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Patients with medically unexplained physical symptoms experience of receiving treatment in a primary-care psychological therapies service: a qualitative study

Published online by Cambridge University Press:  30 June 2015

Chloe Gerskowitch ,
Ian Norman  and
Katharine A. Rimes
Chloe Gerskowitch*
Affiliation:
King's College London and South London and Maudsley NHS Trust, London, UK
Ian Norman
Affiliation:
King's College London, Florence Nightingale School of Nursing & Midwifery, London, UK
Katharine A. Rimes
Affiliation:
King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
*
*Author for correspondence: C. Gerskowitch, King's College London and South London and Maudsley NHS Trust, London, UK. (email: [email protected])
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Abstract

As a pilot site under the primary-care Increasing Access to Psychological Therapies (IAPT) Long Term Condition/Medically Unexplained Physical Symptoms (MUPS) project, patients with MUPS were offered cognitive behaviour therapy (CBT)-based treatments or attendance at a mindfulness-based stress reduction (MBSR) programme. This study aimed to gain an understanding of the views and experiences of MUPS patients that received CBT-based therapy or MBSR within an IAPT service and to investigate the relationship between their experiences and health outcomes measured on self-report questionnaires. Thematic analysis was used to analyse data gathered via semi-structured interviews with 11 patients. Data collected from three self-report measures were considered in relation to key features of participants’ reported experiences and patterns identified. Four main themes emerged: (1) something needs to change; (2) making connections between physical symptoms and mood, thoughts or activities; (3) sharing experiences and feeling understood; and (4) reflections on treatment experience. Participants generally reported a positive experience of treatment and felt better able to cope with their symptoms, although treatment did not necessarily result in reliable change in symptoms as measured by the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7) and Work and Social Adjustment Scale (WSAS). This novel model of treatment appears to be acceptable for this patient group although evaluation of the pilot should consider the ability of routinely used measures to capture the value of treatment to patients, including improved coping with symptoms.

Keywords

CBTprimary careMBSRmedically unexplained physical symptoms (MUPS)qualitative
Type
Original Research
Information
the Cognitive Behaviour Therapist , Volume 8 , 2015 , e12
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2015 

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References

Recommended follow-up reading

DoH (2008). Medically unexplained symptoms positive practice guide (www.iapt.nhs.uk). Department of Health, London.Google Scholar
University of Surrey Evaluation Team (2013). IAPT LTC/MUS pathfinder evaluation project – phase 1 (www.iapt.nhs.uk).Google Scholar

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