Dr. Louis E. Costello is a Board Certified Psychiatrist with a specialization in Child Psychiatry. At The Costello Clinic we also treat adolescents and adults on a daily basis. The Costello Clinic operates using a Nurse Practitioner model. Dr. Costello meets with the patient for an initial one hour appointment; and, during his evaluation he determines the patient’s diagnosis. After the first appointment, the patient will then be paired with one of our Psychiatric Mental Health Nurse Practitioners, whom the patient will see on an ongoing basis.

Prior to meeting with the patient for their initial appointment, Dr. Costello has each patient complete an online diagnostic questionnaire.  The questionnaire is a smart test which takes approximately two hours to complete.  As one question is answered, the next question is determined based on the answer given to the previous question.  This allows the questionnaire to focus on specific issues a patient may be dealing with.  Many of us have multiple concerns and this questionnaire allows each issue to be fully explored. The questionnaire generates a 22-page report which Dr. Costello reviews prior to the first appointment with each new patient.  This questionnaire may be completed at home or here in our office, for your convenience.  If the patient is 18 years or older, they will complete the questionnaire themselves.  If the patient is younger than 18, the parent or legal guardian will be responsible for completing the questionnaire on the patient’s behalf. When you call our office to schedule your first appointment with us, we will inquire as to your preference regarding taking the questionnaire at home or here in our office.

Treatment Approaches

At The Costello Clinic, we utilize individualized treatment approaches, such as psychotherapy and informed cognitive-behavioral therapy, to treat a variety of mental illnesses including but not limited to:

ADD/ADHD (In Children and Adults)

Anxiety Disorders

Autism Spectrum Disorders

Bipolar Depression

Depression

Eating Disorders (Anorexia and Bulimia Nervosa)

Learning Disabilities

OCD – Obsessive-Compulsive Disorder

Panic Disorder

PTSD – Post Traumatic Stress Disorder

Separation Anxiety Disorder

Social Phobias

Substance Abuse

Tourette’s Syndrome

Many resources are available to help someone who is experiencing emotional distress. These resources may include support from friends and family, speaking with clergy, books, research articles, healthy exercise plans, healthy eating plans, and independent coping skills. All of these are extremely valuable to someone who is suffering from any type of mental health issue or emotional pain.

For those who do not find remission through these resources, professional therapy and counseling is available. Cognitive-Behavioral Therapy, or CBT, aims to solve problems by learning to recognize dysfunctional thoughts, emotions, and behaviors. By combining talk and behavioral therapy, the patient is able to redirect negative thinking patterns into positive thoughts and actions.

Techniques used in CBT vary according to the specific issues at hand. Homework may be assigned to help the patient develop new skills. Assignments will vary according to the needs of the patient. They may include keeping a diary of significant events and associated feelings, thoughts, and behaviors. Or the therapist may ask the patient to question and test assumptions and beliefs that may be unhelpful and unrealistic. In addition, a patient may be asked to gradually face activities which may have been previously avoided, and to try out new ways of behaving and reacting to daily life. Focusing on relaxation and distraction techniques is also common.

Individual Therapy

Here at The Costello Clinic we focus primarily on individual therapy. Generally, healing through cognitive-behavioral therapy (CBT) does not happen overnight. Recovery from mental health issues and emotional distress is a process. Daily behaviors and thought processes are often the target of psychotherapy. Even after patients have learned to recognize when and where their thoughts and emotions go awry, it can take considerable time and effort to replace a dysfunctional habit with a more reasonable and constructive one. CBT requires honesty and openness between the patient and therapist. A trusting relationship is necessary for the therapist to develop strategies to help guide the patient to manage their problems and create a better life.

Generally a therapist will go through a variety of treatment approaches to find the option that works best for the individual. Each person is different and what works for one person may not work for another.

Our office does not offer play therapy, group therapy, or family therapy. If you are interested in any of these we can provide contact information for local resources.

Treatment Resistant Depression and TMS

For people who have experienced chronic depression and have not reached remission with antidepressants or mood regulating medications, there is a FDA approved treatment option called Transcranial Magnetic Stimulation (TMS). TMS uses a MRI strength magnet to stimulate nerve cells in the dorsolateral prefrontal cortex (DLPFC). The DLPFC is an area of the brain believed to be associated with controlling mood. In theory, stimulating the neurons in this region causes the release of neurotransmitters and increases cerebral blood flow and glucose metabolism. Unlike antidepressant medications, TMS is not systemic (traveling through the body). Instead it targets the specific region of the brain believed to regulate mood.

The Costello Clinic offers treatment with TMS for patients with chronic depression. TMS has been FDA approved since 2008; and, Dr. Costello acquired the first chair in Texas in 2009. He has been treating Major Depressive Disorder with TMS longer than any provider in Texas.

We are happy to schedule a free TMS Educational Overview for patients who are insured with Aetna, Blue Cross Blue Shield, and Cigna, or choose to come into the clinic as a Private Pay patient. Insurance plans require a patient to have failed multiple antidepressant medications. A patient can also choose to come into the clinic as a Private Pay patient for TMS treatment with only one failed medication, per FDA regulations. To find out more about TMS, please call our office at: 972-317-2082, ext. 4, to schedule an Educational Overview for you or your family member who may be suffering from chronic depression. For additional information please visit our TMS website at: www.dfwtmstherapy.com.