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.

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.

The purpose of this study was to develop a communication skills training (CST) module for oncology healthcare professionals on how to more effectively respond to patient anger. We also sought to evaluate the module in terms of participant self-efficacy and satisfaction.

The development of this module was based on a systematic review of the literature and followed the Comskil model previously used for other doctor–patient CST. Using an anonymous 5-point Likert scale, participants rated their pre-post self-efficacy in responding to patient anger as well as their satisfaction with the course. Data were analyzed using a paired sample t test.

During the academic years 2006–2009, 275 oncology healthcare professionals participated in a CST that focused on responding to patient anger. Participants' confidence in responding to patient anger increased significantly (p < 0.001) after attending the workshop. They also agreed or strongly agreed to five out of six items assessing course satisfaction 92–97% of the time.

We have developed a CST module on how to respond to patient anger, which is both effective and useful. Training healthcare professionals to respond more effectively to patient anger may have a positive impact on the patient–physician relationship.

Personal risk behaviors are modifiable. This report describes the 2002 national baseline of behavioral health risk factors of US emergency medical technicians (EMTs) that can guide policy and program development in improving EMT well-being.

A 19-item Health Behavioral Risk Survey (Appendix) was added to the 2002 Longitudinal Emergency Medical Technician Demographic Study mail survey. Risk survey questions covering physical activity, tobacco use, and alcohol use were modeled after the Centers for Disease Control and Prevention 2002 Behavioral Risk Factor Surveillance System (BRFSS) questionnaire. Personal, non-work related seatbelt use and motor vehicle driving questions were adopted from the 2002 US National Highway Traffic Safety Administration (NHTSA) Motor Vehicle Occupant Safety Survey (MVOSS). Post-stratification adjustment factors were used to allow comparisons with BRFSS and MVOSS national estimates.

A total of 1,919 EMT respondents were compared with 239,866 BRFSS and 5,220 MVOSS respondents. These comparisons indicate that EMT-Basics drove more slowly than paramedics; male EMTs drove faster, drank more, and wore their seatbelts less often than did female EMTs; female EMTs smoked more and engaged in vigorous exercise less than males. Those EMTs who reported to be in fair or poor health, smoked more and exercised less than those who reported to be in good or excellent health. Regardless of gender, age, or race, EMTs, on average, wore their seatbelts less often, drove faster than, and were less likely to engage in moderate physical exercise, compared to US adults.

Stereotypical gender differences in risk behaviors exist among EMTs. An EMT's self-reported health positively correlates with smoking and exercising. Compared to US national estimates, except for smoking and vigorous exercise, EMTs have increased risk behaviors.