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Integrating Social Determinants of Health Within Cognitive Therapy

  • Social Determinants of Health (R Holliday, Section Editor)
  • Published:
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Abstract

Purpose

Social determinants of health (SDOH) encompass the range of conditions in a person’s environment that impacts health and health outcomes. We summarize the literature examining the intersection of SDOH and cognitive therapy (CT) and provide concrete clinical guidance for incorporating SDOH into a cognitively oriented case conceptualization and implementation of CT.

Recent findings

We begin by providing a brief overview of cognitive theory, the impact of SDOH on clinical presentations, and current literature examining SDOH and CT. We then offer a step-by-step approach to incorporate attention to SDOH into assessment, case conceptualization, and delivery of CT. Finally, we explicitly examine five key domains central to SDOH including: health care, social and community context, neighborhood and built environment, education, and economic stability. Within each domain, case examples are provided to highlight possible cognitions and schemas related to SDOH that warrant consideration as possible targets for intervention in CT.

Summary

SDOH undoubtedly intersect with mental health outcomes, and attending to this bidirectional relationship over the course of CT can enhance outcomes. The empirical research evaluating this intersectionality is sparse, and there is little clinical guidance for implementing CT using a SDOH-informed approach. This critical gap in the knowledge base on SDOH-informed CT is particularly relevant when working with minoritized populations for whom disparities across SDOH have been demonstrated. Practical recommendations for therapists are offered to bolster the ability to better provide culturally sensitive care that incorporates attention to SDOH.

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Authors and Affiliations

  1. The Headstrong Project, New York, NY, USA

    Amy M. Williams PhD

  2. VA Boston Healthcare System, Boston, USA

    Allison L. Baier MA, Mercedes G. Woolley BA & Tara E. Galovski PhD

  3. National Center for PTSD, Boston, USA

    Allison L. Baier MA, Mercedes G. Woolley BA & Tara E. Galovski PhD

  4. Boston University School of Medicine, Boston, USA

    Allison L. Baier MA & Tara E. Galovski PhD

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  1. Amy M. Williams PhD
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  2. Allison L. Baier MA
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  3. Mercedes G. Woolley BA
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  4. Tara E. Galovski PhD
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Correspondence to Amy M. Williams PhD.

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Amy Williams declares that she has no conflict of interest. Allison Baier declares that she has no conflict of interest. Mercedes Woolley declares that she has no conflict of interest. Tara Galovski declares that she has no conflict of interest.

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Williams, A.M., Baier, A.L., Woolley, M.G. et al. Integrating Social Determinants of Health Within Cognitive Therapy. Curr Treat Options Psych 9, 215–228 (2022). https://doi.org/10.1007/s40501-022-00268-0

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