Behavioural mechanisms and cognitive-behavioural interventions of somatoform disorders.
Due to the lack of adequate cure or medication for somatoform disorders, cognitive-behavioural intervention or cognitive-behavioural therapy (CBT) seems to be an optimal treatment resource for patients with these disorders, since the cause of the somatoform disorders cannot to be explained by medical illness, but can be analyzed in the process of both responding and operant conditioning. According to the reviews, randomized controlled trials are limited, but the efficacy of the intervention is quite impressive. Most of the studies use multiple treatment strategies, and no standardized treatment methods have been established. In general, the following steps are taken in CBT treatments: (1) assessment; (2) rationale of treatment choice; (3) course of treatment; (4) evaluation of treatment; and (5) reviewing treatment effects. In CBT, functional analysis in the assessment session is the key to success, to identify the relationship among discriminative stimuli and consequences, in order to reduce the undesirable behaviour, and the most effective approach of the treatment would be a combination of multiple techniques. However, as the efficacy of the treatments is established, expansion of accurate knowledge of functional analysis and training sessions for health care providers and patients should be provided. Further research should explore the effect of individual techniques, and comparison should be made to identify the relative benefits of the techniques using both individual, and group format.
Tazaki
Miyako
M
Tokyo University of Science, Tokyo, Japan. tazaki@iijmio-mail.jp
Landlaw
Kenneth
K
D015928:Cognitive Behavioral Therapy; D003214:Conditioning, Classical; D003216:Conditioning, Operant; D006801:Humans; D010348:Patient Care Team; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D012803:Sick Role; D013001:Somatoform Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*