Managing physical symptoms: The clinical assessment as treatment

Physical symptoms are a common cause of attendance at general hospital out- patient clinics. There is good evidence that cognitive therapy is effective in the management of such physical symptoms. This narrative review suggest s that the assessment itself, without formal psychological therapy, may be used as a treatment, regardless of whether relevant pathology is absent or present. Changing patients' beliefs about their symptoms may improve a broa d range of outcomes, including symptoms, disability, distress, and health-c are resource use. The evidence for investigations as treatment is reviewed, along with potential for further development and possible pitfalls. A rati onale is presented for a brief psychoeducational intervention that can be d elivered in the clinic. This would be a logical extension of the kind of si mple explanation and reassurance that occurs routinely today, but which is not explicitly used as, or regarded as, treatment. The dearth of relevant e vidence is emphasized, and recommendations are made for future research. (C ) 2000 Elsevier Science Inc. All rights reserved.