October 8, 2026: Armand M. Nicholi Jr., M.D., and Ingrid Nicholi Lecture in Psychiatry (Spirituality) - Professorial - Use of an Existential Frame in Clinical Practice (Northern)
Use of an Existential Frame in Clinical Practice
Description:
The biopsychosocial model remains the dominant conceptual framework in American psychiatry. However, phenomenologists in Europe and Irving Yalom in the U.S. have drawn attention to the existential dimension of much clinical work (Dong et al., 2025), and therapies such as DBT and ACT explicitly engage questions of meaning and value. In the absence of guidance about how to integrate biopsychosocial with other perspectives, clinicians do well to adopt an existential frame, which involves (a) exploring an individual’s experience and its meaning, (b) accompanying the patient in dealing with problem-sustaining patterns (Voerman et al., 2025), and (c) promoting agency and flourishing (VanderWeele, 2017).
Clinicians can anticipate several challenges in adopting this frame, including pressures to settle on a single paradigm, threats to the self under a burden of suffering, and decision-making in the face of resistance or denial. This lecture addresses knowledge gaps in dealing with the existential dimensions of common psychiatric conditions, as well as the benefits and challenges of approaching patients’ problem-sustaining patterns using an existential frame. An existential stance helps clarify for clinicians and patients both the givens required for flourishing and the risk of losing themselves in any single paradigm detached from the conditions of existence.
Target Audience
This program is intended for:
- Nurses
- Psychiatrists
- Psychologists
- Physicians
- Social Workers
Learning Objectives
Upon completion of the activity, participants will be able to:
- Recognize the existential dimension of conditions such as anxiety and depression.
- Identify three core aspects of an existential frame in clinical practice.
- Describe at least three challenges in the use of an existential frame in clinical practice.
SPEAKER(S)
John Peteet, MD
Professor of Clinical Psychiatry at Harvard Medical School
Attending Psychiatrist at Brigham & Women’s Hospital
Dana-Farber Cancer Institute Site Director of the BWH Consultation-Liaison Psychiatry
Fellowship
Course summary
- 1.00 AMA PRA Category 1 Credit™
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of IHP and Massachusetts General Hospital. IHP is accredited by the ACCME to provide continuing medical education for physicians.
IHP designates this Enduring activity for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
- 1.00 Nursing Contact Hours
Massachusetts General Laws, Chapter 13, sections 13, 14, 14A, 15 and 15D and Chapter 112, sections 74 through 81C authorize the Board of Registration in Nursing to regulate nursing practice and education.
This program meets the requirements of the Massachusetts Board of Registration in Nursing (244 CMR 5.00) for 1.00 contact hours of nursing continuing education credit. Advance practice nurses, please note: Educational activities which meet the requirements of the ACCME (such as this activity) count towards 50% of the nursing requirement for ANCC accreditation.
- 1.00 Social Workers
As a Jointly Accredited Organization, the MGH Institute of Health Professions is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. MGH Institute of Health Professions maintains responsibility for this course. Social workers completing this course receive 1.00 clock hours for continuing education credits.
- 1.00 Participation
This course allows other providers to claim a Participation Certificate upon successful completion of this course.
Participation Certificates will specify the title, location, type of activity, date of activity, and number of AMA PRA Category 1 Credit™ associated with the activity. Providers should check with their regulatory agencies to determine ways in which AMA PRA Category 1 Credit™ may or may not fulfill continuing education requirements. Providers should also consider saving copies of brochures, agenda, and other supporting documents.
- 1.00 Psychologists CE Credit
Continuing Education (CE) credits for psychologists are provided through the co-sponsorship of the American Psychological Association (APA) Office of Continuing Education in Psychology (CEP). The APA CEP Office maintains responsibility for the content of the programs. MGH Institute of Health Professions designates this activity for 1.00 CE credit.

John Peteet, MD
After receiving his M.D. degree at Columbia University, he completed a medical internship at UNC in Chapel Hill, a residency in psychiatry at the Massachusetts Mental Health Center, and a fellowship at the Peter Bent Brigham Hospital in Boston. For over 40 years, he has been a psychiatrist at Brigham and Women's Hospital and Dana-Farber Cancer Institute, where he is a Professor of Clinical Psychiatry at Harvard Medical School. A Distinguished Life Fellow of the American Psychiatric Association, he has received several teaching awards and published numerous papers in the areas of psychosocial oncology, addiction, and the clinical interface between spirituality/religion and psychiatry. He has authored or co-edited 14 books, including Doing the Right Thing: An Approach to Moral Issues in Mental Health Treatment, The Soul of Medicine: Spiritual Perspectives and Clinical Practice, and The Virtues in Psychiatric Practice. He is the recipient of the APA’s Oskar Pfister Award and is past chair of the American Psychiatric Association’s Caucus on Religion, Spirituality, and Psychiatry.
Disclosures:
Available Credit
- 1.00 AMA PRA Category 1 Credit™
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of IHP and Massachusetts General Hospital. IHP is accredited by the ACCME to provide continuing medical education for physicians.
IHP designates this Enduring activity for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
- 1.00 Nursing Contact Hours
Massachusetts General Laws, Chapter 13, sections 13, 14, 14A, 15 and 15D and Chapter 112, sections 74 through 81C authorize the Board of Registration in Nursing to regulate nursing practice and education.
This program meets the requirements of the Massachusetts Board of Registration in Nursing (244 CMR 5.00) for 1.00 contact hours of nursing continuing education credit. Advance practice nurses, please note: Educational activities which meet the requirements of the ACCME (such as this activity) count towards 50% of the nursing requirement for ANCC accreditation.
- 1.00 Social Workers
As a Jointly Accredited Organization, the MGH Institute of Health Professions is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. MGH Institute of Health Professions maintains responsibility for this course. Social workers completing this course receive 1.00 clock hours for continuing education credits.
- 1.00 Participation
This course allows other providers to claim a Participation Certificate upon successful completion of this course.
Participation Certificates will specify the title, location, type of activity, date of activity, and number of AMA PRA Category 1 Credit™ associated with the activity. Providers should check with their regulatory agencies to determine ways in which AMA PRA Category 1 Credit™ may or may not fulfill continuing education requirements. Providers should also consider saving copies of brochures, agenda, and other supporting documents.
- 1.00 Psychologists CE Credit
Continuing Education (CE) credits for psychologists are provided through the co-sponsorship of the American Psychological Association (APA) Office of Continuing Education in Psychology (CEP). The APA CEP Office maintains responsibility for the content of the programs. MGH Institute of Health Professions designates this activity for 1.00 CE credit.
Accreditation
In support of improving patient care, MGH Institute of Health Professions is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.
1.0 Physicians
MGH Institute of Health Professions designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits ™. Physicians should claim only credit commensurate with the extent of their participation in this activity.
1.0 Physician Associates/Assistants
AAPA Credit Designation Statement – Live
MGH Institute of Health Professions has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 1.0 AAPA Category 1 CME credits. PAs should only claim credit commensurate with the extent of their participation.
AAPA Credit Designation Statement – Enduring Materials
MGH Institute of Health Professions has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 1.0 AAPA Category 1 CME credits. Approval is valid until {Expiration Date). PAs should only claim credit commensurate with the extent of their participation.
1.0 Nursing
MGH Institute of Health Professions designates this activity for 1.0 contact hours for nurses. The American Academy of Nurse Practitioners Certification Board (AANPCB) accepts credit from organizations accredited by the ACCME and ANCC.
1.0 Pharmacists
This activity provides 1.0 contact hours of continuing education credit.
NOTE FOR PHARMACISTS: Upon closing of the electronic evaluation, IHP will upload the pharmacy-related continuing education information to the CPE Monitor within 60 days. Per ACPE rules, IHP does not have access nor the ability to upload credits requested after the evaluation closes. It is the responsibility of the pharmacist or pharmacy technician to provide the correct information [NABP ePID and DOB (in MMDD format)] in order to receive credit for participating in a CE activity.
1.0 Psychologists:
Continuing Education (CE) credits for psychologists are provided through the co-sponsorship of the American Psychological Association (APA) Office of Continuing Education in Psychology (CEP). The APA CEP Office maintains responsibility for the content of the programs. MGH Institute of Health Professions designates this activity for 1.0 CE credit.
1.0 Social Workers
As a Jointly Accredited Organization, MGH Institute of Health Professions is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. MGH Institute of Health Professions maintains responsibility for this course. Social workers completing this course receive 1.0 clock hours for continuing education credits.
1.0 IPCE Credit
This activity was planned by and for the healthcare team, and learners will receive 1.0 Interprofessional Continuing Education (IPCE) credit for learning and change.

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