Abstract

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 such as chronic fatigue syndrome and irritable bowel syndrome for about 25 years. She develops specific cognitive behavioural models for understanding and treating these conditions and evaluates the approaches within the context of randomised controlled trials in primary and secondary care. Her recent research involves investigating not only whether treatment works but how it works using mediational analyses.

Symptoms without identifiable organic pathology have been referred to by a variety of more specific labels: irritable bowel syndrome, chronic fatigue syndrome and fibromyalgia to name but a few. Everyone experiences physical symptoms, unrelated to specific aetiology from time to time. However, when the symptoms become the focus of an individual's attention the severity of the symptom often increases and varying degrees of disability results. The aims of this lecture are (a) to describe a generic cognitive behavioural model of understanding the psycho-physiology of somatic symptoms (b) to describe cognitive and behavioural interventions which can be adapted to the needs of the individual (c) to describe ways of engaging patients in the therapeutic process by using a language which is acceptable to the patient and which is likely to engage rather than alienate the patient (d) to examine some of the evidence for cognitive behavioural interventions for these disorders.