Contents of It's not All in Your Head by Asmundson and Taylor

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1.1.4. Treatment In the past many clinicians believed health anxiety was difficult to treat, treatment resulted in only slight improvement in symptoms, and that it was challenging to establish a therapeutic alliance with health anxious individuals (Martínez & Botella, 2005). This belief may have arisen because early treatment techniques, such as psychoanalysis, were mostly ineffective for treating the disorder (Asmundson & Taylor, 2004). Some clients may have also been resistant to psychological treatments because they believed their condition was purely somatic (Barsky et al., 1988). It was sometimes difficult for clinicians to develop a therapeutic alliance with clients because, although the clients wanted help, they often rejected or were skeptical of treatments and the professionals who could not find the cause of their symptoms (Salkovskis et al., 2003). Some health care providers also believed health anxiety was similar to factitious disorder or malingering, and therefore, a waste of their valuable time (Salkovskis et al., 2003). Furthermore, after a medical treatment had been administered, occasionally people with health anxiety developed complications, worse symptoms, or new symptoms (Barsky et al., 1988). This may be due to somatosensory amplification and a tendency to misinterpret any new somatic sensations after medical treatment (Bleichhardt et al., 2005). The 1980s and 1990s saw the development of several behavioural and cognitive- behavioural psychotherapies for health anxiety (Asmundson & Taylor, 2004). 13
Today, effective clinically-supported treatments have been established for health anxiety. Individuals with health anxiety are often referred to psychological practitioners when the biomedical health care system cannot find medical causes or treatments for presenting symptoms (Taylor & Asmundson, 2004). Randomized controlled studies and other research have provided evidence that psychological treatments are efficacious for health anxiety (see Taylor & Asmundson, 2004 for review). For example, cognitive therapies are used to restructure distorted thoughts and attributions about physiological sensations into healthier and less catastrophic thoughts. Behavioural techniques such as graded in vivo exposure, desensitization, and response prevention, are helpful for controlling illness related behaviours and disability. Methods including relaxation training, biofeedback, and behavioural stress management (BSM) help reduce physiological arousal and anxiety. Physiologically-based techniques such as attention training, distraction methods, hypnosis, or environmental manipulations are useful for decreasing individuals‘ attention to their somatic symptoms. Effective treatments for the social aspects of health anxiety may include physician consultations, the involvement of significant others and family members, and the modification of environmental situations that support a client‘s sick role. Accordingly, a multimodal treatment approach may be needed to address the factors involved in the development and maintenance of the various health anxiety symptoms. Many case studies, uncontrolled studies, and randomized 14
Page 1 and 2: RANDOMIZED CONTROLLED FEASIBILITY T
Page 3 and 4: Abstract The purpose of this feasib
Page 5 and 6: Acknowledgement This research was f
Page 7 and 8: Table of Contents Abstract………
Page 9 and 10: 3.2.1. Content analysis…………
Page 11 and 12: List of figures Figure 1. The cogni
Page 13 and 14: Table C7. Comparison of WLC pre- an
Page 15 and 16: this study will inform a future, la
Page 17 and 18: Disorders Draft (APA, 2010) propose
Page 19 and 20: The cognitive symptoms of health an
Page 21 and 22: somatosensory amplification have a
Page 23 and 24: clients with health anxiety from cl
Page 25: Interview Schedule [Robins, Helzer,
Page 29 and 30: decreased disease conviction, witho
Page 31 and 32: identification and reattribution of
Page 33 and 34: within treatment sessions and as ho
Page 35 and 36: more efficacious than wait-list con
Page 37 and 38: participants‘ functioning. The CB
Page 39 and 40: at follow-up (e.g., Bouman, 2002, a
Page 41 and 42: et al., 2003). Self-help treatments
Page 43 and 44: 1.2. Statement of purpose The purpo
Page 45 and 46: an Internet format because it was m
Page 47 and 48: � Do you carry things to use in t
Page 49 and 50: dimensional scales: (a) affective s
Page 51 and 52: severe (15 - 19), and extremely sev
Page 53 and 54: 86 indicate a poor alliance. The HA
Page 55 and 56: included depression symptoms, gener
Page 57 and 58: mailed Part 1, Part 2, and Part 3 o
Page 59 and 60: equests were honored. All randomize
Page 61 and 62: literature; therefore, we had reaso
Page 63 and 64: 3. RESULTS 3.1. Quantitative data a
Page 65 and 66: Table 2 Demographic statistics Mean
Page 67 and 68: Table 3 Comparison of SHB pre- and
Page 69 and 70: was no significant change (t = 1.28
Page 71 and 72: subscale (n = 5); T1 M = 16.80 (SD
Page 73 and 74: treatment participants would have o
Page 75 and 76: At T2 there were significant differ
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Table 7 SHB and WLC effect size and
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sample size or greater effect size
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3.2.1. Content analysis 3.2. Qualit
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analysis resulted in the descriptio
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During the creating subcategories a
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coded the entire data set. There we
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anxiety. After ethical clearance wa
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SHB group symptoms when compared to
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pain, fatigue, and poor health, tha
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3.4. Limitations The results of thi
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usy schedules, worry about reading
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attery of tests is not recommended
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ecommended that the program is exte
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4. REFERENCES American Psychiatric
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Barsky, A. J., Geringer, E., & Wool
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Coull, G, & Morris, P. G. (2011). T
Page 109 and 110:
Furer, P., Walker, J. R., & Freesto
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Lidbeck, J. (1997). Group therapy f
Page 113 and 114:
Nguyen, T. D., Attkisson, C. C., &
Page 115 and 116:
Salkovskis, P. M., Rimes, K. A., Wa
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Taylor, S., Thordarson, D. S., Jang
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5. APPENDICIES Appendix A Contents
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o Week 4 o Week 5 o Things to Remem
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Appendix B SELF-HELP PROGRAM FOR HE
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Table C2 Comparison of SHB complete
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Table C4 Comparison of SHB and WLC
Page 129 and 130:
Table C6 Comparison of WLC pre- and
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Appendix D Draft of unconstrained c
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Questionnaires the questionnaires T
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