penn presbyterian medical center cognitive behavioral therapy counseling

After months of stress and isolation, many people have expressed the feeling that their mental health has taken a hit. The pandemic has been especially tough on individuals struggling with substance use disorder (SUD), and the strain of ongoing medical, financial, and social anxieties can exacerbate the urge to cope with drugs and alcohol. But for those interested in pursuing recovery, Penn Presbyterian Medical Center’s Behavioral Health team is always ready to help.

The only behavioral health program of its kind in the health system, PPMC’s SUD program offers multiple levels of care to support patients at each stage of recovery — from outpatient counseling and community-based support, to acute inpatient care for those experiencing a psychiatric crisis (Wright 5) or in need of substance withdrawal management and rehabilitation (Wright 4), and everywhere in between.

 “A commitment to ongoing education around behavioral health competencies drives each part of our program at PPMC — from inpatient psychiatry and detoxification, to intensive outpatient counseling, to opioid treatment. I am deeply proud of our counselors’ shared determination to enhance their techniques and better support our patients. Being recognized an evidence-based clinical treatment program in CBT is a huge milestone, and I know this one of many accomplishments to come as we continue to improve our program.”

— Gene Gofman, MBA, Associate Chief Financial Officer and Associate Executive Director for Behavioral Health

In October, the Wright 4/5 and outpatient counseling teams earned the EPIC Evidence-Based Practice Program Designation from the Philadelphia Department of Behavioral Health and Intellectual Disability Services.

One of the key stepping stones to receiving this recognition for their tireless work with this patient population and their implementation of evidence-based best practices was a department-wide initiative to certify all of the team’s therapists and counselors in cognitive behavioral therapy (CBT), an intervention focused on illuminating connections between thoughts, feelings, beliefs, and behaviors. Led by the Penn Beck Community Initiative (Penn BCI), this now-mandatory, six-month training has allowed PPMC to share solution-focused, evidence-based interventions with populations that typically don’t receive this level of counseling while also boosting the skills of the team.

Guiding Patients to Light Bulb Moments

Over the course of his nearly 13 years at PPMC, Wright 4 therapist Eugene Moses, MA, has worked with countless individuals with SUD. Having “been down that road before” and worked through his own issues with SUD, Moses has a unique insight into the needs of these patients as well as boundless motivation to get them on the road to recovery. Though he initially trained in Rogerian therapy, he was excited to earn his CBT certification this fall and has already seen plenty of a-ha, light bulb moments.

“If you ask someone why they find themselves using substances over and over again, they typically identify triggering events or patterns — ‘I got into a fight with my partner’ or ‘I always wind up back in the same neighborhoods.’ But it’s deeper than that,” Moses explained. “CBT helps them figure out what thoughts arose after that argument or what feelings pushed them to that neighborhood. That’s what causes them to engage in substance use. My goal is to help them discern those connections, and I think a lot of people find it helpful because it feels casual and practical.”

It may take time and regular therapy for patients to shift their perspectives, but the sense of empowerment that CBT can inspire is significant. By practicing identifying distorted and destructive thoughts, then developing strategies to overcome them, challenges become more manageable, and patients are more equipped to cope after they graduate the program — whether they’ve been discharged for two days or two years.

Transforming Therapists’ Skillsets

In addition to being helpful for patients, many members of PPMC’s Behavioral Health team have reported professional benefits from CBT training too. Lauren Carbone, MA, program coordinator for the Center for Opioid Recovery and Engagement (CORE), was part of first cohort to pursue the Penn BCI training three years ago. At the time, her background was in social work and case management, and while she had spent time working with SUD programs, she wasn’t experienced in therapy.

“Part of the process is recording all of your sessions so other professionals can listen and offer feedback. The training taught me so many valuable clinical skills really quickly; it made me really comfortable doing therapy. Even though I’ve taken on a more administrative role, training other clinicians in CBT helps me stay sharp,” she said. “CBT has a structure, but you can adapt it to your own style. Some of our counselors have been here for years, and we recognize that it can be difficult to be asked to do therapy a completely different way. It’s been amazing to watch people really put the effort in and enhance their practice.”

Implementing CBT interventions also equips clinicians with tools to improve their own resilience in the face of stresses that can contribute to burnout. As they work with patients to determine which techniques work best for them, patients become their own therapists in a way. With guidance and encouragement, they learn to recognize their own thought and behavior patterns, and this success can inspire just as much hope and satisfaction in the therapists as in the patients themselves.

Building Connections with Clients and Colleagues

Like Carbone, Nicole Jaffe, MA, LPC, ATR-BC, a creative arts therapist, was part of the first training group. Though initially nervous that the structure would be at odds with her creative, fluid approach, Jaffe found that just as art therapy can change depending on its purpose (working through trauma vs. promoting general wellness, for example), CBT can also be adapted. She notes that this has further been supported by the discussions that come up during the department’s weekly CBT consultation groups.

“The training gave me some great brief intervention tools and a structure for seeing long-term change, but I’m also constantly learning new techniques from my colleagues. We all come with different backgrounds and have different talents, so it’s really great to talk with clinicians who approach their sessions one way or who have experienced a situation that you haven’t before,” Jaffe said. “We all want to help our clients recover and heal, and CBT gives us a common language. I’ve found that it really helped build stronger connections across teams that previously felt like silos.”

In addition to building a sense of community through shared experience, the required CBT certification has also had an impact of continuity of care. As a patient moves from Wright 5 to Wright 4 to PPMC’s outpatient programs, they are continually building and reinforcing similar concrete skills. In this way, all of a patient’s counselors and therapists are working together to give them a firm foundation to return to their life healthy and sober.

“Our goal is for every patient to graduate from our program and succeed in their communities. CBT helps set them up for success because it’s built on transparency and partnership,” said Director of Behavioral Health Angela Burdick-McPhee, LPC, CAADC, LCADC, ACS. “Patients learn that they’re the expert. They can see the links between their thoughts and behaviors, and we’re just here to walk with them on the journey. And as a bonus, seeing their success is hugely beneficial for clinicians.”


Update: This article originally attributed the CBT training to the Beck Institute. It has been corrected to the Penn Beck Community Initiative.

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