Moving on: the BodyMind ApproachTM for medically unexplained symptoms
| Date | 19 June 2017 |
| Pages | 63-71 |
| DOI | https://doi.org/10.1108/JPMH-10-2016-0052 |
| Published date | 19 June 2017 |
| Author | Helen Payne,Susan D.M. Brooks |
| Subject Matter | Health & social care,Mental health,Public mental health |
Moving on: the BodyMind Approach
TM
for medically unexplained symptoms
Helen Payne and Susan D.M. Brooks
Abstract
Purpose –The purpose of this paper is to summarise practice-based evidence from an analysis of outcomes
from a county-wide pilot study of a specialised primary care clinic employing an original approach for patients
with medically unexplained symptoms (MUS). Conditions with persistent bodily symptoms for which tests
and scans come back negative are termed MUS. Patients are generic, high health-utilising and for most there
is no effective current treatment pathway. The solution is a proven service based on proof of concept, cost-
effectiveness and market research studies together with practice-based evidence from early adopters. The
research was transferred from a university into a real-world primary care clinical service which has been
delivering in two clinical commissioning groups in a large county in England.
Design/methodology/approach –Clinical data calculated as reliable change from the various clinics were
aggregated as practice-based evidence pre- and post-intervention via standardised measurements on
anxiety, depression, symptom distress, functioning/activity, and wellbeing. It is not a research paper.
Findings –At post-course the following percentages of people report reliable improvement whencompared
to pre-course: reductions in symptom distress 63 per cent (39/62), anxiety 42 per cent (13/31) and
depression 35 per cent (11/31); increases in activity levels 58 per cent (18/31) and wellbeing 55 per cent
(17/31) and 70 per cent felt that they had enough help to go forward resulting in the self-management of their
symptoms which decreases the need to visit the GP or hospital.
Research limitations/implications –Without a full clinical trial the outcomes must be interpreted with
caution. There may be a possible Hawthorne or observer effect.
Practical implications –Despite the small numbers who received this intervention, preliminary observations
suggest it might offer a feasible alternative for many patients with MUS who reject, or try and find unsatisfying,
cognitive behaviour therapy.
Social implications –Many patients suffering MUS feel isolated and that they are the only one for whom
their doctor cannot find an organic cause for their condition. The facilitated group has a beneficial effect on
this problem, for example they feel a sense of belonging and sharing of their story.
Originality/value –The BodyMind Approach is an original intervention mirroring the new wave of research in
neuroscience and philosophy which prides embodiment perspectives over solely cognitive ones preferred in
the “talking”therapies. There is a sea change in thinking about processes and models for supporting people
with mental ill-health where the need to include the lived body experience is paramount to transformation.
Keywords Primary care, Embodiment, Practice-based evidence, Medically unexplained symptoms,
The BodyMind Approach
Paper type Research paper
Introduction
Medically unexplained symptoms (MUS) or, more recently, somatic symptom disorder (SSD)
is a long-term condition and global problem with very high health utilisation resulting in large
costs and wastage. The patients account for an estimated 15-30 per cent of primary care
consultations (Kirmayer et al., 2004) and doctors report that these can be among the
most challenging. Other studies in primary care show 19-50 per cent of visits are for MUS (Barsky
and Borus, 1995; Preveler et al.,1997;Reidet al., 2002). Furthermore, MUS account for more than
20 per cent of outpatient activity among frequent attenders (Reid et al., 2001) mainly in neurology,
gastroenterology, rheumatology, cardiology and gynaecology (Hamilton et al., 1996;
Received 23 October 2016
Revised 18 January 2017
Accepted 1 March 2017
Helen Payne is a Professor of
Psychotherapy at the School of
Education, University of
Hertfordshire, Hatfield, UK.
Susan D.M. Brooks is based
at Pathways2Wellbeing,
Hitchin, UK.
DOI 10.1108/JPMH-10-2016-0052 VOL. 16 NO. 2 2017, pp. 63-71, © Emerald Publishing Limited, ISSN 1746-5729
j
JOURNAL OF PUBLIC MENTALHEALTH
j
PAG E 63
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