primhe 2011
TRANSCRIPT
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Iain Caldwell
MUS and Pain management
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Critique of medical model
over-reliance on "categories", "ideals", and "objectivity"
failure to appreciate the significance of internal experiences
lack of appreciation for diversity and for the essential role played by individuals in their own evolution
lack of appreciation for the role of culture in mental health
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Psychological model
Around 40% of outpatients with MUS have diagnosable anxiety and depression (RCP, 2009); Up to 70% of people suffering with MUPS will suffer from depression and/or anxiety disorders (IAPT MUS, 2008)
In many cases physiological and psychological factors co-exist in symptoms presenting (e.g. IBS) i.e. MUS resulting from complex interactions between physiological, social and psychological processes
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Problems with Psychological model
Mad All in the mind Putting it on Not listening
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Functional (medical) Model (Jon Stone)
Introduce how systems and mechanisms function
Neutral model Separate the Why and How.
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Problems with Functional (medical) model
No Why (explanations important) Person story not validated Wellbeing not included No context –culture, personal history
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Whole Context Approach’s (WCA): Functional Wellbeing model.
The Whole Context Approach’s key aspects are:
Integrated approach Reflexive monism Complexity Wholeness and context
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Whole Context Approach’s (WCA): Functional Wellbeing model.
Needs and wishes met in people lives Explanations (models and beliefs) Use of Metaphors Pain and Physical activity Recovery Validation – personal stories – medically
unexplained stories.
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Functional Wellbeing Model
Fits with person’s world view (and family view) Context.
Stress management skills