A review of cognitive therapy in acute medical settings. Part I: Therapy model and assessment Journal Article
| Authors: | Levin, T. T.; White, C. A.; Kissane, D. W. |
| Article Title: | A review of cognitive therapy in acute medical settings. Part I: Therapy model and assessment |
| Abstract: | Introduction: Although cognitive therapy (CT) has established outpatient utility, there is no integrative framework for using CT in acute medical settings where most psychosomatic medicine (P-M) clinicians practice. Biopsychosocial complexity challenges P-M clinicians who want to use CT as the a priori psychotherapeutic modality. For example, how should clinicians modify the data gathering and formulation process to support CT in acute settings? Method: Narrative review methodology is used to describe the framework for a CT informed interview, formulation, and assessment in acute medical settings. Because this review is aimed largely at P-M trainees and educators, exemplary dialogues model the approach (specific CT strategies for common P-M scenarios appear in the companion article.) Results: Structured data gathering needs to be tailored by focusing on cognitive processes informed by the cognitive hypothesis. Agenda setting, Socratic questioning, and adaptations to the mental state examination are necessary. Specific attention is paid to the CT formulation, Folkman's Cognitive Coping Model, self-report measures, data-driven evaluations, and collaboration (e.g., sharing the formulation with the patient.) Integrative CT-psychopharmacological approaches and the importance of empathy are emphasized. Significance of results: The value of implementing psychotherapy in parallel with data gathering because of time urgency is advocated, but this is a significant departure from usual outpatient approaches in which psychotherapy follows evaluation. This conceptual approach offers a novel integrative framework for using CT in acute medical settings, but future challenges include demonstrating clinical outcomes and training P-M clinicians so as to demonstrate fidelity. © 2012 Cambridge University Press. |
| Keywords: | review; methodology; training; empathy; cognitive therapy; psychosomatic medicine; psychologic test; interview, psychological; ct; acute disease; psychological model; models, psychological; psychosomatics; acute medical settings; p-m |
| Journal Title: | Palliative and Supportive Care |
| Volume: | 11 |
| Issue: | 2 |
| ISSN: | 1478-9515 |
| Publisher: | Cambridge University Press |
| Date Published: | 2012-04-01 |
| Start Page: | 141 |
| End Page: | 153 |
| Language: | English |
| DOI: | 10.1017/s147895151200082x |
| PROVIDER: | scopus |
| PUBMED: | 23171846 |
| DOI/URL: | |
| Notes: | --- - Cited By (since 1996):1 - "Export Date: 1 August 2013" - "Source: Scopus" |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work