Dr. Carla Payne has been a psychotherapist and psychologist in San Diego since 1992. For many years, Dr. Payne worked in vocational rehabilitation, helping adults return to work after injury, disability, or severe life disruption made change a necessity. Dr. Payne has performed over 300 psychological test batteries for private firms and for the State of California. These batteries resulted in comprehensive reports full of suggestions for helping people get their careers, and lives, back on track.

Dr. Payne has studied personality disorders extensively, and over the years has counseled many people suffering the pain of living with a narcissist in their midst. She is currently working on several projects for publication.

In her practice in Mission Valley as well as in her mobile “concierge” practice, she specializes in issues of adult development (maturation, assertiveness, commitment, problem resolution in relationships, and late life) as well as care for veterans, persons with disabilities, and stubborn depression. Dr. Payne provides both telemental health care via videoconferencing (VC) and private, in-home or in-office concierge psychotherapy services. Call for more information: 858-922-3803 (direct) or 619-309-8612 (insurance and scheduling).

Her treatment philosophy, which draws on psychodynamic traditions, also incorporates concepts from Mindfulness, Behavioral Activation Theory, Eastern thought, and more. She is a practitioner of Eye Movement Desensitization and Reactivation. It is also important to her that she be a helpful collaborator with her patients’ other treatment providers. 

Dr. Payne is available to provide pre-or-postdoctoral supervision to students working toward licensure at a student-friendly rate.


Dr. Payne can be reached by email drcmpayne@gmail.com or cell (858) 922-3803.

What is Total Context Therapy?

Imagine a tree. What do you see in your mind’s eye? Branches, a trunk, limbs, maybe leaves and fruits. Or you might see a snow-covered pine tree, or a crown afire with the reds and oranges of fall. What you might not see is the roots, or the health of the tree, or its history.


The theory behind Total Context Therapy is that real understanding comes more easily when you take into consideration not just what you see on the surface—the branches, the trunk, the leaves—but the foundation of your unique situation—the roots, the history of the tree, its health.


What I believe as a psychologist is that insight and change come from understanding our roots. Total Context Therapy is a psychodynamically informed dialogue where we untangle the roots of who you are and how you want to be. In the process, you will practice a new way of thinking through your difficulties, and attain assertiveness skills, along with progressive movement.


Total Context is not a years-long process of multiple visits per week. Neither is it uncomfortable, painful rehashing of old mistakes or bad relationships. It’s dynamic because it is about you making different connections between your past and present, and taking steps based on what comes of that. In addition to providing insight, this therapy is skills-based.


Other Total Context Therapies


“Developmental Therapy” is another aspect of Total Context. It is often true that even the most intelligent, active, and thoughtful people are held back by some intangible issues. Total Context helps end the rumination.


Developmental Therapy is also effective for people with trouble getting started in life. Career choice, independence from parents, activating a dating life, and gaining a mature self-concept are all deeply considered.


In 2009, Dr. Carla created Done With Drinking, a unique program designed around the individual. Unlike AA, Moderation Management or Smart Recovery, (abstinence and moderation-based programs in which Dr. Carla finds great merit), DWD is also a psychodynamically informed model. Its basis is a self-paced program of introspective writings and exercises.


Dr. Carla Payne
Founder, Clinical Psychologist (PSY24538)

Professional Team

Our Mission

At Dr. Carla Payne Total Context Therapy Group, our mission is simple: to provide a new way of thinking through your difficulties, and attain assertiveness skills, along with progressive movement.

Our Pledge

We here at Dr. Carla Payne Total Context Therapy Group pledge to treat you, our client, with respect, provide our individual attention, and preserve your confidentiality.
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