Lessons from a Therapist’s Chair: Optimizing Palliative Communication through Psychotherapy Best Practices and Skills

The use of communication as a therapeutic tool is an essential piece of both palliative medicine and psychotherapy. The approach with which communication is conceptualized and taught, however, is markedly different between the two fields. In hospice and palliative medicine training, we often teach generalized communication tools and strategies. By contrast, communication training in the psychotherapy setting hinges upon the concept of case formulation. 

A case formulation is a conceptualization of the unique core psychological issue a patient or family may be struggling with. Case formulations are considered essential to guiding the appropriate choice of communication strategies with patients and families. Although palliative medicine is quite different than a psychotherapy setting, there are many key principles from a psychotherapeutic case formulation that can be extrapolated and adapted to enhance communication in hospice and palliative medicine. 

These principles can guide palliative care clinicians to enhance their efficacy in selecting communication strategies, tools, and adjustments tailored to the psychological needs of specific patients and families. Ultimately, these skills optimize our therapeutic presence to patients and families as they process their unique experience with serious illness. 

This session is led by two practicing palliative medicine physicians who have completed psychiatric residency, psychotherapy training, and palliative medicine fellowships. Their educational and clinical experiences across both fields give us a unique perspective on how optimal psychotherapy strategies can enhance communication skills for hospice and palliative medicine clinicians. 

Participants appreciate the session's engaging exercises, which help expand understanding, communication skills, and therapeutic presence for patients and families facing life-limiting illness.     

Learning Outcomes

Upon completion of this activity the learner should be better able to:

  • Describe what a case formulation is in a psychotherapy setting and how it provides a helpful compass for communication approaches.
  • Identify key principles about case formulation and communication in a therapy setting that can be directly applied to the use of therapeutic communication in a hospice and palliative care setting.
  • Practice strategies that can be used to enhance our ability to formulate the core psychological issues a unique patient or family may be struggling with in their illness experience.
  • Practice applying the most fitting therapeutic communication tools based on unique case formulations.
  • Describe concrete strategies for teaching this framework for therapeutic communication to hospice and palliative care learners and colleagues.


Activity summary
Available credit: 
  • 0.50 ABIM MOC
  • 0.50 CME (physician only)
  • 0.50 Participation
Activity Published: 
Activity Expires: 
Member cost:
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AAHPM endorses the Accreditation Council for Continuing Medical Education (ACCME) Standards for disclosure and commercial support and endeavors to ensure balance, independence, objectivity, and scientific rigor for all accredited products or programs. All who are in a position to control or influence the content of an educational activity must disclose any relevant financial relationships with ineligible companies.*Disclosure documents were reviewed for potential conflicts of interest and, if identified, they were resolved prior to confirmation of participation. Only those who had no conflict of interest or who agreed to an identified resolution process prior to their participation were involved in this activity.

All editors, faculty and staff have disclosed no relevant financial relationships.

*An ineligible company is defined as any entity producing, marketing, reselling, or distributing healthcare goods or services consumed by, or used on, patients. (Exclusions at the time of this writing included 501-C not-for-profit organizations, government organizations, liability and health insurance providers, non-healthcare-related companies, group medical practices, for-profit healthcare providers, blood banks and diagnostic laboratories.)

Danielle M. Chammas, MD
Keri O. Brenner, MD MPA

Content Editors
Patricia Stillwell

Stephanie Adams
Kemi Ani
Julie Bruno
Angie Forbes
Julie Tanner
Angie Tryfonopoulos

Continuing Medical Education (CME)

The American Academy of Hospice and Palliative Medicine (AAHPM) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The American Academy of Hospice and Palliative Medicine (AAHPM) designates this Enduring material for a maximum of 0.50 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

CME credits expire October 13, 2024.

Maintenance of Certification (MOC)

“Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.50 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

ABIM MOC points expire on October 13, 2024.

Physicians certified with the American Board of Internal Medicine who wish to earn MOC points within the current calendar year must submit their MOC data no later than December 31 of the calendar year.


Available Credit

  • 0.50 ABIM MOC
  • 0.50 CME (physician only)
  • 0.50 Participation


Member cost:
List Price:
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