Primhe 2011

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Primhe 2011

  1. 1. Iain Caldwell MUS and Pain management
  2. 2. Critique of medical model <ul><li>over-reliance on &quot;categories&quot;, &quot;ideals&quot;, and &quot;objectivity&quot; </li></ul><ul><li>failure to appreciate the significance of internal experiences </li></ul><ul><li>lack of appreciation for diversity and for the essential role played by individuals in their own evolution </li></ul><ul><li>lack of appreciation for the role of culture in mental health </li></ul>
  3. 3. Psychological model <ul><li>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) </li></ul><ul><li>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 </li></ul>
  4. 4. Problems with Psychological model <ul><li>Mad </li></ul><ul><li>All in the mind </li></ul><ul><li>Putting it on </li></ul><ul><li>Not listening </li></ul>
  5. 5. Functional (medical) Model (Jon Stone) <ul><li>Introduce how systems and mechanisms function </li></ul><ul><li>Neutral model </li></ul><ul><li>Separate the Why and How. </li></ul>
  6. 6. Problems with Functional (medical) model <ul><li>No Why (explanations important) </li></ul><ul><li>Person story not validated </li></ul><ul><li>Wellbeing not included </li></ul><ul><li>No context –culture, personal history </li></ul>
  7. 7. Whole Context Approach’s (WCA): Functional Wellbeing model. <ul><li>The Whole Context Approach’s key aspects are: </li></ul><ul><li>Integrated approach </li></ul><ul><li>Reflexive monism </li></ul><ul><li>Complexity </li></ul><ul><li>Wholeness and context </li></ul>
  8. 8. Whole Context Approach’s (WCA): Functional Wellbeing model. <ul><li>Needs and wishes met in people lives </li></ul><ul><li>Explanations (models and beliefs) </li></ul><ul><li>Use of Metaphors </li></ul><ul><li>Pain and Physical activity </li></ul><ul><li>Recovery </li></ul><ul><li>Validation – personal stories – medically unexplained stories. </li></ul>
  9. 9. Functional Wellbeing Model <ul><li>Fits with person’s world view (and family view) Context. </li></ul><ul><li>Stress management skills </li></ul>

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