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  • 1. Iain Caldwell MUS and Pain management
  • 2. 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
  • 3. 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
  • 4. Problems with Psychological model
    • Mad
    • All in the mind
    • Putting it on
    • Not listening
  • 5. Functional (medical) Model (Jon Stone)
    • Introduce how systems and mechanisms function
    • Neutral model
    • Separate the Why and How.
  • 6. Problems with Functional (medical) model
    • No Why (explanations important)
    • Person story not validated
    • Wellbeing not included
    • No context –culture, personal history
  • 7. Whole Context Approach’s (WCA): Functional Wellbeing model.
    • The Whole Context Approach’s key aspects are:
    • Integrated approach
    • Reflexive monism
    • Complexity
    • Wholeness and context
  • 8. 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.
  • 9. Functional Wellbeing Model
    • Fits with person’s world view (and family view) Context.
    • Stress management skills