Christina Brezing, MD, is the new Medical Director of Ellenhorn New York

Dr. Christina Brezing works collaboratively with her clients to achieve their individual goals by developing personalized treatment strategies and integrating the latest evidence-based care. She completed an adult psychiatry residency at Harvard Medical School’s Massachusetts General Hospital/McLean Hospital training program, where she served as a chief resident. Dr. Brezing also completed an addiction fellowship at Columbia University Medical Center/New York State Psychiatric Institute. After graduating alpha omega alpha with honors in research from the University of Florida College of Medicine, she received a BS in biology with a focus in biochemistry from Duke University.

During medical school, Dr. Brezing completed the Howard Hughes Medical Institute-National Institutes of Health Research Scholars Program. At the NIH, she studied the neuroimaging of impulse control disorders, including pathological gambling, compulsive sexual behavior and excessive shopping.

Dr. Brezing is double board certified in adult psychiatry and addiction psychiatry. She is currently an Assistant Clinical Professor of Psychiatry in the Division on Substance Use Disorders at Columbia University, where her research focuses on the application of technology to the development of novel treatments for problematic substance use. Dr. Brezing’s work in problematic substance use and mental health has been funded by the National Institutes of Health, the American Psychiatric Institute for Research and Education, and by the Dartmouth Center for Technology and Behavioral Health.

In addition to publishing work in numerous academic journals and books, Dr. Brezing has presented at national conferences and received awards for both her research and clinical care. She previously served on the board of the American Academy of Addiction Psychiatry and currently serves on the board of the New York Society of Addiction Medicine.

Dr. Brezing completed a one-year fellowship in psychodynamic therapy at the Boston Psychoanalytic Society and Institute, and completed formal training in Motivational Interviewing, Dialectical Behavior Therapy, and Mentalization-Based Treatment. She maintains a small private practice in Manhattan.

Q: What attracted you to Ellenhorn New York?  

A: While working on McLean Hospital’s inpatient psychotic unit, I had really positive experiences collaborating with [then] Prakash Ellenhorn. Ellenhorn’s teams met with us and the patient and developed this unbelievable continuity of care. This was of great concern to me, as a psychiatrist getting ready to discharge patients from residential and inpatient settings.

Q: Why do you believe in the community integration approach to treatment for people diagnosed with psychiatric issues?

A: For me, it’s common sense. People who are admitted to inpatient or residential settings to get better eventually have to go back into their own environment. That’s when we see things break down. The person hasn’t had the opportunity to get healthy while living in their own space.  In order to have longitudinal stability, treatment and support have to, at some point, translate into one’s own environment. The reality is that, historically, treatment has stemmed from the convenience of providers and not from consumers of that care. Ellenhorn is a leader in disrupting that model, building services toward the client, not the other way around.

Community integration is particularly valuable for handling complex psychiatric issues because it allows treatment to take place in the setting (or settings) most comfortable for the client — settings that are not clinical, not sterile. Treatment is at home, in neighborhoods, with friends, families, and significant others. We all feel more comfortable in our own environment. The added benefit is that we’re creating an experience in the person’s own ecology that allows them to live in the setting where they want to be.

Q: What is the role of medical director at Ellenhorn New York?  

A: I oversee the medical and psychiatric care provided by the psychiatrists at Ellenhorn New York.  Additionally, I run my own clinical team and see clients.  People ask me to help with challenging situations when there’s more significant clinical concern. There is a lot of discussion — very active and open discourse about treatment.  I collaborate with the team on complicated clinical situations or concerns.  Any given client gets an unbelievable amount of space in their clinicians’ dialogue and thinking, beyond the in-person sessions.

When we think about time spent on a client, many clinicians think about face-to-face contact. But here, there is so much discussion reflecting an extraordinarily thoughtful commitment to treatment and care that goes on outside of face-to-face time. Part of this out-of-session contact includes rounds on every single client every morning. In addition, we bring in outside consultants — clinical staff from Ellenhorn Boston — to weigh in on cases. That means every client gets an unbelievable degree of outside attention. It’s hard to express how much we think collectively, as well as alone, about each client.

Q: What is rewarding for you about this approach to your work? 

A: I love discussing things. I love this ongoing iterative process that occurs at Ellenhorn in which we share different perspectives, including those of the clients and families. They’re experts in their own lives. They’ve lived it.  And it’s so rewarding: By sharing multiple perspectives and incorporating them into a solution, we come up with the most overall fruitful approach to achieving goals.

As an example, a big part of how we start any relationship with a client and their family begins with hospitality. It’s about us going to the client and family in a way that’s most convenient for them. We often say, ‘We’d love to have a meal with you.’ Having a meal bridges cultures and any number of different communities. Breaking bread together is a wonderful way to break down walls, and to have the conversation about what we want to achieve. So we’ll first meet in restaurant or in their home. Or we’ll set up dinner in our offices and have an anchoring meeting to determine the initial plan for where we want to go and begin a new relationship. Our goal is to sit down and think through what is important to the client and their family, and how to begin to achieve these goals.

Ellenhorn New York has the most wonderful clinicians. Everyone goes above and beyond in terms of their commitment to the clients we work with. We travel all over the city, all boroughs, to meet people in neighborhoods and apartments, and to do fun and enriching activities. New York is such an amazingly rich community; there are such wonderful things to take advantage of. We really make use of all that New York City has to offer.

Q: Please comment on the role of hope – and fear of hope – with respect to clients at Ellenhorn New York, and how the program  fosters hope in one’s own future.

A: The big picture is that I think clients lose hope because they are frequently exposed to the same treatment or therapeutic environment over and over again. Whether an inpatient unit, a residential program, outpatient services, or a psychiatrist office visit a few times a week – these programs and procedures have a certain care protocol that doesn’t always work for everyone. When people do the same thing again and again without getting the change or purpose they are seeking, they can lose hope.

Clients at Ellenhorn NYC have needs and wants that often require creative and tailored approaches to care that can’t be met by these other models or systems. That’s where Ellenhorn can break the cycle of hopelessness. It is such a unique model.  By not repeating the same process, we try to create, from the beginning, a very different experience. And sometimes that can be enough to open the door to hope – a client’s belief that things might be different, that life can move forward in a different direction.

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