Therapeutic activities and psychological interventions by cognitive behavioural and psychodynamic therapists working with medically unexplained symptoms: A qualitative study

Abstract

Aim: To explore therapeutic activities and psychological interventions used by experienced cognitive behavioural and psychodynamic therapists to treat clients with medically unexplained symptoms (MUS). Method: Twelve in-depth, semi-structured, qualitative interviews with psychotherapists, recruited from two British National Health Service (NHS) Departments were conducted. Interview transcripts were analysed using grounded theory. Findings: Therapists from two modalities share the following therapeutic activities and psychological interventions in their work with MUS clients: working together with clients, sensitive, empathic responding and building trust, being flexible with techniques, keeping an open mind and multi-disciplinary cooperation. They also use modality specific interventions discussed in this paper. Even though participants experienced difficulties in forming alliances with MUS clients early on in their work, they expressed the importance of nurturing hope, empowering and engaging clients in jointly constructing understandings, which helps symptom management.

Keywords:

• therapeutic activities
• psychological interventions
• qualitative
• medically unexplained symptoms
• cognitive behavioural therapy
• psychodynamic

Acknowledgements

I wish to thank all participants in this study. Thanks also go to Dr Anthony Bateman, Eric Karas and Dr Georgia Lepper for their support and advice.

This work was undertaken with the support of Barnet, Enfield, and Haringey NHS Mental Health Trust, who received funding from the NHS Executive; the views expressed in this publication are those of the authors and not necessarily those of the NHS Executive. The East Kent Hospitals NHS Trust Research and Development Department also supported the study.