Learning Objectives
- Describe treatment options for somatic disorders.
Treatment for these disorders is often difficult as individuals see their problems as completely medical, and therefore, do not think psychological intervention is necessary (Lahmann, Henningsen, & Noll-Hussong, 2010). Once an individual does not find relief from their symptoms after meeting with several different physicians, they often do willingly engage in psychotherapy, psychopharmacology, or both (Raj et al., 2014).
Among the most effective treatment approaches is the biopsychosocial model of treatment. This approach considers the various biological, psychological, and social factors that influence the illness and presenting symptoms (Gatchel et al., 2007). This treatment is often achieved through a multidisciplinary approach where the symptoms are managed by many providers, usually including a physician, psychiatrist, and psychologist. The interdisciplinary approach involves a higher level of care as the multiple disciplines interact with one another and identify a treatment goal (Gatchel et al., 2007). This approach, although more difficult to find, particularly in more rural settings, is presumed to be more effective due to the integration of health care providers and their ability to work together to treat the patient uniformly.
Psychotherapy
8.5.1.1. Psychodynamic. Interpersonal psychotherapy, a type of psychodynamic therapy, has been found to be efficacious in treating somatic disorders. Interpersonal psychotherapy focuses on the relationship between self-experience and the unconscious, and how these factors contribute to body dysfunction. This type of treatment has been shown to reduce anxiety, depression, and improve the overall quality of life immediately following treatment; however, effects appear to diminish over time (Abass et al., 2014; Steinert et al., 2015).
8.5.1.2. CBT. Traditional cognitive-behavioral therapies (CBT) have been employed to address the cognitive attributions and maladaptive coping strategies that are responsible for the development and maintenance of the disorder. The most common misattribution for these disorders is catastrophic thinking, or the rumination about worst-case scenario outcomes. Additionally, goals of CBT treatment are the acceptance of the medical condition, addressing avoidance behaviors, and mediating expectations of treatment (Gatchel et al., 2014).
8.5.1.3. Behavioral. Behavioral therapies have also been shown to effectively manage complex chronic somatic symptoms, particularly pain. The behavioral approach involves bringing attention to physiological symptoms, the individual’s attribution to those symptoms, and the subsequent anxiety produced by the negative attributions (Looper & Kirmayer, 2002).
Psychopharmacology
Psychopharmacological interventions are rarely used due to possible side effects and unknown efficacy. Given that these individuals already have a heightened reaction to their physiological symptoms, there is a high likelihood that the side effects of medication would produce more harm than help. With that said, psychopharmacological interventions may be helpful for those individuals who have comorbid psychological disorders such as depression or anxiety, which may negatively impact their ability to engage in psychotherapy (McGeary, Harzell, McGeary, & Gatchel, 2016).
Key Takeaways
You should have learned the following in this section:
- The biopsychosocial model of treatment is one of the most effective for somatic disorders as it considers the various biological, psychological, and social factors that influence the illness and presenting symptoms and includes a multidisciplinary approach.
- Psychotherapy options include interpersonal psychotherapy, CBT, and behavioral.
- Psychopharmacological interventions are rarely used for somatic disorders due to the side effects of the medication producing more harm than good. When used, they deal with comorbid disorders such as depression or anxiety.
Review Questions
- Discuss the difference between multidisciplinary and interdisciplinary approaches to treatment of somatic disorders.
- What is the biopsychosocial model for treatment of somatic disorders? What are the three main components of this treatment?
- Are there any treatments that are not effective in treating somatic disorders? If so, why?
