Manualized psychodynamic-interactional group therapy for the treatment of somatoform pain disorders

Abstract

Medically unexplained and clinically significant symptoms of pain are highly prevalent in the general population. More than one third of all patients in general practices and various departments of hospitals suffer from somatoform disorders with pain being the main complaint of 70% of these patients. This treatment manual is the first disorder-specific, psychodynamically oriented treatment for these patients. Based on psychodynamic-interactional group psychotherapy, it focuses on disorder-specific aspects as well as on psychic and interpersonal problems which have resulted from adverse childhood experiences and insecure attachment. In three treatment phases comprising an "information and motivational phase" followed by "work" and ultimately "transfer" phase spread over a period of 6 to 7 months, between seven and nine patients were treated in 40 group therapy sessions. The group started with psychoeducational elements intended to inform them about their illness. Through the discussion and formulation of individual treatment goals, the patients are drawn into the work phase of the group therapy, in which the relationship of the patients in the group and their behavior is the main focus of the therapeutic interventions.

Effects of exercise and group counselling on body composition and VO2max in overweight women with polycystic ovary syndrome

“…We do not know whether the food intake changed, but in the group counselling, women's current experience of their disease provided background for each session. The possibility to express disease‐related emotions such as food craving or lack of motivation in a group situation might have enabled the participants to consider their behavior and attitudes in a supportive environment . The women who started to lose weight during the counselling period increased their weight loss and their fitness level during the exercise period.…”

“…The aim of the counselling sessions was to examine psychological aspects such as motivation and barriers for physical activity. The group counselling focused on disorder‐specific aspects as well as interpersonal problems as a result of earlier experiences . This included a focus on group cohesion, corrective emotional experiences, similarities in suffering, and group climate.…”

“…Psychological group counselling focuses on disorder‐specific aspects as well as on interpersonal problems which have resulted from earlier experiences. The relationship between women in the group and their behavior is central, and treatments combining psycho‐educational, disorder‐specific and transfer‐oriented aspects show positive results . In the present study we assessed the impact of high‐intensity training combined with group counselling sessions on anthropometry measures and cardio‐respiratory fitness in overweight and obese women with PCOS.…”

Effectiveness of a Multimodal Treatment Program for Somatoform Pain Disorder

“…In addition to traumatic life experiences, gender, socioeconomic status, and education level seem to influence somatoform pain disorder onset and course . Cognitive‐behavioral models focus on the phenomenon of somatosensory amplification, which means that due to an interceptive perception style, normal physical sensations tend to be perceived more intensely and are interpreted as signs of a somatic illness . Because of the patient's strong belief in an underlying somatic illness, they frequently seek further somatic diagnostics and therapy.…”

Unsichere Bindung – Ein entwicklungspsychologisches „missing link” zur Erklärung somatoformer Störungen?

“…Die klinische Bindungsforschung der letzten Jahre hat eine Reihe von Befunden geliefert, die das Verständnis somatoformer Störungen um eine entwicklungspsychologische Dimension erweitert hat und das klinisch oft beschriebene Phänomen einer eher "alexithymen" Art der Symptombeschreibung mit der auf der Basis früher Interaktionen entwickelten Strategie des Rückzugs aus Gründen des Selbstschutzes erklären [6]. Dieser Befund hat bereits Eingang gefunden in störungs-orientierte Behandlungsansätze bei somatoformen Schmerzstörungen [7] und könnte in Zukunft auch dazu anregen, die oft schwierige ArztPatient-Interaktion bei Patienten mit somatoformen Störungen besser zu verstehen [8].…”