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Psychological treatment in medical practice 

Psychological treatment in medical practice

Psychological treatment in medical practice

Michael Sharpe

and Simon Wessely

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date: 24 April 2017

Patients have minds as well as bodies, and medical treatment must often address both if it is to be effective.

Psychological treatments—these may be divided into general and specialist types. All medical consultations have an important and inescapable psychological effect, hence all physicians are general psychotherapists. All medical consultations have the potential for both psychological help and for harm. Helpful consultations educate the patient, reassure them, and achieve adherence to treatment. Harmful consultations leave the patient confused or with inaccurate ideas about their health, increase anxiety, and make adherence to the physician’s treatment less likely. Being able to deliver a psychologically helpful consultation is therefore a core medical skill.

Specialist psychological treatments—these also have an important role in medical practice. Referral to specialist services may be needed for patients who are distressed by their disease or its treatment, and for those who have medically unexplained symptoms (see Chapter 26.5.3). Short- and medium-term structured therapies such as cognitive behavioural therapy (CBT) are evidence-based treatments for these problems. Before the need to make a referral arises, physicians should familiarize themselves with what psychological treatments are available for their patients, how long they will have to wait to be seen, and how they will be received.

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