Layout: AV-gruppen, Århus Kommunehospital, Aarhus University Hospital The TERM-model for somatisation: the training of general practitioners Per Fink, MD, PhD, Dr.Med.Sc.

The Research Unit for Functional Disorders Layout: AV-gruppen, Århus Kommunehospital, Aarhus University Hospital Aarhus University Hospital The Research Unit for Functional Disorders The Definition of Somatization or functional disorders  Conditions where the patient complains of physical symptoms that cause excessive worry or discomfort or lead the patient to seek treatment, but for which no adequate organic or patho- physiological basis can be found. Fink 96

The Research Unit for Functional Disorders Layout: AV-gruppen, Århus Kommunehospital, Aarhus University Hospital Aarhus University Hospital The Research Unit for Functional Disorders The TERM Model - preconditions and aims  Acceptable and applicable in primary care  Mediation of knowledge  (aetiology, epidemiology, diagnostics, treatment, etc.)  Training of skills  Interview techniques  Treatment techniques  Change of attitude towards functional disorders

The Research Unit for Functional Disorders Layout: AV-gruppen, Århus Kommunehospital, Aarhus University Hospital Aarhus University Hospital The Research Unit for Functional Disorders The TERM Model Structure  A two-day residential course  3-4 follow-up meetings  Booster meeting after 1½ months  Facilitator visit after 6 months

The Research Unit for Functional Disorders Layout: AV-gruppen, Århus Kommunehospital, Aarhus University Hospital Aarhus University Hospital The Research Unit for Functional Disorders The TERM Model Educational Material  Theoretical folder  Work folder for the participants  Teacher’s folder  Demonstration video (patient examples) Available on:

INTRODUCTION 20 min. Exercise min. Video supervision 30 min. Exercise min. Video supervision 30 min. THEORY 20 min Break Modules Group exercise: As above There is a running rotation so all GPs will record at least one video with an actor Plenary: Theoretical presentation about functional illness Video supervision as above. Supervision of the video recording in groups of 8 persons 2 of the GPs interview an actor. The first interview is recorded on video Plenum: An introduction of the exercise, including a short video demonstration Group exercise: Training of specific skills in groups of 2 GPs

Fink P et al. Assessment and Treatment of Functional Disorders in General Practice: The Extended Reattribution and Management Model - An Advanced Educational Program for Nonpsychiatric Doctors. Psychosomatics 2002; 43:93-131

The Research Unit for Functional Disorders Layout: AV-gruppen, Århus Kommunehospital, Aarhus University Hospital Aarhus University Hospital The Research Unit for Functional Disorders The TERM Model - testing the effect  2 randomized controlled studies  79 general practitioners  Approx patients  Aarhus County  Vejle County  Follow-up after 1-2 years

The Research Unit for Functional Disorders Layout: AV-gruppen, Århus Kommunehospital, Aarhus University Hospital Aarhus University Hospital The Research Unit for Functional Disorders VERSPREIDING  170 PRAKTIJKEN  190 HUISARTSEN  24 DEELNEMERS PER REGIO  HUISARTSEN  Hebben meer vertrouwen  Bespreken meer PS-zaken  PATIENTEN  Meer tevreden  Minder lichamelijke klachten