Sara and her Pac-Man’s journey: The contribution of CBT amidst developmental challenges, complex settings, and integrated multilevel interventions

Journal title QUADERNI DI PSICOTERAPIA COGNITIVA
Author/s Stefania Ferrante, Grazia Tiziana Vitale, Michele Simeone, Maria Grazia Foschino Barbaro
Publishing Year 2026 Issue 2025/56
Language Italian Pages 16 P. 60-75 File size 0 KB
DOI 10.3280/qpc56-2025oa21771
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The clinical case of Sara, 17, suffering from a rare multisystem disease and chronic kidney disease, is presented. She was treated at the UOSD Psychology Department of the Giovanni XXIII Pediatric Hospital in Bari.
The intervention, in line with the most recent recommendations for comprehensive care in complex organic diseases (CNOP, 2019; PNMR, 2023; PNC, 2016; 2025; PANSM, 2025), involved the integration of different levels: assessment, psychoeducation with a medical team, parent training, patient engagement, CBT psychotherapy and third-generation techniques (ACT and Mindfulness); and evaluation of psychological outcomes. The goals of the psychotherapy included promoting acceptance and self-regulation of the disease, pain management, and end-of-life support. The use of the Pac-Man metaphor helped to represent the illness, promoting acceptance, emotional regulation, and resilience.
This case study demonstrates how psychotherapy, within an integrated approach, can help renegotiate meaning and developmental tasks even in the face of severe prognoses.

Keywords: complex organic pathology;developmental age;adaptation to illness;CBT;end of life

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Stefania Ferrante, Grazia Tiziana Vitale, Michele Simeone, Maria Grazia Foschino Barbaro, Il viaggio di Sara e del suo Pac-Man: il contributo della CBT tra sfide evolutive, setting complessi e interventi integrati multilivello in "QUADERNI DI PSICOTERAPIA COGNITIVA" 56/2025, pp 60-75, DOI: 10.3280/qpc56-2025oa21771