CL Case Conference: Management of Demoralization in the Medical Setting

Alyssa C Smith; Jonathan S Gerkin; Diana M Robinson; Emily G Holmes

doi:10.1016/j.jaclp.2025.06.006

CL Case Conference: Management of Demoralization in the Medical Setting

J Acad Consult Liaison Psychiatry. 2025 Jun 17:S2667-2960(25)00508-7. doi: 10.1016/j.jaclp.2025.06.006. Online ahead of print.

Authors

Alyssa C Smith¹, Jonathan S Gerkin², Diana M Robinson³, Emily G Holmes⁴

Affiliations

¹ Indiana University School of Medicine, Department of Psychiatry. Electronic address: Acs13@iu.edu.
² University of North Carolina at Chapel Hill School of Medicine, Department of Psychiatry.
³ University of Texas Southwestern Medical Center, Department of Psychiatry.
⁴ Indiana University School of Medicine, Department of Psychiatry.

PMID: 40553998
DOI: 10.1016/j.jaclp.2025.06.006

Abstract

Demoralization has important implications for patients' health, but consultation-liaison psychiatrists may be less familiar with diagnosis and management due to limited inclusion in the DSM-5 TR. We present the case of a multivisceral transplant patient who experienced demoralization due to complications from her post-transplant course. We discuss the diagnosis of demoralization, including differential diagnoses to consider, followed by a discussion of management of demoralization in the inpatient setting using acceptance and commitment therapy. We then discuss the consultation-liaison psychiatrist's role in assisting with management of teams' counter-transference to difficult patient cases, including the possibility of teams experiencing their own demoralization.

Keywords: acceptance and commitment therapy; consultation-liaison psychiatry; demoralization; transplant psychiatry; transplantation.

Publication types

Review