My clinical, teaching, and research interests fall into three basic areas: a) the development and provision of integrated behavioral medicine services, b) psychotherapy to adults with advanced medical illness, and c) advocacy for socially responsive training in psychology.
Early in my career, my research interests focused on the developmental period of adolescence and the impact that traumatic events, such as childhood abuse and the exposure to community violence, played in the development and symptomatic expression of psychopathology—specifically as related to adolescent depression, aggression, substance abuse, PTSD, and personality dysfunction.
More recently, my clinical and research interests have shifted to behavioral medicine and the relationship between physical illness, emotional functioning, and quality of life. Clinically, my colleagues and I have developed a psychological behavioral medicine service that is integrated within several specialty medical services of Yale New Haven Hospital (oncology, palliative care, transplant, sleep, pain, tobacco, cardiovascular and digestive health). Within these settings, we have initiated several pilot studies to examine the relationship between coping, resilience and quality of life, while also exploring the psychological, behavioral, and neuropsychiatric comorbidities among patients facing serious, chronic, and life threatening illnesses. We are interested in developing novel therapies, and testing their feasibility and effectiveness for reducing the risk of adverse stress-related symptoms such as drug and alcohol abuse, depression, anxiety and PTSD in these vulnerable patient populations.
Specialized Terms: Behavioral Medicine; Resilience; Coping with chronic illness; Quality of life; Palliative Care; Depression; Psychotherapy
Demoralization in cancer patients receiving palliative care. The specific aim of this research is to study the relationship between demoralization and certain other variables, such as spiritual well-being, sense of meaning, purpose in life, and overall quality of life in patients receiving palliative care. The long-term objective of this research is to contribute to the personalization of palliative care by designing an algorithm for evidence-based selection of psychotherapeutic interventions tailored to meet the needs of individual patients and aimed at countering demoralization, suicidal ideation or requests for hastened death. This study is ongoing and currently recruiting subjects (Primary Investigator: Dr. Dwain Fehon).
Psychiatric, psychological, and behavioral correlates in patients with end-stage liver disease awaiting organ transplantation. This exploratory study recruited and assessed 125 waitlisted liver transplant candidates using self-report measures of emotional adjustment and quality of life (Dr. Dwain Fehon, Primary Investigator).
Liver SMART: A Stress Management and Relaxation Training Intervention for Liver Transplant Candidates. This is a Stage 1A treatment development study examined the feasibility and preliminary effectiveness of an 8-session group cognitive-behavioral stress management intervention for liver transplant candidates (Dr. Dwain Fehon, Primary Investigator).
Text Messaging to Reduce Alcohol Relapse in Liver Transplant Patients. This study was an 8-week, randomized controlled pilot trial to investigate the feasibility and acceptability of a text-messaging intervention for alcohol relapse prevention and stress reduction in 20 liver transplant patients with alcohol-related liver disease (Dr. Benjamin Toll, Primary Investigator; Dr. Dwain Fehon, Co-investigator).
Development of the Yale Liver Transplant Psychosocial Risk Scale (YLTRS). This study developed and performed an initial validation of a brief, evidence-based, clinician administered scale to assess level of psychosocial risk among liver transplant candidates (Dr. Dwain Fehon, Primary Investigator).
Alcoholism; Anxiety; Behavioral Medicine; Depression; Quality of Life; Stress Disorders, Post-Traumatic; Resilience, Psychological