Medical populations include those presenting with problems that are caused or exacerbated by psychobehavioral processes, including hypertension, headaches, insomnia, diabetes, constipation, irritable bowel disorder, sexual dysfunction, obesity, cardiovascular disease, TMD, encopresis, enuresis, sexual dysfunction and tic disorder. Services are also provided for patients who are having difficulty adjusting to, and coping with, the emotional and behavioral demands of chronic and life-threatening medical problems. A cognitive-behavioral approach to treatment is typically utilized. While many of these interventions are brief in duration, Fellows will also have the opportunity to do longer-term work with some patients. Most work will be done in the outpatient setting, but inpatient evaluation with outpatient follow-up is sometimes possible.
Clinical work includes intakes, assessments, brief psychological testing, and ongoing psychotherapy.
Marital therapy, individual work with family members of cancer patients, and participation in support group activities are also available. Treatment modalities include cognitive, behavioral, psychodynamic, problem-solving, and occasional crisis management. Fellows with training in medical hypnosis can also receive supervision in this modality. Close coordination with nurses, physicians, social workers, chaplains, and patient education workers is an integral part of treatment. New patients are reviewed weekly by the outpatient psychosocial team, and twice-monthly team meetings provide team coordination, case review and didactic presentations.