The Contribution of Psychotherapists to Patient Care in Multidisciplinary Heart Transplantation Care Teams

Abstract

Background: The participation of mental health professionals in multidisciplinary care teams for heart transplantation has become an international standard practice. The contribution of these professionals in this setting, which involves assessment and interventions, has not been the subject of systematic study. Methods: This paper explores how psychotherapists contribute to multidisciplinary decision making and care in transplant teams before, during, and after transplantation. To illustrate, it uses the case of a 19-year-old woman with anorexia nervosa who underwent heart transplant at a large transplantation center in Germany. She received psychotherapeutic interventions intended to lower the risk of non-adherence. Results: This first reported case of heart transplant in a patient with a previous diagnosis of anorexia nervosa also documents psychotherapeutic interventions that were favorable for sustainable weight-gain and how the multidisciplinary environment enabled their development and implementation. We provide details on the contribution of the psychologist in the case, including hypnotherapy interventions and adjustments in routine nursing practices. Conclusions: This paper shows how mental health professionals working in multidisciplinary teams improve patient outcomes in organ transplantation. In order to collect and systematize clinical knowledge of psychotherapeutic interventions for transplant candidates with mental health issues, additional studies with multiple centers, multiple cases, and a range of mental health disorders are needed.

Clinical experience with medical hypnosis as an adjunctive therapy in heart surgery

“…Heart surgery patients’ predominant stressors and their common presentations of distress during the surgery process vary across three phases of hospital care: initial assessment and admission, shortly before and during the operation, and immediately after surgery ( Tigges-Limmer et al, 2019 ; Salzmann et al, 2020 ). Typical sources of mental distress and common support tasks for medical hypnosis are summarized for each phase in Table 2 , and these tasks dictate which hypnotherapeutic interventions are most common in each stage.…”

“…For example, patients in a trance state are invited to approach a source of anxiety with an open mind for the purpose of finding a means of emotional accommodation. This is used postsurgery, e.g., with transplant patients in the "greeting the new heart" script (Tigges-Limmer and Gummert, 2010).…”