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Cognitive behavioral therapy (CBT) examines relationships among cognitions, emotions, and behaviors to help patients address maladaptive patterns of thinking and behaving. Despite its robust evidence base for the treatment of psychopathology, questions remain about the feasibility, acceptability, and efficacy of CBT approaches in palliative care settings. However, meta-analytic evidence indicates that CBT is not only feasible and acceptable to patients with palliative care needs, but also that it is effective in the treatment of psychological distress among patients in palliative care and their care partners (e.g., spouses, adult children). Importantly, CBT can be incorporated into treatment for patients with a wide range of medical diagnoses (e.g., cancer, heart failure, kidney disease) and psychological and somatic concerns (e.g., anhedonia, death anxiety, fatigue, insomnia, and pain). CBT is also recommended by the National Institute of Health Care and Excellence guidelines for individuals nearing end of life who are in need of psychological support. This chapter summarizes the traditional CBT framework and applies this framework to the care of patients in palliative care settings. The authors also briefly describe the evidence base for CBT use in palliative care, enumerate special considerations for practicing CBT with patients receiving palliative care, and offer recommendations about how CBT might be applied across the palliative care trajectory. |
