Tailoring a cognitive behavioural model for unexplained physical symptoms to patient's perspective: a bottom-up approach.
The prevalence of unexplained physical symptoms (UPS) in primary care is at least 33%. Cognitive behavioural therapy has shown to be effective. Within cognitive behavioural therapy, three models can be distinguished: reattribution model, coping model and consequences model. The consequences model, labelling psychosocial stress in terms of consequences rather than as causes of UPS, has high acceptance among patients and is effective in academic medical care. This acceptance is lost when applied in primary care. To increase acceptance of the consequences model among patients in primary care, we tailor this model to patient's perspective by approaching the model from bottom-up instead of top-down. Subsequently, we use this tailored model in an easily accessible group training. We illustrate our approach using two illustrative cases.
Zonneveld
Lyonne N L
LN
Riagg Rijnmond, Vlaardingen, The Netherlands. lzonneveld@riaggrijnmond.nl
Duivenvoorden
Hugo J
HJ
Passchier
Jan
J
van 't Spijker
Adriaan
A
D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D015673:Fatigue Syndrome, Chronic / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D005260:Female; D005356:Fibromyalgia / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D019222:Mind-Body Relations, Metaphysical; D009426:Netherlands; D011615:Psychotherapy, Group / Q000379:methods*; D011788:Quality of Life / Q000523:psychology; D012064:Relaxation Therapy; D012648:Self Care / Q000523:psychology; D012803:Sick Role; D013001:Somatoform Disorders / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*