The treatment of somatization: Teaching techniques of reattribution

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Abstract

Patients commonly present to general practitioners with somatic symptoms for which no adequate physical cause can be found, which are accompanied by the symptoms of an anxiety state or a depressive illness. These illness pose a major public health problem, but little is known about optimal management. A three stage model is proposed to encourage patients to reattribute these symptoms, and relate them to psychosocial problems. These stages are; feeling understood; changing the agenda; and making the link. A videotaped learning package is described suitable for use with vocational trainees in general practice, consisting of demonstrations of component parts of the model followed by micro-teaching, as a preliminary to video-feedback of actual interviews with such patients.

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