CBT for Long-Term Conditions and Medically Unexplained Symptoms: A Practitioner’s Guide PDF
Preview CBT for Long-Term Conditions and Medically Unexplained Symptoms: A Practitioner’s Guide
CBT for Long-Term Conditions and Medically Unexplained Symptoms CBT for Long-Term Conditions and Medically Unexplained Symptoms describes how cognitive behavioural therapy (CBT) can be used to treat anxiety and depression with a co-morbid long-term physical health condition (LTC) or medically unexplained symptoms (MUS). The book teaches cognitive behavioural therapists and other clinicians to help patients deal with the psychological aspects of physical symptoms, whatever their cause. It is divided into three parts, beginning with core skills for working with people with LTC and MUS. This includes assessment, formulation and goal setting. Part II focuses on CBT for LTC and includes chapters on low- intensity interventions, working with depression and anxiety using protocols, and a consideration of an identity and strengths-based approach to working with LTC. The final part provides details of a formulation-driven approach to working with MUS, broken down into individual chapters on working with behaviours, cognitions and emotions. With numerous case examples, the book provides accessible and practical guidance for mental health professionals, particularly CBT practitioners, working with anyone with long-term conditions or MUS. Philip Kinsella is a CBT practitioner specialising in psychological medicine, and a lecturer in CBT at Nottingham university training IAPT practitioners. He is the co-author of Cognitive Behavioural Therapy for Mental Health Workers and author of Cognitive Behavioural Therapy for Chronic Fatigue Syndrome. Dr Helen Moya is a CBT practitioner and Chartered Psychologist. She currently works in a UK IAPT service and has her own private practice. Previously the Course Director of a CBT training programme at the University of Nottingham, she has an academic background rooted in psychology and mental health. CBT for Long-Term Conditions and Medically Unexplained Symptoms A Practitioner’s Guide Philip Kinsella and Helen Moya First published 2022 by Routledge 2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN and by Routledge 605 Third Avenue, New York, NY 10158 Routledge is an imprint of the Taylor & Francis Group, an informa business © 2022 Philip Kinsella and Helen Moya The right of Philip Kinsella and Helen Moya to be identified as authors of this work has been asserted by them in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. British Library Cataloguing-in-Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging-in-Publication Data Names: Kinsella, Philip, author. | Moya, Helen, author. Title: CBT for long-term conditions and medically unexplained symptoms : a practitioner’s guide / Philip Kinsella and Helen Moya. Description: Milton Park, Abingdon, Oxon New York, NY : Routledge, 2022. | Includes bibliographical references and index. Identifiers: LCCN 2021024521 (print) | LCCN 2021024522 (ebook) | ISBN 9780367424893 (hardback) | ISBN 9780367424879 (paperback) | ISBN 9780367824433 (ebook) Subjects: LCSH: Long-term care of the sick. | Cognitive therapy. Classification: LCC RT120.L64 K56 2022 (print) | LCC RT120.L64 (ebook) | DDC 362.16—dc23 LC record available at https://lccn.loc.gov/2021024521 LC ebook record available at https://lccn.loc.gov/2021024522 ISBN: 978-0-367-42489-3 (hbk) ISBN: 978-0-367-42487-9 (pbk) ISBN: 978-0-367-82443-3 (ebk) DOI: 10.4324/9780367824433 Typeset in Times New Roman by Apex CoVantage, LLC PK dedication: to my wife Hazel, for her kindness and support. HM dedication: I dedicate this book to my family, who have always supported me through all my endeavours and adventures. Contents List of figures and tables ix Introduction 1 PART I Core skills to treat long-term medical conditions, and medically unexplained symptoms 3 1 Core skills in understanding and helping this patient group 5 2 Assessment and formulation 18 3 Measuring problems, establishing suitability and negotiating goals 35 PART II Treatment approaches: low intensity, protocol and formulation-based CBT for long-term conditions 43 4 Low-intensity work with health conditions 45 5 Cognitive therapy for depression in long-term conditions 59 6 ACT and third wave approaches to depression in long- term conditions 73 7 Skills in working with anxiety disorders in long-term conditions 86 8 A different angle: helping patients maintaining identities through life story work, social interaction and strengths- based CBT 106 viii Contents PART III A formulation approach to medically unexplained symptoms 119 9 Making sense of MUS, through a formulation approach 121 10 CBT from the inside out: a lived experience account 129 11 Ways of helping MUS patients to change negative behaviours 137 12 Skills in working with cognition 151 13 Aiding patients with emotional expression and regulation 166 14 Identifying and helping patients who are fearful of recovery 177 References 186 Index 204 Figures and Tables Figures 1.1 Overlap of problems 10 3.1 Pathway after assessment 35 6.1 Watering can 75 6.2 Rumination graph 77 6.3 Values compass 83 14.1 Fear of recovery 179 Tables 1.1 Long-term conditions (the patient may have one of these and develop anxiety/depression) 6 1.2 Common medically unexplained symptoms and diagnostic labels by medical speciality 8 2.1 Common formulation problems and actions 26 2.2 Common presentations and maintenance factors, as seen in clinical practice or in the literature 30 3.1 Questionnaires 36 3.2 Generic diary 37 3.3 Behavioural responses 38 4.1 Benefits of BA 47 4.2 Factors associated with outcomes 48 4.3 Case study BA for depression – Tanya 49 4.4 Some of the common self-help resources available currently in the UK 55 5.1 Comparison of CT for depression approach with Behavioural Activation (BA) 61 5.2 Troubleshooting problems with activity scheduling 63 5.3 Working with NATS in LTC 66 5.4 CT skills in LTC 67 5.5 Case study – John 67
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