsive disorder. Anxiety can often be associated with a depressive episode. Anxiety disorders are very common and if unrecognised and untreated, can cause severe disability. Treatment Self help: learning techniques like relaxation, distraction and education Cognitive Behavioural Therapy (CBT) Medication.

ADHD is a common disorder with its onset in childhood, which can sometimes persist into adulthood. Symptoms are grouped into clusters related to inattention, hyperactivity and impulsivity. A range of problems such as poor time management, inattention, forgetfulness, and difficulty winding down or sitting still may indicate the presence of ADHD, however the diagnosis is only made where symptoms are causing distress or dysfunction. ADHD is diagnosed by clinical interview supplemented by psychometric tests in some cases. The mainstay of treatment is medication, however a range of time management skills and other interventions can be very useful. It is important that ADHD symptoms be considered holistically as other physical or mental disorders can mimic ADHD symptoms. A range of practitioners at Practice 92 have experience in assessing and treating ADHD in children and adults.

This is a mood disorder in which both depressive (persistent low mood) and manic (elevated or high mood) episodes are experienced. It is usually a recurring (i.e. keeps coming back) disorder that can cause a lot of havoc in all aspects of a person’s life. People with this disorder will experience periods of extreme mood changes but also periods of stable mood during which they may be able to return to everyday routines. These changes of mood can be very extreme and occur for no apparent reason. Different people will experience this disorder in different ways; some may have few episodes, others many, and symptoms may vary from mild to severe. When severely depressed or elevated, a person can become ‘psychotic’ i.e. lose touch with reality. Treatment Usually by medication (antidepressants if depressed and mood stabilisers if depressed and manic) A combination of counselling and psychotherapy (‘talking therapy’) may hasten recovery Hospitalisation may be required for those who are very unwell and are posing a risk to themselves or to others.

Child sexual abuse is defined as sexual contact ranging from fondling to penetration, by someone who is 5 or more years older than the survivor. Children exposed to sexual abuse are at risk of profound and ongoing effects on their childhood, adolescence and adult development. If not able to access help straight away, then there can be complex and long lasting effects. It is important to seek help from a professional psychologist or psychotherapist who is experienced and specially trained in working with the effects of child sexual abuse. The ACC Sensitive Claims Unit can often help fund the counselling.

Chronic Fatigue Syndrome (PDF, 64.2 KB) Chronic Fatigue Syndrome and its treatments

Chronic Illness (PDF, 67.2 KB) Management of chronic illness

Chronic Pain Management (PDF, 66.3 KB)

Depression is a mood disorder. Emotional states like sadness, ‘feeling blue’ or tearfulness are part of normal human experience. Clinical depression is called Major Depression and is characterised by the presence for at least two weeks of symptoms such as depressed mood, diminished interest and pleasure in most activities, change in appetite and weight (these can be increased or decreased) sleep disturbance, fatigue, bodily symptoms (headache, backache etc) poor concentration, feelings of anxiousness, worthlessness, hopelessness, guilt, and suicidal ideation. Depression is a common disorder and about 10-20 % of the population in New Zealand will suffer from depression during their lifetime. Treatment Once depression has been diagnosed by your GP/Psychiatrist, it can be effectively treated by: Antidepressant medication Psychological interventions e.g. counselling (various types) and psychotherapy (talking therapy which is of various types).

Psychologists and psychotherapists at Practice 92 undertake both counselling and assessment work for the Family Court. The Family Court provides funded counselling for adults, parents and children in certain circumstances. Practice 92 practitioners specialise in working with children and in working with conflicted family systems. Psychologists at Practice 92 also undertake assessments for the Family Court. Clients and their referrers are asked to ensure that the receptionist is aware that a client may be seeking assessment or counselling funded through the Family Court when making an appointment.

Fibromyalgia (PDF, 60.7 KB)

Neuropsychology is a professional specialty concerned with learning and behaviour in relationship to an individual’s brain. Neuropsychologists and Clinical Psychologists are trained in the formal testing of abilities such as memory and language skills to assess brain functioning, and have expertise in how learning and behaviour are associated with the development of brain structures and systems. A child is usually referred for neuropsychological assessment when they: experience difficulties in learning, attention, behaviour, socialisation or emotional control have a disease or inborn developmental problem (i.e. epilepsy, Asperger’s syndrome) that affects the brain in some way, or have a brain injury from an accident, birth trauma etc.

Personality disorders are mental disorders characterised by an enduring pattern of inner experience and behaviour that deviates markedly from the expectations of the individual's culture. The pattern is manifest in the individual's cognitive distortions, problems with emotions and emotional regulation, poor interpersonal functioning and difficulties with impulse control. Treatment is usually long term and may require access to both specific psychotherapy and medication. The practitioners at Practice 92 are all trained and experienced in the treatment of Personality Disorders.

Schizophrenia is a serious mental disorder that affects about 1% of the general population. It is a complex illness characterised by ‘psychosis’, a word used to describe disorder of thoughts (e.g. delusions - false beliefs held in spite of evidence that they are not real), perceptions (e.g. hallucinations - seeing, hearing or feeling things which are not there), disorganised speech and grossly disorganised behaviour, which are not experienced by others and which are not seen as abnormal by the sufferer. These four symptoms are often referred to as the ‘Positive Symptoms’ of schizophrenia because they are the result of the disease process. The fifth group of symptoms: withdrawal, decreased ability to feel pleasure, lack of energy, and flat affect, are referred to as ‘Negative Symptoms’ because they represent a loss of normal functions. Schizophrenia affects different people in different ways. Some people may experience only a few short episodes and then fully recover. For others it lasts throughout their lives and needs to be treated like any other physical illness such as asthma or diabetes. It is important that schizophrenia is treated as soon as it is diagnosed by a psychiatrist to prevent long-term disability and loss of function. Treatment Schizophrenia may be treated using a number of different approaches: Use of antipsychotic medication Psychosocial education programs e.g. education, support, counselling and assistance to return to job/studies/performing daily tasks Ongoing support e.g. housing, monitoring of treatment, support groups.

Please click on the link for information about sex therapy. Sex Therapy Information (PDF, 57.4 KB)

Dr Tony Fernando is our Sleep and Insomnia Specialist at Practice 92 in Mt Eden. At present we do have a long waiting list but we also offer cancellations if you are flexible and can come at short notice. Dr Antonio Fernando Consultant Psychiatrist and Sleep & Insomnia Specialist Appointments are 1.1/2 hrs for the initial assessment and consultation: $620 Follow up appointments are 20 minutes: $215 To make a referral please contact: Practice 92 on 09 638 9804 or fax a referral to: 09 638 9814. Referrals may also be emailed to: Once a referral is received a sleep diary, sleep questionnaire, a cover letter and a map of how to find Practice 92 will be sent to the patient. Sleep/Insomnia Insomnia is one of the most common medical problems. It is defined as poor quality sleep, often with a long wait for sleep to happen, middle of the night awakening or waking up too early. At least 10% of adults in the developed world have chronic, longstanding insomnia. Treating insomnia is not as simple as avoiding coffee and having a warm milk or bath at night. A detailed assessment is necessary to find out what exactly is causing insomnia. Different causes of insomnia include long standing poor sleep habits anxiety, stress and depression biological clock problems chronic pain certain personality types medical or neurological problems substances. Only after a cause is identified should a proper treatment plan ensue.Treatment of insomnia can include: 1) non medication, psychological approaches 2) bright light and hormone treatments 3) medications. Sleep Questionaire (PDF, 332.8 KB) Sleep Diary (PDF, 246.6 KB)

Skype Therapy (PDF, 61.3 KB)

Dr Emme Chacko specialises in Mindfulness Based Cognitive Therapy (MBCT). This is a structured programme developed for depressive disorders and has been shown in research studies to be as effective as an antidepressant. MBCT is delivered in 8 individual sessions. It is also indicated for anxiety disorders, pain and workplace/caregiver burnout states.