Treatment innovation for Medically Unexplained Symptoms: developing clinical competence, a case study

Abstract

Background: Medically Unexplained Symptoms (MUS) are common and often complex with co-morbid presentations of anxiety, depression and long term conditions (LTC’s). The development of competence to deliver effective treatments for MUS with or without LTC co-morbidity is important for patients, health professionals, the wider healthcare system and the economy. Innovative treatment approaches are being developed yet there is little research in the development and evaluation of clinical skills competence in this area. The primary objective was to develop and evaluate the competence of mental health practitioners to adapt an innovative transdiagnostic cognitive behavioural approach to treat patients with MUS. Methods: A single case study was used to guide future directions in training and research development. Kolb's experiential learning model and didactic teaching methods were used to teach clinicians how to adapt a transdiagnostic CBT model to treat specific MUS conditions with or without LTC co-morbidity. Findings: Confidence increased significantly by 28% to 74.5% in a sample of 16. Knowledge also increased but not significantly due to high pre workshop scores. On average participants agreed strongly that the workshop included a good balance of teaching methods; the content was understood and relevant to clinical practice and would be applied following the workshop. Discussion: The development and evaluation of competence to treat MUS and LTC effectively will be discussed including consideration of the implementation of the new IAPT LTC/MUS NHS services. It is limited by the evaluation of a single workshop but identifies directions for further training and research.