1. Managing persistent bodily symptoms which have no medical explanation
Professor Helen Payne, University of Hertfordshire
Susan Brooks, Pathways2Wellbeing

2. What is MUS? e.g. chronic pain, chronic fatigue, IBS, fibromyalgia etc
MUS -Previously known as psychosomatic conditions/MUPS
Persistent, physical symptoms which do not appear to have an organic cause or respond to treatment
Clinical & social predicament, includes broad spectrum of presentations, difficulty accounting for symptoms based on known pathology (Edwards et al 2010)

3. Lack of Effective Interventions
Psychological therapies- disadvantages
Pain clinics- not all have pain/fail to integrate mind and body
Medication- can have pain/symptom relief
Alternative therapies- e.g. yoga, relaxation

4. MUS Characteristics 1
Fewer years in formal education (Creed, Barsky 2004)
Parental neglect/illness in childhood (for women) (Craig, Cox, Klein 2002)
Far more consultations, healthcare costs (£18 billion per year), & hospitalisations
High levels of health anxiety/anxiety; depression (Malhi 2013)
Aggravated by stress
Unnecessary procedures/surgery

5. MUS Characteristics 2 More sick leave/ likely to be unemployed
Comparable to MES in impairment of function/poorer quality of life than MES
Poorer general health & worse mental health
Poor affect regulation / needy of emotional support
Past/current family dysfunction and/or a history of trauma, neglect or abuse
Attachment issues (Adshead & Guthrie 2015)

6. Problems of MUS to patient and NHS
Emotional costs
Financial costs
Lack of self-management
Isolation
NHS:
GPs frustration
Health care costs (primary/secondary)
GP lack of capacity
Wastage

7. The BodyMind Approach™
Based on research conducted at UH; practice-based evidence since
Derived from AM & Mindfulness, group work & integrative psychotherapy
Physical symptom acts as gateway to the mind
‘Playing with the symptom so it does not play on you’
Promotes wellbeing and resilience leading towards Recovery

8. Structure of courses
Up to 12 patients per group, 12 x 2 hour workshops
Inclusion /exclusion criteria
Triage/assessment/monitoring
Variety of symptoms
Two phases- over 12 months
Facilitated groups

9. Experiential Practice
Self care - hand massage
Breathing practice
2s discuss with partner how your body reacted when shocked

10. Assessment Tools
Standardised measurements: Pre, post and at 6 month follow up
MYMOP (symptom/activity/wellbeing)
PHQ9 (depression)
GAD (anxiety)
GAF (functioning)
In-house questionnaire (demographics)

11. Real-world Lessons Learned
Champion
Self / Other health professionals referral
No time and venue on adverts
Patients failing to return PEF
Responding to locality requests for courses
We need to recruit more facilitators
Trialling of individual sessions
Promote cross referrals between IAPT and p2w

12. Outcomes comparing pre to 6 month follow up Wellbeing:

13. Symptom Severity:

14. Difficult Activity:

15. Global Functioning:

16. Overall MYMOP2:

17. Anxiety:

18. Other data 87.5% of participants completed sessions.
The 6 month follow up has been completed

19. Percentage Change in Questions Pre Group Compared with Six Month Follow-up
Question Asked
Percentage Improved
Percentage Worsened
Percentage No Change
Support
100%
GP Visits
57%
43%
Hospital Visits
14%
29%
Medication
15%
70%
Number of Symptoms
Employment Status

20. Information
Introductory courses (BACP CPD accredited): Oct 2016 Training for facilitators (BACP accredited): Nov Anticipated courses for patients: May-June 2016; Sept-Nov 2016

21. Questions
Over to you

22. Contact details @p2w_ltd info@pathwayswellbeing.com
@p2w_ltd