"Reattribution for medically unexplained symptoms": Authors' reply
Morriss, Richard K.
Morriss, Richard K.
Abstract
Reply to the commentary Reattribution for medically unexplained symptoms by Hiske J. van Ravesteijn, Peter L. B. J. Lucassen, and Tim C. olde Hartman, (see record 2008-05194-021) on the current authors' original article Randomised controlled trial of training practices in reattribution for medically unexplained symptoms (2007). First, we conducted a 6-hour training intervention in reattribution because, on the basis of a series of studies of training in primary care, this is the length of training that most general practitioners (GPs) are prepared to attend in the UK and also in many other healthcare systems in the world. Second, the paper describing the reattribution model, which was written by one of our team and subsequent descriptions of reattribution written by members of our team, have always promoted a model in which doctors provide the 'making the link' explanation although they should do this through negotiation with the patient. Third, we agree that an instrumental task-oriented consultation such as reattribution might be perceived as less empathic by patients with medically unexplained symptoms than treatment as usual. However, in our trial the data from the patient satisfaction questionnaire suggests that compared with treatment as usual, after reattribution training twice as many patients were very satisfied with how well the GP understood the nature of their problems and their worries. Finally, we agree that certain subgroups of patients with medically unexplained symptoms may benefit from reattribution. However, our trial was not powered to examine this issue. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
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2008
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Commentary
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Morriss, R. K., Dowrick, C., Salmon, P., Peters, S., Dunn, G., Rogers, A. & Gask, L. (2008). "Reattribution for medically unexplained symptoms": Authors' reply. The British Journal of Psychiatry, 192 (4), pp.315.