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Cognitive therapy (CT) has considerable utility for psychosomatic medicine (PM) in acute medical settings but, to date, no such cohesive adaptation has been developed. Part I delineated a CT model for acute medical settings focusing on assessment and formulation. In Part II, we review how CT can be applied to common PM clinical challenges. A pragmatic approach is helpful because this review targets PM trainees and educators.
Narrative review is used to discuss the application of CT strategies to common challenges in acute medical settings. Treatment complexities and limitations associated with the PM setting are detailed. Exemplary dialogues are used to model techniques.
We present CT approaches to eight common scenarios: (1) distressed or hopeless patients; (2) patients expressing pivotal distorted cognitions/images; (3) patients who catastrophize; (4) patients who benefit from distraction and activation strategies; (5) panic and anxiety; (6) suicidal patients; (7) patients who are stuck and helpless; (8) inhibited patients. Limitations are discussed.
Significance of results:
A CT informed PM assessment, formulation and early intervention with specific techniques offers a novel integrative framework for psychotherapy with the acutely medically ill. Future efforts should focus on dissemination, education of fellows and building research efficacy data.
Low energy ion bombardment has been utilized to fabricate rectifying contacts on aluminum nitride grown on single crystal silicon substrates. Bombardment of aluminum nitride with methane was followed by sputter deposition of gold contacts. To our knowledge, this is the first report of rectifying contact formation on aluminum nitride. Scanning electron micrographs show that the initially ordered aluminum nitride surface is significantly altered with low energy methane ion beam exposure. Electrical measurements made on samples which had been partially masked during implantation indicate that rectification is a result of the ion bombardment.
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