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Talk Therapy Plus Self-Help May Fight Pain

Study Shows Talk Therapy and Self-Help Workbook Help Patients With Unexplained Symptoms
WebMD Health News
Reviewed by Laura J. Martin, MD

July 27, 2011 -- Cognitive behavior therapy (CBT) that incorporates a self-help workbook may help people with pain, weakness, dizziness, and other symptoms -- with no underlying physical disease -- to feel and function better, a study shows.

The study is published in Neurology.

CBT is a time-limited course of talk therapy that aims to improve symptoms by changing the way people think about and cope with their symptoms. It can be helpful on its own. But access to CBT can be an issue in certain communities.

The new method incorporates a self-help workbook to overcome these barriers by giving people the tools to practice on their own. Study participants are taught how to use this workbook during four, 30-minute counseling sessions over a three-month period by a nurse or therapist.

The workbook explains symptoms as changes in the nervous system that are influenced by behavioral and psychological factors. It provides self-management tips on reducing "unhelpful thinking" about coping with symptoms, as well as homework assignments.

After three months, the 62 participants who received the self-help workbook with counseling were about twice as likely to report improvements in their overall health as those who did not. All participants received usual medical care which may include antidepressants and pain drugs.

Thirteen percent more people in the CBT group said their health was "better" or "much better" compared to those who received usual care. These improvements waned after six months, but those receiving the CBT continued to show greater improvement in their symptoms, physical functioning, and were more satisfied with their treatment. Most of the participants in the study also had psychiatric diagnoses such as panic disorder, anxiety disorder, and depression.

Unexplained Symptoms

"Functional or unexplained symptoms make up approximately a third of patients attending neurology clinics," says study researcher Michael Sharpe, MD, a psychiatrist at the University of Edinburgh, U.K. "These are symptoms which occur either without any disease or which seems markedly disproportionate to any disease that is present."

"We know that in the majority of cases these symptoms do not disappear after an assessment with a neurologist who tells them that they are not due to disease," he says.

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