Sutter Health

Department Chair

Site Lead and Psychiatrist

Self-Management of Depression

Depression is a complex illness, which presents in a myriad of ways and almost 60-70% people treated with antidepressants fail to achieve a symptom-free state when first treated with these medications. The treatment of depression cannot be pigeon-holed into one or two kinds of treatment modalities. Self-management is increasingly becoming the standard of care in people with long-standing medical conditions. Self-management puts one in the driver’s seat with regards to making choices regarding one’s health. However, treatment of depression has lagged behind in incorporating the concept of self-management with the most popular self-help paradigm on depression focusing mostly on cognitive-behavioral approaches. Self-management goes beyond the narrow perspective of self-help and addresses life style changes, social relationships, communication, problem-solving, and also includes elements of wellness and recovery.

Author and Blogger

Kaiser Permanente

Senior Physician

County of Humboldt

Medical Director

ProMedica

UPMC

Resident Physician

Central Institute of Psychiatry

Mahatma Gandhi Institute of Medical Sciences

House Officer

Harpreet S. Duggal, MD, FAPA, is a board-certified psychiatrist and an international expert on self-management of depression. He has practiced psychotherapy and psychopharmacology for over 20 years and has authored over one hundred articles in scientific journals. He is also a bestselling author of books on depression. Check out his blog on evidence-based strategies for self-management of depression and lifestyle psychiatry. The content on this platform or other social media sites should not be construed as treatment advice or a substitute for it.

Harpreet Duggal, MD, FAPA

Adventist Health

Inpatient Acute Care (Level III Trauma Center)

• Serving patients on the med-surg floors, CVICU, ICU, IMCU, and ER.
• Conducting daily caseload triage.
• Implementing an evidence-based approach towards dysphagia risk assessment within a clinical bedside evaluation to determine risk for aspiration-related pneumonia and to determine candidacy for a VFSS.
• Using dynamic and standardized tools, including the MoCA, WAB-R Bedside Record Form, and the Colorado Motor Speech Framework, to develop appropriate treatment goals.
• Implementing bedside oral hygiene practices and facilitating carryover via staff and caregiver education/demonstration.
• Providing frequent in-service staff/team education to optimize care for patients with speech, language, voice, cognition, and swallowing disorders.
• Administering VFSS, interpreting imaging findings using the MBSImP protocol, and applying results to generate swallow treatment plans and other recommendations.
• Engaging in extensive chart review, point-of-service documentation, and interdisciplinary communication using Cerner EMR.

Speech-Language Pathologist

Completed my CFY experience under the mentorship of Christina Johnson, M.S., CCC-SLP.

Speech-Language Pathology Clinical Fellow

Madison Metropolitan School District

• Worked with elementary school children (ages 3-4) in a specialized phonology classroom setting at the John Muir Elementary School supervised by Beth Gunshor, M.S., CCC-SLP, and Jenn Hackel, M.S., CCC-SLP.
• Analyzed sound error patterns and phonological processes using dynamic assessment and standardized tools such as the HAPP-3 to devise appropriate treatment goals and chart progress.
• Integrated evidence-based strategies such as the Cycles Approach to target goals into an educational play-based approach to treatment.
• Facilitated self-monitoring, self-regulation, and behavior management strategies amongst students to maximize peer engagement and participation within treatment sessions.
• Completed comprehensive speech and language evaluations via language sample analysis, administration of formal, standardized assessments, classroom observations, and obtaining caregiver/parent/teacher reports.
• Engaged in interdisciplinary collaboration during treatment and contributed to IEP meetings under clinical supervisor guidance.

Speech-Language Pathology Graduate Student Intern

Dewane Neurorehabilitative Pro Bono Clinic

Advanced clinical practicum experience (Interdisciplinary Outpatient Adult Neurorehabilitation) across two semesters – Spring 2023 and Spring 2024.

• Volunteered at an interdisciplinary pro bono neurorehabilitation clinic alongside physical therapy and occupational therapy graduate students for 4 hours/week.
• Mentored first-year SLP students through their initial clinical experiences to help target functional goals using evidence-based approaches for the rehabilitation of neurogenic communication disorders during my second year.
• Provided cognitive-communication rehabilitation services to clients with aphasia following neurogenic communication disorders (such as TBI and stroke) in a triad team intervention approach with fellow SLP graduate students under the supervision of CSD clinical faculty (Kimberly Caul, M.S., CCC-SLP, CBIS, and Kristin Murphey, M.S., CCC-SLP) during my first year.
• Engaged in active interdisciplinary collaboration with physical and occupational therapy teams to identify synergistic intervention areas and optimize therapy programs.
• Completed documentation via the Vericle Medical Billing Software.

First-Year SLP Student Clinician | Second-Year Student Mentor

UnityPoint Health – Meriter

14-week full-time fall placement – Inpatient Adult Acute Care.

• Provided comprehensive evidence-based services to adults with speech/language, cognitive-communication, and swallowing disorders following acute illnesses/injuries including but not limited to TBI, stroke, sepsis, UTI, orthopedic injuries, acute hypoxic respiratory failure, dementia, and COVID-19, supervised by Katie Garnier, M.S., CCC-SLP, and Elizabeth Villanueva, M.S., CCC-SLP.
• Assessed swallow safety and tolerance of oral intake at bedside to facilitate the transition from NPO to PO diet and to reduce the risk of aspiration pneumonia for patients with dysphagia.
• Conducted assessments of patients' cognitive/communicative abilities using the Brain Injury Test Battery, RBANS, CLQT, MoCA, WAB-R Bedside Record Form, WAB-R, and the Colorado Motor Speech Framework.
• Implemented and facilitated oral hygiene practices at the bedside for patients with compromised respiratory status and heightened risk for aspiration pneumonia.
• Administered VFSS under supervision, interpreted imaging results, and applied findings to generate swallow treatment plans and diet recommendations.
• Presented an Independent Study Project on the utility of the Frazier Free Water Protocol within the acute care setting.
• Completed point-of-service documentation/billing using Epic software.

LS Digital Tech

Channeled my multilingual skills to help translate and develop pediatric speech and language therapy resources in Hindi and Kannada to cater to bilingual South Asian-American populations across the United States.

Product Development Consultant

Ensign Services

12-week full-time summer placement at Boulder Canyon Health and Rehabilitation – Skilled Nursing/Short-term and Long-term Post-Acute Care.

• Provided evidence-based intervention for older adults with speech/language, swallowing, and cognitive-communication disorders following medical conditions, including but not limited to dementia, chronic stroke, TBI, UTI, sepsis, COPD, developmental disabilities, cerebral neoplasms, and vertebral injuries, supervised by Alaina Fernandez, M.S., CCC-SLP.
• Conducted periodic assessments of cognitive-communication, receptive/expressive language, and swallow function with the CLQT, BIMS, SLUMS, FLCI, BDAE, ABCD, SCCAN, MASA, SBT, VPJ, BNT, BCIS, OHAT, and BCAT.
• Implemented SPEAK OUT!® strategies with skilled residents.
• Facilitated oral hygiene practices for residents with a heightened risk for aspiration pneumonia.
• Helped implement the Frazier Free Water Protocol for residents on dysphagia diets/enteral nutrition.
• Administered bolus trials during mobile FEES and interpreted findings.
• Incorporated evidence-based strategies into personalized treatment plans to target complex cognitive/linguistic skills including functional planning, verbal sequencing, medication management, problem-solving, insight, verbal reasoning, financial planning/management, fall risk awareness, and judgment to maximize functional independence and safety within the residents' living environments and/or anticipated discharge environments. 
• Engaged in active treatment collaboration with PT and OT.
• Attended weekly rehab team meetings and morning interdepartmental meetings.
• Completed Medicaid, Medicare A/B, and TRU PACE documentation/MDS billing via the PointClickCare and Net Health software.

University of Wisconsin Department of Surgery

• Completed logistical tasks in Dr. Michelle Ciucci's translational research laboratory at the Department of Surgery, Division of Otolaryngology–Head and Neck Surgery, School of Medicine and Public Health.
• Linked grants/manuscripts/bio sketches and organized presentation materials.
• Contributed to organizing and backing up archival experimental data.
• Kept up with NIH guidelines and linked publications to grants.
• Assisted in updating and maintaining chemical hygiene plans, indexing/inventorying lab supplies, defrosting lab freezers, and maintaining tissue/antibody inventories.
• Compiled and updated digital publication inventories via citation management programs and maintained laboratory databases such as purchases, personnel, and animal inventories.
• Tracked and updated weekly progress in ongoing projects, publications, and grant applications.
• Updated the lab home website and created outreach material.

Graduate Student Researcher

University of Wisconsin-Madison Communication Sciences and Disorders

Cognitive-communication:
• Provided coma stimulation and eye-gaze rehabilitation for a young adult client in a minimally conscious state following Grade III DAI to maximize functional and meaningful communication using high-tech AAC in collaboration with the Waisman Center to identify synergistic areas of intervention for maximum success.
• Targeted processing speed, attention, memory, anosognosia, turn-taking, receptive/expressive language, and working memory for a young adult client with TBI, incorporating evidence-based approaches such as CART and SCA to help meet the client's academic goals.
• Supported a young adult student in a college immersion program to identify suitable communication strategies and engage in functional planning for a collaborative project with a fellow UWSHC client.
• Completed dynamic and formal assessments using the BADS and the JFK CRS-R to develop appropriate and functional treatment goals.

Voice:
• Modified clients’ vocal behaviors using a combination of direct and indirect approaches (Resonant Voice Therapy, SOVT, flow phonation, vocal relaxation, and vocal function exercises).
• Helped clients develop a personalized voice training program by assisting them in identifying appropriate vocal techniques and exercises.
• Conducted comprehensive assessments to devise treatment goals, identified appropriate treatment approaches, and provided ongoing feedback on progress using Visi-Pitch, VHI, TWVQ, GRBAS, MDVP, and CAPE-V.

Articulation and Resonance:
• Integrated evidence-based approaches such as DTTC into child-directed play-based therapy for two child clients (suspected childhood apraxia of speech and velopharyngeal inadequacy).
• Conducted comprehensive evaluations using Praat, CSL KayPENTAX system, and the MacKay-Kummer SNAP test and speech sound evaluation using the KSPT and Praat, and maximized functional treatment outcomes to meet each child's communicative goals devised in collaboration with the child and their families.

Speech-Language Pathology Graduate Student Clinician

Stamurai

• Completed induction training to provide high standards of holistic stuttering management services across the lifespan (4–60+).
• Developed personalized fluency management goals and strategies for a wide range of clientele encompassing various linguistic groups across the lifespan from India, Canada, Australia, Nigeria, and the United Kingdom as a quadrilingual speech-language pathologist.
• Maximized communication outcomes via the implementation of personalized goals and treatment plans for a wide range of communicative disorders including but not limited to repaired cleft lip and palate, speech sound disorders, voice disorders, epilepsy, intellectual disability, cluttering, dysarthria, aphasia, apraxia of speech, cerebral palsy, dysphagia, craniofacial syndromes, autism spectrum disorders, ADHD, and delayed speech/language across the lifespan.
• Communicated treatment/assessment findings via interdisciplinary collaborations with other disciplines through written correspondence as indicated.

Danat Al Emarat Hospital for Women & Children

• Trained under trilingual SLPs in the rehabilitation of neonates, and pediatric patients aged 0–17, with developmental delay, autism, attention deficit disorders, intellectual disability, speech sound disorders, AAC dependence, speech/language delay, challenging behaviors, syndromes, cleft lip & palate, laryngomalacia, apraxia of speech, cerebral palsy, learning disability, fluency disorders, epilepsy, enteral nutrition, oral aversion, ARFID, dysphagia, & other speech, language, and swallowing/feeding disorders at the pediatric outpatient clinic, for 40 hours (5 days) per week.
• Conducted assessments with the PLS-5 and SSI-4.
• Shadowed and assisted during neonatal and pediatric VFSS, feeding evaluations, cervical auscultations, oral-motor examinations, primitive reflex assessments, enteral nutrition weaning & oral intake transition, feeding & swallowing therapy, neonatal distress identification, and nurse/caregiver counseling at the Level III NICU, HDU, SCBU, and inpatient wards.
• Completed documentation and billing on the EMR system.
• Shadowed PTs, OTs, and psychomotor therapists at the outpatient clinic, NICU, HDU, and SCBU.

Speech-Language Pathology Student Trainee

As a medical speech-language pathologist, I work at the intersection of communication, cognition, and swallowing—supporting medically complex patients in regaining essential functions that deeply affect quality of life.

My clinical focus is in acute and post-acute care, particularly with adult and geriatric populations, with a specific interest in dysphagia. I received specialized, graduate-level training in swallowing disorders, trach/vent management, head and neck cancer, voice disorders, brain injury, cognitive-communication disorders, aphasia, and neurodegenerative conditions. I also work with patients with disorders of and implement AAC solutions across the lifespan. I am currently working towards my specialty certification in swallowing (BCS-S), and also want to earn my clinical doctorate someday.

With clinical experience across South Asia, the Middle East, and North America, I bring a culturally responsive, evidence-based approach to care. I value interdisciplinary teamwork and am committed to improving outcomes through clear communication, timely assessments, and patient- and family-centered care.

If you're passionate about advancing speech pathology practice in health settings—whether through collaboration, education, or quality improvement—I’d love to connect.

taplio

The Battle

Harpreet Duggal, MD, FAPA

Aditi Kini, M.S., CCC-SLP

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