Live Workshops
Therapeutic Interventions
Samuel Greenstein, MD
Director, Consultation-Liaison Psychiatry Fellowship
Long Island Jewish Medical Center - Northwell Health
New Hyde Park, New York
Julia Ruark, MD, MPH
Clinical Assistant Professor
University of Washington
Seattle, Washington
Amelia Dubovsky, MD
Clinical Associate Professor
University of Washington
Seattle, Washington
Mounika Ganguly, MD
Consultation-Liaison Psychiatry Fellow
The Ohio State University
Columbus, Ohio
Kaleena Chilcote, MD (she/her/hers)
Director, Psycho-Oncology
Cleveland Clinic
Cleveland, Ohio
Psychotherapy is an integral part of the treatment plan for medically ill patients (Karasu 1979). And yet, too often our learners are surprised that clinicians must be well versed in various psychotherapy modalities.
This workshop, sponsored by the Residency Education Subcommittee, will demonstrate utilization of evidence-based psychotherapies in the management of medically ill patients. The workshop features two clinical vignettes involving marginalized patients at opposite stages of their life, specifically an adolescent case as well as an adult facing end of life.
10 minutes: Dr. Samuel Greenstein, a CL psychiatrist, introduces the speakers and moderates the discussion. He will provide an overview of why psychotherapy is necessary in CL. He will highlight specific DEI issues, including racism and unconscious bias, and demonstrate how psychotherapy can address these issues (Miller 2018).
10 minutes: Participants break into small groups to discuss their assigned clinical scenario and which psychotherapy modalities they would naturally utilize and how they would address DEI related issues.
10 minutes: Debrief breakout groups.
10 minutes: Dr. Mounika Ganguly is a child and adolescent psychiatrist and is currently completing her CL fellowship. Her training provides a unique experience in treating patients that span the adolescent to early adulthood period. She will specifically discuss how to utilize relaxation and family therapy to help improve prognosis for patients and their families. 10 minutes: Dr. Julia Ruark, a CL psychiatrist, will discuss the principles of CBT and motivational interviewing (MI). Utilizing the clinical scenarios, she will review foundational features of CBT and MI, as well as review specific ways to apply these modalities in CL settings, focusing on simple and brief effective applications. 10 minutes: Dr. Amelia Dubovsky, a CL psychiatrist, will discuss the principles of dialectical behavior therapy (DBT) and Good Psychiatric Management. She will discuss how to utilize these principles in the patient interactions and also with hospital teams with the goal of engaging the patient, minimizing destructive patient behaviors and minimizing team countertransference enactment. 10 minutes: Dr. Kaleena Chilcote, a CL psycho-oncologist will discuss principles from Acceptance and Commitment Therapy and Meaning-Centered Psychotherapy and how to apply them in the treatment of patients facing death, demoralization, and the need to find meaning. 10 minutes: Dr. Greenstein will discuss psychodynamic theory and how this can help the CL psychiatrist treat the patient and family, as well as improve the liaison aspect with the primary teams and hospital staff. 10 min: Wrap up and Q/A The workshop is relevant to trainees, teaching CL faculty, and general CL psychiatrists.
References:
1) Karasu TB. Psychotherapy of the medically ill. Am J Psychiatry. 1979 Jan;136(1):1-11. doi: 10.1176/ajp.136.1.1.
2) Miller MJ, Keum BT, Thai CJ, Lu Y, Truong NN, Huh GA, Li X, Yeung JG, Ahn LH. Practice recommendations for addressing racism: A content analysis of the counseling psychology literature. J Couns Psychol. 2018 Nov;65(6):669-680. doi: 10.1037/cou0000306. Epub 2018 Aug 9. PMID: 30091623.Learning Objectives:
