Psychotherapy & Liaison Skills
Medical providers seeking assistance from behavioral health professionals overwhelmingly request for “cognitive behavioral therapy (CBT)” for whatever presenting concerns their patients have. We see this as a missed opportunity for making a more rich, individualized referral for psychotherapy. To begin, the term CBT, however, refers less to a specific intervention and more to a broad, diverse family of interventions that are unified by a strong evidence-base and a focus on maladaptive thinking patterns that are assumed to underlie emotional and behavioral problems[i]. Furthermore, over the past 15 years a group of psychotherapies have emerged that attend less to patients’ specific thinking patterns and instead seek to incorporate a more inclusive range of psychological, social, and biological processes vis-à-vis our patients’ unique, dynamic needs and contexts[ii]. These interventions tend to rely more heavily on experiential rather than didactic learning as the primary mechanism for change, and often emphasize acceptance, values, engagement, and mindfulness as a vehicle toward making meaningful change on an acute timeline. Their transdiagnostic quality makes them well-suited to address a wide range of problems in medically and psychologically complex individuals receiving either acute or long-term care.
Speakers are psychologists who have extensive experience working in C-L settings alongside and collaboratively with psychiatrists. Jessica Farrar, PhD will begin with an overview discussion of the theoretical underpinnings of, clinical indications for, and practical application of a few of these approaches. Tess Kilwein, MA will then recent research on the effectiveness of Motivational Interviewing in medical settings and will then discuss how she has used MI to improve treatment engagement in CL patients whose medical conditions are complicated by substance abuse. Next, Spencer Richards, PhD will introduce Focused-Acceptance and Commitment Therapy and how it can be used to promote health-related behaviors with medically compromised patients. Finally, Thom Dunn, PhD will provide an overview of DBT-informed and other skills-based interventions for managing safety in C-L patients that are not appropriate for an inpatient admission, yet are chronically suicidal. The session will conclude with audience question-and-answer, focusing on opportunities and challenges for implementing a wide range of behavioral health interventions.
[i] Hayes, S. C., & Hofmann, S. G. (2017). The third wave of cognitive behavioral therapy and the rise of process‐based care. World Psychiatry, 16(3), 245.
[ii] Dimidjian, S., Arch, J. J., Schneider, R. L., Desormeau, P., Felder, J. N., & Segal, Z. V. (2016). Considering meta-analysis, meaning, and metaphor: A systematic review and critical examination of “third wave” cognitive and behavioral therapies. Behavior therapy, 47(6), 886-905.