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Department of Supportive CarePrincess Margaret Cancer Centre
Carmine Malfitano, MSW, RSW
Managing Cancer and Living Meaningfully (CALM)
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Simulation #1
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Introduction
CALM therapy
Q&A
Simulation #2
PRESENTATION OUTLINE
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Parts of therapy
• First session
o Assessment (based on theoretical framework)
o Therapeutic Alliance
• Middle sessions
o Intervention (based on theoretical framework)
• Termination
o Review of therapy
o Good byes
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In a psychotherapy session…
• Structure (from theoretical framework)
• Understand/validate/normalize experience
• Emotional empathy
• Affect regulation
• Attention to content and to process
• Attention to transference and counter-transference
• Case formulation and hypotheses
• Shared agenda
• Intervention (questions/reflections/psychoeducation)
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The most effective intervention
• The therapeutic relationship is the most effective intervention
in fostering changes in clients (Lambert and Barley, 2001).
• 45% of the outcome variance is accounted for by the
therapeutic alliance (Bogo, 2006; Sprenkle, Davis, &
Lebow, 2009)
• Alliance (Bogo, 2006; Sprenkle et al., 2009):
o goals (to agree upon)
o tasks (that make sense to the client)
o bond
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CALM therapy
Brief semi-structured supportive-expressive intervention (Designed
by Gary Rodin, Sarah Hales, and Christopher Lo)
• 6-8 individual sessions
• Primary caregiver attends one or more sessions
• Delivered over 6 months
• Semi-structured, with attention to four domains
• Delivered by specially trained mental health professionals
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Symptom Management and Communication with Health
Care Providers
Future, Hope and Mortality
Changes in Self-Concept
and Relations with Close
Others
Spirituality, Sense of Meaning
and Purpose
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The Essential Ingredients
• Reflective Space
• Attachment Security
• Mentalization
• Double awareness
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Simulation #2