Bibliographic Details
| Title: |
Distress Intolerance: Dialectical Behavior Therapy Informed Communication for Serious Illness Care. |
| Authors: |
Goyal N; Psycho-oncology, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California, USA.; Division of Palliative Medicine, Department of Medicine, UCSF, San Francisco, California, USA., Cramer MA; Department of Psychiatry, Harvard Medical School/Mass General Brigham, Boston, Massachusetts, USA., Kantoff E; Psycho-oncology, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California, USA., Brenner KO; Section of Palliative Care, Department of Medicine, Stanford University, Palo Alto, California, USA., Chammas D; Division of Palliative Medicine, Department of Medicine, UCSF, San Francisco, California, USA.; Department of Psychiatry and Behavioral Sciences, UCSF, San Francisco, California, USA. |
| Source: |
Journal of palliative medicine [J Palliat Med] 2026 Oct; Vol. 29 (10), pp. 1448-1452. Date of Electronic Publication: 2026 Aug 13. |
| Publication Type: |
Journal Article; Case Reports |
| Language: |
English |
| Journal Info: |
Publisher: Mary Ann Liebert, Inc Country of Publication: United States NLM ID: 9808462 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1557-7740 (Electronic) Linking ISSN: 15577740 NLM ISO Abbreviation: J Palliat Med Subsets: MEDLINE |
| Imprint Name(s): |
Original Publication: Larchmont, NY : Mary Ann Liebert, Inc., c1998- |
| MeSH Terms: |
Dialectical Behavior Therapy*/methods , Palliative Care*/psychology , Palliative Care*/methods , Neoplasms*/psychology , Neoplasms*/therapy , Stress, Psychological*/therapy , Communication* , Adaptation, Psychological* , Psychological Distress*, Humans ; Coping Skills ; Male ; Female |
| Abstract: |
Patients with serious illness coupled with a history of difficulty coping with challenging situations often exhibit behaviors consistent with emotion dysregulation and low distress tolerance. Dialectical behavior therapy (DBT), an evidence-based psychological treatment originally developed for patients with borderline personality disorder and now widely applied across clinical settings, offers skills-based tools to support patients navigating the intense and understandable distress that arises with illness. This article explores the care of a patient with advanced cancer who presents with significant emotion dysregulation and low distress tolerance, which negatively affects their interactions with the medical team and generates secondary distress among clinicians. Drawing on foundational DBT principles, including distress tolerance skills, emotional validation, dialectical thinking, and clinician self-regulation, we demonstrate how DBT-informed communication strategies can help patients manage distress more effectively. We also explore how clinicians can use these skills to manage their own distress while interacting with patients experiencing high distress. |
| Competing Interests: |
Author Disclosure StatementNo competing financial interests exist. |
| Contributed Indexing: |
Keywords: coping; dialectical behavior therapy; distress intolerance; palliative care; psychological needs; serious illness communication |
| Entry Date(s): |
Date Created: 20260814 Date Completed: 20260917 Latest Revision: 20260921 |
| Update Code: |
20260921 |
| DOI: |
10.1177/10966218261478411 |
| PMID: |
42596557 |
| Database: |
MEDLINE |