The BodyMind Approach (BMA) to psychotherapeutic groupwork with patients with medically unexplained symptoms (MUS): A review of the literature, description of approach and methodology for a pilot study

Abstract

This paper presents a literature review of research into interventions with people with medically unexplained symptoms (MUS). The review forms the basis for the research questions, provides a rationale for an innovative approach (The BodyMind Approach/BMA) to intervention for patients with anxiety/depression with MUS and justification for the most suitable methodology for the pilot study. An overview of the problem is provided as backdrop to the rationale. Patients with MUS make up a substantial percentage of all primary care (PC) consultations, are notoriously difficult to treat and make huge demands on resources. A pilot study took place in the National Health Service (NHS) in the UK between 2004 and 2007 receiving full NHS ethical approval for delivery in PC. Following on from the systematic search of the literature the argument for, and description of, the BMA (based on the discipline Authentic Movement from within the field of Dance Movement Psychotherapy) to group psychotherapy is presented. The intervention emphasises learning in a verbal and non-verbal-integrated approach, encouraging an awareness of the inter-relationship between body, self and mind. It uses meditative, mindful movement deriving from natural body gestures and posture, relaxation, massage promoting movement metaphor to change beliefs and to understand the meaning of the symptoms within a self-managing framework. The symptom is seen as a metaphor for connections between body, self and mind. It is founded on the principle that bodily experience can be an avenue for meaning-making in personal development leading to increased well-being; better coping strategies; changes in perception of the body-felt sense and improved lifestyle choices and behaviours. The research sought to answer a number of questions concerning the intervention such as benefits, process and outcomes from the perspective of participants and the facilitator. The methodology selected was mixed, using both qualitative (analysis of pre, post and follow-up interviews with participants and facilitator's process recordings); and quantitative whereby standardised outcome measures were completed by patients pre/during/post intervention and at follow-up. Medication, secondary referral and GP visits were also quantified pre/post-intervention and at follow-up. Findings supported the hypothesis, and went beyond it, revealing a reduction in, and disappearance of, symptoms to a significant effect.