About Achieving Optimal

Welcome to Achieving Optimal, a psychological consultation practice that addresses the wellness needs of physicians via use of a performance-focused paradigm. My name is Stephanie Cunningham, Ph.D. and I am a counseling psychologist who has specialized in treating physicians and medical learners. After years of providing psychotherapy to doctors in traditional outpatient behavioral health contexts, I became increasingly dissatisfied with extant narratives about “physician wellness” that seemed to be implicitly deficit-focused and decided that a new, more expansive paradigm was necessary. I began to develop an approach to practice that is intentional in incorporating the best elements of counseling psychology, performance psychology, liberation psychology, medical education literature, and psychological consultation interventions in an effort to better meet the full scope of physicians’ needs for psychological support. It was out of this amalgamation of influences that Achieving Optimal was born.

About Dr. Cunningham

I am a counseling psychologist who is currently licensed in Ohio and Indiana. I have been practicing for more than 14 years, and have more than seven years of experience with treating physicians and medical learners. My approach to clinical work utilizes a performance psychology paradigm, incorporating theory and interventions from cognitive behavioral therapy and critical liberation psychotherapy modalities.

What do I have to offer you?

I have all the skills and experience that come with being a trained, licensed, and mid-career practicing counseling psychologist. In addition, I have specialized knowledge and experience treating clients with concerns related to performance, achievement, and learning. I have over seven years’ experience working with individuals in the field of medicine, at all stages of their career, ranging from undergraduate medical learners through to attending physicians nearing retirement. Because of this, I have as intimate of a familiarity with the culture of medicine and the demands of medical education that one can have without having been through it themselves. I also have the personal understanding that comes from being partnered with a physician and having supported my partner through residency and the transition into beginning work as an attending. I have deep appreciation for the discipline of medicine as a whole, empathy for the rigors and challenges of professional training in the practice of medicine, tremendous respect for the value of your time, and a sense of purpose that comes from the satisfaction of helping people become the best possible versions of themselves.

I have experience with use of short-term therapy models, solution-focused treatments, and collaborative problem solving. Most of my professional experience has been with treating high-functioning individuals, particularly focused on adult learners (undergraduate medical students, residents, and fellows). My approach to practice emphasizes the significance of understanding people within their specific context, including appreciation for their culture and identity, and recognition of how this impacts individuals’ presenting concerns and their lived experience. As such, my work incorporates a range of foci, including development of skills for performance enhancement, learning-related skills and interventions, career counseling interventions, identity and values clarification, and other strengths-based strategies rooted in counseling psychology and performance psychology.

How did I come to do this work?

Throughout my training and work experience, I never saw performance psychology as being “for me.” All of my exposure to that domain of psychology came from the context of sports psychology, which is decidedly not in my wheelhouse. Everyone I had ever met who did that work was an athlete themselves and focused their performance enhancement work on serving athletes. I had essentially assumed that “performance psychology” was synonymous with “sport psychology,” and thus not at all relevant to my own work and practice.

As I reached mid-career, I began actively reflecting on the aspects of my work that I found most meaningful and where I felt most effective. I realized that I could most readily characterize that “sweet spot” in my practice as relating to achievement (broadly defined). Further self-reflection and reading of the extant literature led me to the insight that I have actually been doing “performance psychology” in my practice for a very long time, without ever conceptualizing it as such. I also realized that this framing was much more effective in addressing aspects of my work that had frustrated me for a long time. In the realm of physician wellness, so much of the work is focused on addressing the needs of doctors who are already at the point where they are exhibiting some degree of psychopathology or other impairment. In my experience working with medical learners, however, it seemed to me that the most fruitful point of intervention is earlier in the pathogenesis of mental illness. (This is also congruent with my values around prevention and my background doing psychoeducational outreach.) Medical learners are fundamentally high-functioning individuals. They are smart, capable, and resilient. For many individuals, the problems in functioning that I have seen are rooted in an overreliance on certain coping strategies and narratives that start out as being beneficial to achievement but over time become an impediment to effective functioning. I want to help prevent those problems from happening by catching folks further upstream and empowering them to keep those tools that work for them, abandon or refashion those that don’t, and add to their repertoire of effective strategies. There is some degree of overlap with the process of therapy, but the work that I do is not about healing illness. It’s about taking what works and making it even more effective.