MESSAGES ON FILM: USING LESSONS FROM MOVIES IN COUPLES THERAPY

Educational Objectives

The goal of this program is encourage innovative couples counseling through the use of lessons from mass media. After hearing and assimilating this program, the clinician will be better able to:

1. Recognize the impact that socially mediated sex-based expectations have on marriage and divorce.

2. Identify perspectives and behaviors conducive to healthy marriages.

3. Identify perspectives and behaviors that jeopardize marriages.

4. Provide interventions that improve and facilitate communication among couples.

5. Facilitate harmonious marital dissolution and subsequent behavioral change among partners.

Summary

Couples therapy: can be quite challenging; involves 3 distinct “personalities” (2 individuals in relationship, plus personality of these 2 as integrated couple); divorce rates — 50% to 52% for first marriages; 60% for second marriages; 72% for third marriages

Social conditioning: speaker expects institution of marriage to survive because young girls still indoctrinated into “princess model” (ie, they will marry “prince on white horse”); however, society does not teach boys “how to be princes”; messages about being “princesses”, wives, and mothers conveyed to girls through media and movies; speaker states that although many young women go to college, large proportion have no career plans (ie, simply wish to marry and have children)

Stages of relationships: chance encounters (eg, grocery store) or blind dates; correspondence via telephone and letter writing (before advent of internet); socially mediated progression — couple begins to date; family repeatedly questions whether relationship serious; couple eventually becomes engaged; societal pressure “pushes” couple into having wedding, then into having children (couples tend to “cave in” to pressure to take “next step”)

Abundance and strength: key terms; refer to how one views ability to care for one’s self (ie, have own place, job, and money; also suggests ability to avoid feelings of failure if alone); examples from media — Peggy Sue Got Married (film suggests “something wrong” if woman has no date on Saturday night; message reinforced by society); television series Sex in the City

Importance to marriage: marriage of 2 individuals with “abundance and strength perspective” most likely to be successful; such couples go to counseling for retooling, rather than divorce

Consequences of lacking abundance and strength: characteristic of majority of couples requiring counseling; reasons people marry despite lack of abundance and strength — in order move out of parents’ house; because they have no other place to go; fear of being alone; desire to parent (need to find co-parent); examples from media — Shall We Dance (female character gives reason for marriage [“if we connect with to somebody else in a marriage, we have a witness for our lives”]; sums up marriage that comes from abundance and strength; Mirror Has Two Faces (male character suggests marriage to female colleague and friend based on companionship, rather than sexual attraction or physical intimacy; female character eventually falls in love with mate; however, new-found self-esteem (ie, abundance and strength) brings her to realization that she desires full relationship, despite confusion and complications that accompany true romance

Reasons couples enter treatment: differences in parenting decisions; decline in or cessation of sexual intimacy; infidelity (sometimes, couples enter treatment in order to have witness for their anger; [“anger is a cover for fear”]); differences in housekeeping decisions (eg, which partner responsible for particular chores); despite having ≥1 of preceding issues, one or both spouses want to save, or, to end, marriage

Clinician as investigator: ask about first date and how couple met; observe body language; notice whether partners finish one another’s sentences or look at one another as they relate story (watch communication; assess interaction in waiting room; observe whether partners change as story unfolds [may bring up positive aspects of marriage]); regardless of level of hostility, members of couple remember reasons relationship formed; assess what issues brought couple to therapy; determine whether couple wants to stay together or desires civil separation; some couples want script for telling children about divorce without acrimony

Reasons marriages fall apart: lack of communication; maladaptive communication styles; unfulfilled expectations

Examples from films: Funny Girl has song lyrics “I am woman, you are man; I am smaller, so you can be taller than” (makes reference to common expectations about husband being taller, older, and more financially secure; people focus on these qualities, rather than on those that truly matter in relationship; expectations originating from family of origin — in The Story of Us, couple married 15 yr contemplates trial separation; they recall remarks of one therapist who said that couples bring things from their parents into marriage; in following imaginary scene, husband, wife, and parents of both appear together in marriage bed; even trivial matters rooted in family of origin (eg, how dishwasher loaded, how towels folded and put away) can bring couples to therapy

Using movies in couples therapy: speaker often assigns watching movie as homework for couple; whether both partners watch movie indicates commitment to working on relationship; consider which partner initiated therapy and whether other partner less willing to participate; The Break Up — female character wants her partner to wash dishes after dinner party; when male partner expresses desire to defer chore, argument ensues, during which girlfriend complains that “she wants him to want to do dishes”; About Last Night — couple moves in together; after hosting holiday dinner, couple discovers differences in their expectations (woman tried to have celebration of holiday that mimicked similar occasions experienced with her parents; man criticizes her desire to recreate “Norman Rockwell painting”); parents who have had long healthy marriage can provide model for children’s relationships, but superimposition of such models on cohabitating relationship not always feasible; Two for The Road — story of progression of couple’s marriage over 10-yr period; fighting and infidelity of both partners occur; resolution comes with recognition that “marriage is for life”; teaches that arguing with spouse does not mean divorce inevitable; speaker also cautions that absence of fighting does not necessarily indicate unhealthy relationship (some couples find ways to have reasonable adult communication without arguing)

Exercise for couples (1): ask both partners to draw square, circle, triangle, plus sign, and spiral, and then to rank each shape as their first, second, third, fourth, or fifth favorite; speaker states that preferences give information about person’s state of mind

Interpretation of preferences: square — stability and security; circle — wholeness, independence, and desire to develop one’s own identity; triangle — identifying, pursuing, and attaining goals and dreams; plus sign — relationships, integration, and need for connection; spiral — growth, evolution, and need for change; rank chosen for each shape significant to individual at that moment; shape ranked first (most favorite) represents where individual is or would like to be; couples with discordant ranking “not on the same page”; match of 3 of 5 symbols suggests couple has strong connection; after explaining meaning of each shape, discuss implications of ranking

Exercise for couples (2): from Huffington Post, “31 Ways to Know You’re in the Right Relationship”; addresses issues of privacy and confidentiality (eg, whether person feels need to have total access to partner’s information [speaker believes this to be unnecessary, regardless of length of marriage or relationship]); clinician can explore client’s rationale for privacy preferences

Effects of internet on relationships: background checks — common when dating; speakers warns that although dating websites represent positive concept, “scammers” now pervasive on social media sites; secret “plan B” — individuals with fear of being alone use internet to have emotional affairs within committed relationship (ie, another potential partner “lined up” in case current relationship does not work out)

Exercise for couples (3): addresses ability to maintain sense of self; those who lack ability become codependent and have difficulty determining own wants and needs; have couple faces one another across room; after identifying which party drives anger or conflict in relationship, ask this individual what he or she wants; often, such individuals can state what they do not want, but not what they do want

Exercises for couples (4): members of couple face one another across room; clinician has one partner tell other something he or she wants the other to know; listener asked to tell partner what was said (ie, practice reflective listening); often difficult for partners to repeat what other says without injecting reactions to partner’s comments (speaks to communication and selective hearing)

Practices of couples with successful relationships: talk about sex; engage in arguments; have time together without talking; use terms “always” and “never” cautiously; members of couple should look at one another across room; do not take one another for granted; remember “little things” (eg, say “thank you” and be able to make sincere amends)

Examples from films: The Four Seasons — 3 couples; one couple breaks up, but other 2 provide good representation of long-term communication between 2 people in working couple; couples discuss whether partners still “thoughtful”; one falls in love with spouse repeatedly over course of long marriage, while, at other times, “couple drives each other crazy”; On Golden Pond — husband and wife have successful relationship and love one another; she no longer gets “worked up” if he does something wrong; he depends on her to have positive attitude, while she depends him to be realist

Foundations of good relationship: speaker refers to work of Glasser, who identified “seven deadly habits that destroy relationships” (eg, contempt, criticism) and “seven caring habits” (eg, acceptance); important considerations when choosing life partner — whether partners admire one another; whether partners would want to have children with one another; whether members of couple could spend rest of their lives together without changing one another (ie, couples should not assume that problems can be “fixed” after marriage)

Ending marriage with honor: emotion of hate equally strong as that of love; other common emotions associated with divorce include bewilderment, sadness, anger, fear, and loneliness

Examples from films: Kramer vs Kramer — father learns to survive after divorce; The Way We Were — couple too philosophically far apart to be together; lessons — both films about coming to acceptance, and finding ways to collaborate and cooperate; communication is key

Obstacles faced after divorce: patterns of old relationship may imprint on new relationship; dating — children should not be expected to accept new partner or meet every person parent dates; feelings of failure often motivate divorced parents to prove themselves desirable by entering into sexual relationships, but children need not be cognizant of this; children need to be allowed to grieve loss of absent parent

Changing patterns from past: explore parent-child dynamics; patterns from past provide tools for learning how to be better as individual in order to be better in relationship

Learning from mistakes: therapy offers corrective emotional experience; client should reflect on own mistakes in relationship (per accusations made by former spouse, and own admissions of wrongdoing) to try to avoid repeating these in new relationship; speaker cites example of divorced couple in film, A New Life

“Fear vs love” (Martha Beck): anger provides cover for fear; clinicians should assess fear underlying anger in couple’s arguments about sex and money, as anger may reflect pattern learned from family of origin (eg, financial worries may have been source of parent’s anger

Conclusion: couples counseling interesting and fulfilling due to “moments of connection,” regardless of whether couple staying together or parting

Acknowledgements

Ms. Shinbaum was recorded at Creativity and Madness: Psychological Studies of Art and Artists, held July 30 to August 3, 2012, in Santa Fe, NM, and presented by the American Institute of Medical Education. For information on other meetings hosted by the American Institute of Medical Education, please visit creativityandmadness.com. The Audio-Digest Foundation thanks Ms. Shinbaum and the American Institute of Medical Education for their cooperation in the production of this program.

Suggested Reading

Allen ES et al: The effects of marriage education for army couples with a history of infidelity. J Fam Psychol 26:1, 2012; Anker MG et al: Using client feedback to improve couple therapy outcomes: a randomized clinical trial in a naturalistic setting. J Consult Clin Psychol 77:4, 2009; Baucom BR et al: Prediction of response to treatment in a randomized clinical trial of couple therapy: a 2-year follow-up. J Consult Clin Psychol 77:1, 2009; Bullard L el at: Effects of the oregon model of parent management training (PMTO) on marital adjustment in new stepfamilies: a randomized trial. J Fam Psychol 24:4, 2010; Butler MH et al: A comparison of attachment outcomes in enactment-based versus therapist-centered therapy process modalities in couple therapy. Fam Process 50:2, 2011; Collins JL et al: An exploration of young ethnic minority males' beliefs about romantic relationships. Issues Ment Health Nurs 32:3, 2011; Cummings EM et al: Evaluating a brief prevention program for improving marital conflict in community families. J Fam Psychol 22:2, 2008; Dinero RE et al: Influence of family of origin and adult romantic partners on romantic attachment security. J Fam Psychol 22:4, 2008; Doherty, WJ et al: Interest in marital reconciliation among parents. Fam Court Rev 49:313–321, 2011; Glasser W, Glasser C: Getting Together and Staying Together: Solving the Mystery of Marriage. New York, NY: HarperCollins, 2000; Halford WK et al: Couple relationship education at home: does skill training enhance relationship assessment and feedback? J Fam Psychol 24:2, 2010; Hernandez, BC et al: Spouses in mixed-orientation marriage: A 20-year review of empirical studies. J Marital Fam Ther 37:3, 2011; Karahan TF: The effects of a couple communication program on the conflict resolution skills and active conflict tendencies of Turkish couples. J Sex Marital Ther 35:3, 2009; Madhyastha TM et al: Investigating spousal influence using moment-to-moment affect data from marital conflict. J Fam Psychol 25:2, 2011; Mahaffey BA: Couples counseling directive technique: A (mis)communication model to promote insight, catharsis, disclosure, and problem resolution. Family Journal 18:1, 2010; Martinson VK et al: The relationship between coming to terms with family-of-origin difficulties and adult relationship satisfaction. Am J Fam Ther 38:3, 2010; Sbarra DA et al: Deeper into divorce: using actor-partner analyses to explore systemic differences in coparenting conflict following custody dispute resolution. J Fam Psychol 22:1, 2008; Sevier M et al: Observed communication and associations with satisfaction during traditional and integrative behavioral couple therapy. Behav Ther 39:2, 2008; Smith DA et al: Overperception of spousal criticism in dysphoria and marital discord. Behav Ther 39:3, 2008; Willoughby BJ et al: Transitioning into cohabitation early in a relationship: Associations with family of origin assessments and couple outcomes. J Couple Relatsh Ther 11:3, 2012.

Readings

Allen ES et al: The effects of marriage education for army couples with a history of infidelity. J Fam Psychol 26:1, 2012; Anker MG et al: Using client feedback to improve couple therapy outcomes: a randomized clinical trial in a naturalistic setting. J Consult Clin Psychol 77:4, 2009; Baucom BR et al: Prediction of response to treatment in a randomized clinical trial of couple therapy: a 2-year follow-up. J Consult Clin Psychol 77:1, 2009; Bullard L el at: Effects of the oregon model of parent management training (PMTO) on marital adjustment in new stepfamilies: a randomized trial. J Fam Psychol 24:4, 2010; Butler MH et al: A comparison of attachment outcomes in enactment-based versus therapist-centered therapy process modalities in couple therapy. Fam Process 50:2, 2011; Collins JL et al: An exploration of young ethnic minority males' beliefs about romantic relationships. Issues Ment Health Nurs 32:3, 2011; Cummings EM et al: Evaluating a brief prevention program for improving marital conflict in community families. J Fam Psychol 22:2, 2008; Dinero RE et al: Influence of family of origin and adult romantic partners on romantic attachment security. J Fam Psychol 22:4, 2008; Doherty, WJ et al: Interest in marital reconciliation among parents. Fam Court Rev 49:313–321, 2011; Glasser W, Glasser C: Getting Together and Staying Together: Solving the Mystery of Marriage. New York, NY: HarperCollins, 2000; Halford WK et al: Couple relationship education at home: does skill training enhance relationship assessment and feedback? J Fam Psychol 24:2, 2010; Hernandez, BC et al: Spouses in mixed-orientation marriage: A 20-year review of empirical studies. J Marital Fam Ther 37:3, 2011; Karahan TF: The effects of a couple communication program on the conflict resolution skills and active conflict tendencies of Turkish couples. J Sex Marital Ther 35:3, 2009; Madhyastha TM et al: Investigating spousal influence using moment-to-moment affect data from marital conflict. J Fam Psychol 25:2, 2011; Mahaffey BA: Couples counseling directive technique: A (mis)communication model to promote insight, catharsis, disclosure, and problem resolution. Family Journal 18:1, 2010; Martinson VK et al: The relationship between coming to terms with family-of-origin difficulties and adult relationship satisfaction. Am J Fam Ther 38:3, 2010; Sbarra DA et al: Deeper into divorce: using actor-partner analyses to explore systemic differences in coparenting conflict following custody dispute resolution. J Fam Psychol 22:1, 2008; Sevier M et al: Observed communication and associations with satisfaction during traditional and integrative behavioral couple therapy. Behav Ther 39:2, 2008; Smith DA et al: Overperception of spousal criticism in dysphoria and marital discord. Behav Ther 39:3, 2008; Willoughby BJ et al: Transitioning into cohabitation early in a relationship: Associations with family of origin assessments and couple outcomes. J Couple Relatsh Ther 11:3, 2012.

Disclosures

In adherence to ACCME Standards for Commercial Support, Audio-Digest requires all faculty and members of the planning committee to disclose relevant financial relationships within the past 12 months that might create any personal conflicts of interest. Any identified conflicts were resolved to ensure that this educational activity promotes quality in health care and not a proprietary business or commercial interest. For this program, Ms. Shinbaum and planning committee reported nothing to disclose.

Couples therapy: can be quite challenging; involves 3 distinct “personalities” (2 individuals in relationship, plus personality of these 2 as integrated couple); divorce rates — 50% to 52% for first marriages; 60% for second marriages; 72% for third marriages

Social conditioning: speaker expects institution of marriage to survive because young girls still indoctrinated into “princess model” (ie, they will marry “prince on white horse”); however, society does not teach boys “how to be princes”; messages about being “princesses”, wives, and mothers conveyed to girls through media and movies; speaker states that although many young women go to college, large proportion have no career plans (ie, simply wish to marry and have children)

Stages of relationships: chance encounters (eg, grocery store) or blind dates; correspondence via telephone and letter writing (before advent of internet); socially mediated progression — couple begins to date; family repeatedly questions whether relationship serious; couple eventually becomes engaged; societal pressure “pushes” couple into having wedding, then into having children (couples tend to “cave in” to pressure to take “next step”)

Abundance and strength: key terms; refer to how one views ability to care for one’s self (ie, have own place, job, and money; also suggests ability to avoid feelings of failure if alone); examples from media — Peggy Sue Got Married (film suggests “something wrong” if woman has no date on Saturday night; message reinforced by society); television series Sex in the City

Importance to marriage: marriage of 2 individuals with “abundance and strength perspective” most likely to be successful; such couples go to counseling for retooling, rather than divorce

Consequences of lacking abundance and strength: characteristic of majority of couples requiring counseling; reasons people marry despite lack of abundance and strength — in order move out of parents’ house; because they have no other place to go; fear of being alone; desire to parent (need to find co-parent); examples from media — Shall We Dance (female character gives reason for marriage [“if we connect with to somebody else in a marriage, we have a witness for our lives”]; sums up marriage that comes from abundance and strength; Mirror Has Two Faces (male character suggests marriage to female colleague and friend based on companionship, rather than sexual attraction or physical intimacy; female character eventually falls in love with mate; however, new-found self-esteem (ie, abundance and strength) brings her to realization that she desires full relationship, despite confusion and complications that accompany true romance

Reasons couples enter treatment: differences in parenting decisions; decline in or cessation of sexual intimacy; infidelity (sometimes, couples enter treatment in order to have witness for their anger; [“anger is a cover for fear”]); differences in housekeeping decisions (eg, which partner responsible for particular chores); despite having ≥1 of preceding issues, one or both spouses want to save, or, to end, marriage

Clinician as investigator: ask about first date and how couple met; observe body language; notice whether partners finish one another’s sentences or look at one another as they relate story (watch communication; assess interaction in waiting room; observe whether partners change as story unfolds [may bring up positive aspects of marriage]); regardless of level of hostility, members of couple remember reasons relationship formed; assess what issues brought couple to therapy; determine whether couple wants to stay together or desires civil separation; some couples want script for telling children about divorce without acrimony

Reasons marriages fall apart: lack of communication; maladaptive communication styles; unfulfilled expectations

Examples from films: Funny Girl has song lyrics “I am woman, you are man; I am smaller, so you can be taller than” (makes reference to common expectations about husband being taller, older, and more financially secure; people focus on these qualities, rather than on those that truly matter in relationship; expectations originating from family of origin — in The Story of Us, couple married 15 yr contemplates trial separation; they recall remarks of one therapist who said that couples bring things from their parents into marriage; in following imaginary scene, husband, wife, and parents of both appear together in marriage bed; even trivial matters rooted in family of origin (eg, how dishwasher loaded, how towels folded and put away) can bring couples to therapy

Using movies in couples therapy: speaker often assigns watching movie as homework for couple; whether both partners watch movie indicates commitment to working on relationship; consider which partner initiated therapy and whether other partner less willing to participate; The Break Up — female character wants her partner to wash dishes after dinner party; when male partner expresses desire to defer chore, argument ensues, during which girlfriend complains that “she wants him to want to do dishes”; About Last Night — couple moves in together; after hosting holiday dinner, couple discovers differences in their expectations (woman tried to have celebration of holiday that mimicked similar occasions experienced with her parents; man criticizes her desire to recreate “Norman Rockwell painting”); parents who have had long healthy marriage can provide model for children’s relationships, but superimposition of such models on cohabitating relationship not always feasible; Two for The Road — story of progression of couple’s marriage over 10-yr period; fighting and infidelity of both partners occur; resolution comes with recognition that “marriage is for life”; teaches that arguing with spouse does not mean divorce inevitable; speaker also cautions that absence of fighting does not necessarily indicate unhealthy relationship (some couples find ways to have reasonable adult communication without arguing)

Exercise for couples (1): ask both partners to draw square, circle, triangle, plus sign, and spiral, and then to rank each shape as their first, second, third, fourth, or fifth favorite; speaker states that preferences give information about person’s state of mind

Interpretation of preferences: square — stability and security; circle — wholeness, independence, and desire to develop one’s own identity; triangle — identifying, pursuing, and attaining goals and dreams; plus sign — relationships, integration, and need for connection; spiral — growth, evolution, and need for change; rank chosen for each shape significant to individual at that moment; shape ranked first (most favorite) represents where individual is or would like to be; couples with discordant ranking “not on the same page”; match of 3 of 5 symbols suggests couple has strong connection; after explaining meaning of each shape, discuss implications of ranking

Exercise for couples (2): from Huffington Post, “31 Ways to Know You’re in the Right Relationship”; addresses issues of privacy and confidentiality (eg, whether person feels need to have total access to partner’s information [speaker believes this to be unnecessary, regardless of length of marriage or relationship]); clinician can explore client’s rationale for privacy preferences

Effects of internet on relationships: background checks — common when dating; speakers warns that although dating websites represent positive concept, “scammers” now pervasive on social media sites; secret “plan B” — individuals with fear of being alone use internet to have emotional affairs within committed relationship (ie, another potential partner “lined up” in case current relationship does not work out)

Exercise for couples (3): addresses ability to maintain sense of self; those who lack ability become codependent and have difficulty determining own wants and needs; have couple faces one another across room; after identifying which party drives anger or conflict in relationship, ask this individual what he or she wants; often, such individuals can state what they do not want, but not what they do want

Exercises for couples (4): members of couple face one another across room; clinician has one partner tell other something he or she wants the other to know; listener asked to tell partner what was said (ie, practice reflective listening); often difficult for partners to repeat what other says without injecting reactions to partner’s comments (speaks to communication and selective hearing)

Practices of couples with successful relationships: talk about sex; engage in arguments; have time together without talking; use terms “always” and “never” cautiously; members of couple should look at one another across room; do not take one another for granted; remember “little things” (eg, say “thank you” and be able to make sincere amends)

Examples from films: The Four Seasons — 3 couples; one couple breaks up, but other 2 provide good representation of long-term communication between 2 people in working couple; couples discuss whether partners still “thoughtful”; one falls in love with spouse repeatedly over course of long marriage, while, at other times, “couple drives each other crazy”; On Golden Pond — husband and wife have successful relationship and love one another; she no longer gets “worked up” if he does something wrong; he depends on her to have positive attitude, while she depends him to be realist

Foundations of good relationship: speaker refers to work of Glasser, who identified “seven deadly habits that destroy relationships” (eg, contempt, criticism) and “seven caring habits” (eg, acceptance); important considerations when choosing life partner — whether partners admire one another; whether partners would want to have children with one another; whether members of couple could spend rest of their lives together without changing one another (ie, couples should not assume that problems can be “fixed” after marriage)

Ending marriage with honor: emotion of hate equally strong as that of love; other common emotions associated with divorce include bewilderment, sadness, anger, fear, and loneliness

Examples from films: Kramer vs Kramer — father learns to survive after divorce; The Way We Were — couple too philosophically far apart to be together; lessons — both films about coming to acceptance, and finding ways to collaborate and cooperate; communication is key

Obstacles faced after divorce: patterns of old relationship may imprint on new relationship; dating — children should not be expected to accept new partner or meet every person parent dates; feelings of failure often motivate divorced parents to prove themselves desirable by entering into sexual relationships, but children need not be cognizant of this; children need to be allowed to grieve loss of absent parent

Changing patterns from past: explore parent-child dynamics; patterns from past provide tools for learning how to be better as individual in order to be better in relationship

Learning from mistakes: therapy offers corrective emotional experience; client should reflect on own mistakes in relationship (per accusations made by former spouse, and own admissions of wrongdoing) to try to avoid repeating these in new relationship; speaker cites example of divorced couple in film, A New Life

“Fear vs love” (Martha Beck): anger provides cover for fear; clinicians should assess fear underlying anger in couple’s arguments about sex and money, as anger may reflect pattern learned from family of origin (eg, financial worries may have been source of parent’s anger

Conclusion: couples counseling interesting and fulfilling due to “moments of connection,” regardless of whether couple staying together or parting

Acknowledgements

Ms. Shinbaum was recorded at Creativity and Madness: Psychological Studies of Art and Artists, held July 30 to August 3, 2012, in Santa Fe, NM, and presented by the American Institute of Medical Education. For information on other meetings hosted by the American Institute of Medical Education, please visit creativityandmadness.com. The Audio-Digest Foundation thanks Ms. Shinbaum and the American Institute of Medical Education for their cooperation in the production of this program.

CME/CE INFO

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The Audio- Digest Foundation is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Audio- Digest Foundation designates this enduring material for a maximum of 0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

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Lecture ID:

PG012201

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