Overview of Psychotherapy Principles for Patients with Kidney Disease

This chapter presents an overview of factors to consider when providing psychotherapy to kidney disease patients. Psychological distress is common in patients with chronic kidney disease (CKD) due to the chronic and progressive nature of the disease. Given the reciprocal relationship among biological, psychological, and social factors, a biopsychosocial framework is useful for conceptualizing psychological distress in kidney patients. Cognitive behavioral therapy (CBT) is an evidence-based treatment for many psychological disorders and is efficacious in reducing symptoms of depression, anxiety, and sleep disturbance in kidney patients. CBT is best delivered within the context of a multidisciplinary kidney care team by a psychotherapist familiar with CKD and its management. Therapists should consider the specific impact of CKD in case of conceptualization and goal setting and be flexible in how psychotherapy is administered. Regular monitoring of symptoms and therapeutic alliance are important.