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Psychological interventions in Chronic Illness

Q: Roles for health psychologists

- Deliver interventions - Pre-intervention research - provide advice/training to HCPs - Guideline committees

Q: Type of health psychology interventions

1. interventions that help patients to manage their condition with the goal of improving or maintaining physical health or slowing down progress 2. treatment of ' psycho-physiological disorders' (chronic fatigue syndrome, chronic pain,...) with the goal to alleviate symptoms and improving functioning 3. addressing psychosocial adjustment to illness (e.g. life after heart attack, living with anxiety/depresion following a heart attack, ...)

10 important questions on Psychological interventions in Chronic Illness

Health psychology interventions for long-term conditions

target a range of outcomes, use a variety of techniques, and may be aimed at patients and/or significant others.

Health psychologists aim to understand what is mediating the change when successful interventions work and to examine whether evidence for the effect of mediating variables is consistent with theoretical predictions. Additionaly, health psychologists are interested in the factors moderating the effect of an intervention, whether individual, interpersonal or environmental.

Roles for health psychologists

- Deliver interventions
- Pre-intervention research
- provide advice/training to HCPs
- Guideline committees

Type of health psychology interventions

1. interventions that help patients to manage their condition with the goal of improving or maintaining physical health or slowing down progress

2. treatment of 'psycho-physiological disorders' (chronic fatigue syndrome, chronic pain,...) with the goal to alleviate symptoms and improving functioning

3. addressing psychosocial adjustment to illness (e.g. life after heart attack, living with anxiety/depresion following a heart attack, ...)

Interventions to help patients to manage their illness

- Educational or information-based interventions --> e.g. via (national) campagnes / patient-health professional communication / group education (how to recognise a stroke example).
- interventions targeting motivation and the control of behaviour
- developing interventions for the management of long-term conditions

Educational or information-based interventions

In order for people to be able to manage a long-term condition effectively, they need to know what it is, and what actions are recommended. OFTEN NOT ENOUGH.

Targeting illness-related behaviours by addressing motivation/control of action

Health psychology interventions to improve self-management draw on a number of different psychological theories and models in order to address two factors:
- motivation
- control of action

Motivational interventions want to change beliefs and attitudes that shape illness-related behaviours. They help patients consider different courses of action and determine priorities.

A range of behavioural techniques are:
- teach problem solving
- develop 'if-then' plans
- behavioural experimentation with feedback to increase self-efficacy
- collaborative development of 'implementation intentions'

Interventions to treat (psycho-physiological) symptoms

Interventions for the management of symptoms in conditions such as chronic pain, MS, cancer and rheumatoid arthritis differ from other health pychology interventions in...'

- not driven by an overarching theoretical model, but by a model of the condition or symptoms to be managed
- often inspired by CBT type of interventions; try to relate cognitive factors to emotional responses to behavioural attempts to manage the situation
- the example of 'chronic fatigue syndrome' CFS

Interventions to Address Psychological Adjustment to Illness

- psychological adjustment to chronic condition is challenging:
* adaptation to limitations
* achieving acceptable quality of life in various domains (work, social, leisure, ...)
* maintaining satisfying relationships
* manage negative emotions or psychological disorders

- Again... popular is the use of CBT and coping skills training to reduce and manage stress, and interventions to regulate emotions.

Interventions to adress psychological adjustment to illness

- stress management techniques; reducing anxiety thorugh:
* relaxation
* meditation
* mindfulness training

- often in combination with cognitive techniques (cognitive behavioural stress management; CBSM)
* cognitive reframing
* enhancing social support by interpersonal skills training
* enabling greater sense of control
* redirect coping resources to aspects that are controllable and amenable to change

The use of new technology - internet, telephone and mobile phone interventions

- explosion of interest in using new technologies, particularly through the internet, to deliver health interventions to patients
- use for preventive and health promotion purposes
- but also to manage patiens' chronic conditions

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Health Psychology

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Psychological interventions in Chronic Illness

10 important questions on Psychological interventions in Chronic Illness

Health psychology interventions for long-term conditions

Roles for health psychologists

Type of health psychology interventions

Interventions to help patients to manage their illness

Educational or information-based interventions

Targeting illness-related behaviours by addressing motivation/control of action

Interventions to treat (psycho-physiological) symptoms

Interventions to Address Psychological Adjustment to Illness

Interventions to adress psychological adjustment to illness

The use of new technology - internet, telephone and mobile phone interventions

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