Abstract ID: 1144

Primary Topic: Clinical skills-building
Secondary Topic: Integrative medicine delivery models

Avoid the struggle: Empowering your most complex patients to make sustainable health behavior change
Caryn Seebach, PsyD, Thomas Jefferson University , Philadelphia, PA, United States; Alyssa Adams, PsyD, , Washington, DC, DC, United States

Commercial product: N/A

Commercial product support: N/A

Category: Clinical

Late Breaker: No


Integrative Medicine (IM) providers encounter some of the most complex patients. These patients often present with multiple comorbid conditions and may feel psychologically overwhelmed and disempowered. There can be a high burden of responsibility placed on the IM healthcare provider to transition the patient from disillusioned to an active participant in his/her own healthcare. This workshop will provide practical, applied approaches to effectively support the biopsychosocial needs of even the most complex patients. The theory and research supporting sustainable health behavior change will be reviewed and clinicians will learn techniques grounded in health coaching, positive neuroplasticity, and motivational enhancement that can be directly applied in the next patient encounter. Providers will also explore their own subjective reactions to complicated patients and how they impact the clinical encounter.


The cornerstone of IM is treating the whole person, which necessitates a grounded understanding of behavioral medicine principles that foster sustainable health behavior change. A growing proportion of patients with complicated emotional and physical concerns are seeking IM providers. This workshop is designed to support the IM clinician in facilitating the patient’s transition from disempowered and frustrated to empowered and hopeful using a health psychology framework. IM and functional medicine training programs typically teach basic patient-provider communication skills, but this workshop is designed to delve deeper into the nuances and common barriers that many clinicians face during real world implementation with complex patients. The instructors have an extensive and varied background in clinical health psychology, nutrition, and health behavior change and have worked with many complex and challenging patients with chronic health issues.


To provide evidence-based support, guidance, and skill-building to integrative medicine providers working with their most challenging cases (e.g., multiple comorbidities, externalizing patients, passive/disempowered patients).


  1. Identify various models of health behavior change
  2. Assess patient stage of change and identify the appropriate intervention to match
  3. Explore personal reactions to difficult patients and resultant impact on the clinical encounter
  4. Hone communication and health behavior change skills

Time Frame

Background and evidence-base: 10-15 minutes

Models of care in health behavior change: 10-15 minutes

Applied skills: 20-30 minutes

Group experiential exercise/discussion 15-20 minutes


Background and evidence-base- Alyssa Adams, PsyD

Models of care in health behavior change: Caryn Seebach, PsyD

Applied Skills: Alyssa Adams, PsyD and Caryn Seebach, PsyD

Group experiential exercise/discussion: Alyssa Adams, PsyD and Caryn Seebach, PsyD

Teaching/Learning Strategies

The workshop will be a combination of lecture format and small group exercise (e.g., PowerPoint, experiential exercise, group discussion).

Methods/Session Format

A 60-minute workshop was used to estimate.

Background/evidence base: 10 minutes

Models of care in health behavior change: 10 minutes

Applied skills: 20 minutes

Group exercise/discussion: 20 minutes


Providers will have an understanding of the extant research regarding patient-provider communication with complex patients, communication tools for facilitating health behavior change, and countertransference.


Patients with complex presentations are likely to seek the care of IM providers, which requires IM providers to communicate in a way that facilitates health behavior change, empowers the patient, and maintains awareness of their own personal reactions to difficult patients. At the end of this workshop, providers will have identified various models of health behavior change, assessed patient stages of change and how to identify the appropriate intervention to match, explored their personal reactions to difficult patients and the resultant impact on the clinical encounter, and honed their communication and health behavior change skills.


Background and evidence-base

  1. The empirical study of non-adherence, what the research says
  2. What is health psychology and how it applies?
  3. The empirical tenets of health behavioral change

Models of care in health behavior change

    1. A new understanding of why change is possible
      • Positive neuroplasticity
      • Foundational principles of health coaching
      • The role of Motivational Enhancement

Applied Skills

  1. The ‘holding’ environment
  2. Assessment and alignment with patient’s stage of change
  3. Tools for externalization and the ‘yes, but’ patient
  4. Assessment and strategies for illness and identity
  5. Techniques for empowerment and shifting responsibility to the patient
  6. Awareness and management of subjective clinician experience and countertransference

Group experiential exercise/discussion

If the program committee feels your presentation would be better suited for a different presentation type, such as a symposium (shorter format during the main meeting), would you be willing to adapt your presentation to fit the new format?


Who is the target audience of the workshop? Are there particular skills or background that are recommended as pre-requests?


Is this workshop proposed by an organization?


Has the content (or substantial parts) of this workshop been previously presented or published (note: previous experience presenting the material may be considered a strength as long as continued interest is anticipated)?


Please provide Location of Presentation and/or Publication Information and date of each presentation


Three Anticipated Questions or Issues
How to choose an intervention based on a patient's particular stage of change?
How to implement health behavior change skills with particular populations/presentations?
How to manage subjective reactions to difficult patient presentations?

Materials to be Distributed