The primary theoretical treatment approach at the UFMB is eclectic with an emphasis on Cognitive Behavior Therapy, Behavioral Activation (BA), Motivational Interviewing, Mindfulness-Based Cognitive Therapy, and Acceptance and Commitment Therapy. Initial consultations emphasize a case conceptualization that highlights the relationships between a patient’s life context, experience, and symptoms/behavior. Subsequent visits include evidence-based interventions based on collaborative decision-making between patients, trainees, and the clinical supervisor (see Figure 1 for BA
Figure 1. BA Case “Map”
(What happened?) EXPERIENCE
(How do I feel?) BEHAVIORS
(What do I do?)
Mid 20s - Diagnosed with type II diabetes, didn’t take it serious
Minor tingling in feet, no pain. Mood generally okay, but increasingly irritable.
No major lifestyle changes, work through the tingling
Late 20s/early 30s - Worsening type II diabetes
Tingling turns into pain, frustrated with pain.
“Muscling” through pain + long recovery periods
Late 30s - Poorly controlled type II diabetes
Severe neuropathic pain and depression. Difficulty standing for more than 5-10 minutes. Low mood, feels worthless and guilty.
Stopped working, less time with family and friends.
More time watching TV and taking naps.
Short-term consequences = distraction from pain and depression, small bit of immediate “relief”
Long-term consquences = no improvement with pain or depression, increased guilt, new problems
Potential Interventions = MI to clarify motivation/commitment to learning new skills; ACT to clarify values; BA to increase frequency of value-consistent behavior; mindfulness to accept pain.