This document outlines the presentation for a CALM therapy simulation. It discusses the structure and key parts of psychotherapy sessions, including assessment, therapeutic alliance, intervention, and termination. It notes that the most effective intervention is the therapeutic relationship, which accounts for 45% of outcome variance. CALM therapy is then introduced as a 6-8 session semi-structured intervention that addresses symptom management, the future/mortality, changes in self-concept and relationships, and spirituality/meaning. The essential ingredients are said to be providing a reflective space, attachment security, mentalization, and double awareness.

1. Department of Supportive Care
Princess Margaret Cancer Centre
Carmine Malfitano, MSW, RSW
Managing Cancer and
Living Meaningfully (CALM)

2. Simulation #1

3. Introduction
CALM therapy
Q&A
Simulation #2
PRESENTATION OUTLINE

4. 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

5. 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)

6. 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

8. 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

9. 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

10. The Essential Ingredients
• Reflective Space
• Attachment Security
• Mentalization
• Double awareness

12. Simulation #2

13. carmine.malfitano@uhnresearch.ca
Thank you