BABCP 2023 Cardiff (British Association for Behavioural & Cognitive Psychotherapies)

[Sly Saint]

pre conference workshop:

Workshop Nine

Treating distress and persistent symptoms in people with physical health conditions: a process focused approach

Trudie Chalder, King’s College London, South London and Maudsley NHS Trust

More information...
Around 15 million people in the UK have a physical health condition which is long lasting ie. diabetes and inflammatory disease. Other serious health problems such as cancer can be treated with curative intent, but patients may be left with poor quality of life due to fear of recurrence and uncertainty.

Anxiety and depression are common and can be associated with difficulties with adjustment and / or may be linked to pre-existing difficulties such as low self-esteem. Impairment (degree of pathology) is not correlated with disability and multi-morbidity is common.

A transdiagnostic model of understanding common, physiological, cognitive, attentional and behavioural responses often perpetuate distress, symptoms, poor functioning and low quality of life.

This workshop focuses on how, illness behaviour, attentional, physiological and cognitive processes can be targeted in therapy to enable people to lead more fulfilled lives.

Key learning objectives:

1. To develop an understanding of the transdiagnostic model
2. To draw on a suite of interventions to target transdiagnostic processes

Trudie Chalder is Professor of Cognitive Behavioural Psychotherapy at King’s College London. She has worked as a clinician and a researcher in the area of long-term conditions and functional symptoms for about 30 years. She develops specific cognitive behavioural models for understanding and treating symptoms and distress in these conditions and evaluates the approaches within the context of randomised controlled trials in primary and secondary care. The primary focus is always on improving people’s quality of life. Her research involves investigating not only whether treatment works in the context of gold standard randomised controlled trials but how and for whom it works. Her work spans adolescents and adults.

Key references

Armes J, Chalder T, Addington-Hall J, Richardson A, Hotopf M. (2007) A randomized controlled trial to evaluate the effectiveness of a brief, behaviorally oriented intervention for cancer-related fatigue. Cancer. 110(6):1385-95. doi.org/10.1002/cncr.22923

Chalder T, Patel M, James K, Hotopf M, Moss-Morris R, Ashworth M, Watts K, David AS, Husain M. PRINCE Secondary: Transdiagnostic cognitive behaviour therapy for persistent physical symptoms. Psychol Med. 2021 Sept 7. doi.org/10.1017/S0033291721003615

James K, Patel M, Goldsmith K, Moss-Morris R, Ashworth M, Landau S, Chalder T. Transdiagnostic therapy for persistent physical symptoms: a mediation analysis of the PRINCE secondary trial. Behaviour Research and Therapy. 2022 Dec;159. doi.org/10.1016/j.brat.2022.104224

Matcham FAE, Ali S, Irving K, Hotopf MH, Chalder T. (2016) Are depression and anxiety associated with disease activity in rheumatoid arthritis? A prospective study. BMC Musculoskelet Disord. 2016;17(1):155. doi.org/10.1186/s12891-016-1011-1.

https://babcp2023.org/pre-conference-workshops

 

[JemPD]

shudder

 

[bobbler]

Genuine question: how are people/patients/subjects ending up under her?

What is the mechanism feeding her patients.

Transdiagnostic meaning noone I won't have and label with these assumptions, and once here I won't worry about what you've got or adapt treatment to that - as it is about assuming the issue is these rather hysterical women terms of 'distress' and 'low self-esteem' and the need being for their life to be 'more fulfilling' (I wonder what deep down she assumes that involves)

So it is pretty important if it isnt' people paying privately and/or seeking her out by choice having thought 'yep, that really applies to me' etc. because I want to know who she is really getting and what they think they actually have and might really have benefitted from, and what the pathway or mechanism between that is.

 

[Trish]

I don't think there will be any shortage of patients being referred by GP's to Chalder's sort of clinic. Anyone with fatigue, pain, irritable bowel, headaches, any physical symptom they can't diagnose...