Concordance of Illness Representations: The Key to Improving Care of Medically Unexplained Symptoms

How can effective patient-provider relationships be developed when the underlying cause of the health condition is not well understood and becomes a point of controversy between patient and provider? This problem underlies the difficulty in treating medically unexplained symptoms and syndromes (MUS; e.g., fibromyalgia, chronic fatigue syndrome), which primary care providers consider to be among the most difficult conditions to treat.1 This difficulty extends to the patient-provider relationship which is characterized by discord over MUS.1 In this article, we argue that the key to improving the patient provider relationship is for the patient and provider to develop congruent illness perceptions about MUS

Toward a Broader Understanding of Split Alliances in Family Therapy: Adding the Therapist to the Mix

Financiado para publicación en acceso aberto: Universidade da Coruña/CISUG[Abstract] To broaden our understanding of a split alliance in fam-ily therapy, we investigated the frequencies and correlates of sessions in which therapists, youth, and caregivers re-ported markedly different perceptions of the alliance. The sample consisted of 156 Spanish families who received Alliance Empowerment Family Therapy (Escudero, Adolescentes y familias en conf licto, 2013) for child mal-treatment. Family members and therapists rated the al-liance on the SOFTA-s (Friedlander et al., Journal of Counseling Psychology, 2006, 53, 214) after sessions 3, 6, and 9; family members rated their perceptions of treat-ment progress before sessions 4, 7, and 10. A cluster analy-sis differentiated sessions with a split adult- youth alliance(27.7%) from a split family- therapist alliance (44.1%), and a balanced alliance (similar ratings across the three per-spectives; 28.2%). Client- rated treatment progress was dif-ferentially associated with the type of alliance split and the average alliance rating, whereas better posttreatment outcomes (child functioning and family goal attainment) were associated with fewer sessions having either type of split allianceThis study was carried out with the collaboration of the Program for Therapeutic Treatment of Children and Adolescents at Risk, financed by the Xunta de Galicia, Spai

Psychometric study of the differentiation of self scale-revised in a sample of Spanish adults

This study analyzes the psychometric properties of the Differentiation of Self Scale-Revised (DSS-R), an instrument assess-ing the differentiation of the self of Spanish adults through the dimensions I Position, Emotional Reactivity, Fusion with Others and Emotional Cutoff, and of a new dimension, Dominance over Others. In Study 1, carried out with 1445 subjects, exploratory factor analysis was performed with one half of the participants, and confirmatory factor analysis with the other, comparing the five-factor and bifactor models. In Study 2, examining convergent validity, 180 subjects participated and completed the revised scale and the Differentiation of Self Inventory-Revised. Studies 3 and 4 verified concurrent validity, with 401 subjects completing the DSS-R and the State-Trait Anxiety Inventory in Study 3, and 170 subjects completing the DSS-R and the Couple Assertion Questionnaire in Study 4. Adequate internal consistency indices and evidence of construct, convergent and concurrent validity were found. The use of the DSS-R is recommended for assessing the differentiation of the self in the Spanish population

The Common Sense of Counseling Psychology: Introducing

The goal of therapy is typically to improve clients’ self-management of their problems, not only during the course of therapy but also after therapy ends. Although it seems obvious that therapists are interested in improving client’s self-management, the psychotherapy literature has little to say on the topic. This article introduces Leventhal’s Common-Sense Model of Self-Regulation, a theoretical model of the self-management of health, and applies the model to the therapeutic process. The Common-Sense Model proposes that people develop illness representations of health threats and these illness representations guide self-management. The model has primarily been used to understand how people self-manage physical health problems, we propose it may also be useful to understand self-management of mental health problems. The Common-Sense Model’s strengths-based perspective is a natural fit for the work of counseling psychologists. In particular, the model has important practical implicationsfor addressing how clients understand mental health problems over the course of treatment and self-manage these problems during and after treatment

Medically Unexplained Physical Symptoms: Why Counseling Psychologists Should Care About Them

Medically unexplained symptoms and/or syndromes (MUS) affect the health of 20% to 30% of patients seen in primary care. Optimally, treatment for these patients requires an interdisciplinary team consisting of both primary care and mental health providers. We propose that counseling psychologists may develop expertise to improve the care of patients with MUS who are already in their practice, expand the number of patients they help, and enhance the integration of counseling psychology into the broader medical community. Additionally, counseling psychologists’ expertise in culture, attunement to therapeutic processes, and focus on prioritizing patients’ perspectives and quality of life can fill the gap in research on MUS. By focusing on MUS, counseling psychologists can provide unique contributions to health service delivery

Medically Unexplained Physical Symptoms: Why Counseling Psychologists Should Care About Them

Medically unexplained symptoms and/or syndromes (MUS) affect the health of 20% to 30% of patients seen in primary care. Optimally, treatment for these patients requires an interdisciplinary team consisting of both primary care and mental health providers. We propose that counseling psychologists may develop expertise to improve the care of patients with MUS who are already in their practice, expand the number of patients they help, and enhance the integration of counseling psychology into the broader medical community. Additionally, counseling psychologists’ expertise in culture, attunement to therapeutic processes, and focus on prioritizing patients’ perspectives and quality of life can fill the gap in research on MUS. By focusing on MUS, counseling psychologists can provide unique contributions to health service delivery.This article is published as McAndrew, Lisa M., Myrna L. Friedlander, David R. Litke, L. Alison Phillips, Justin M. Kimber, and Drew A. Helmer. "Medically unexplained physical symptoms: Why counseling psychologists should care about them." The Counseling Psychologist 47, no. 5 (2019): 741-769. DOI: 10.1177/0011000019888874.</p