Lessons from a Therapist's Chair: Optimizing Palliative Communication Through Psychotherapy Best Practices and Skills (TH367)

Abstract

•Describe what a case formulation is in a psychotherapy setting and how it provides a helpful compass for communication approaches.•Identify key principles about case formulation and communication in a therapy setting that can be directly applied to the use of therapeutic communication in a hospice and palliative care setting.•Practice strategies that can be used to enhance our ability to formulate the core psychological issues a unique patient or family may be struggling with in their illness experience.•Practice applying the most fitting therapeutic communication tools based on unique case formulations.•Describe concrete strategies for teaching this framework for therapeutic communication to hospice and palliative care learners and colleagues. The use of communication as a therapeutic tool is an essential piece of both palliative medicine and psychotherapy. The approach with which communication is conceptualized and taught, however, is markedly different between the two fields. In hospice and palliative medicine training, we often teach generalized communication tools and strategies. By contrast, communication training in the psychotherapy setting hinges upon the concept of case formulation. A case formulation is a conceptualization of the unique core psychological issue a patient or family may be struggling with. Case formulations are considered essential to guiding the appropriate choice of communication strategies with patients and families. Although palliative medicine is quite different than a psychotherapy setting, there are many key principles from a psychotherapeutic case formulation that can be extrapolated and adapted to enhance communication in hospice and palliative medicine. These principles can guide palliative care clinicians to enhance their efficacy in selecting communication strategies, tools, and adjustments tailored to the psychological needs of specific patients and families. Ultimately, these skills optimize our therapeutic presence to patients and families as they process their unique experience with serious illness. This session will be led by two practicing palliative medicine physicians who have completed psychiatric residency, psychotherapy training, and palliative medicine fellowships. Our educational and clinical experiences across both fields give us a unique perspective on how optimal psychotherapy strategies can enhance communication skills for hospice and palliative medicine clinicians. Moreover, we have taught this proposed session to a multitude of trainees and colleagues; it has received consistently positive feedback, specifically regarding its insightful approach and applicability to challenges in clinical work. Participants appreciate the session's engaging exercises, which help expand understanding, communication skills, and therapeutic presence for patients and families facing life-limiting illness.