Dr. Casey cautioned. He said a rehearsal of the actions needed to achieve the assigned goals might be helpful before the patient leaves the treatment session. This allows the clinician to recognize and address potential obstacles, including practical issues, such as mobility, or psychological issues, such as fear of physical activities.
Developing persistence in the face of high levels of negativity can be a challenge not only for the patient but also for the physician. According to Dr. Casey, maintaining a positive attitude can be challenging after treating a series of highly withdrawn and discouraged patients. But he emphasized the need for a professional orientation, recognizing that incremental gains in patient well-being, not cure, should be considered a reasonable goal.
“If I can improve the patient’s quality of life, this is a significant success,” he said. He believes it is sometimes necessary to distract patients from potential problems to focus on expected benefits.
“Patients can have a view of their limitations that is accurate but unhelpful,” Dr. Casey said. The goal of CBT is to move the focus to strategies that can restore lost interest and pleasure in daily life.
Dr. Casey and Dr. Wright reported no potential conflicts of interest related to this topic.