Prolonged Exposure Therapy for Somatization Disorder

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Prolonged Exposure Therapy for Somatization Disorder

Prolonged exposure therapy (PET) is a trauma-focused intervention that addresses specific PTSD symptoms. Studies have demonstrated its efficacy in both mild and severe PTSD cases. Furthermore, PET can also be used to address recurring somatic symptoms related to chronic illnesses like asthma or diabetes.

Extending exposure therapy (LET) helps the patient confront a traumatic event they have been avoiding since their PTSD diagnosis. This usually involves imagining an imagined scenario such as a dog bite or accident, where they will be forced to engage with the trauma they are feeling.

The therapist helps the patient approach their trauma with greater empathy and care, decreasing unwanted reminders of it and relieving distressing memories.

Treatment for Posttraumatic Stress Disorder (PTSD) entails individual sessions with a trained therapist over an eight to 15 week period. These 90 minute meetings typically include psychoeducation about PTSD and ways to manage anxiety through breathing techniques.

Exposure-based treatment is a well-researched treatment option for many health conditions where patients experience significant distress due to somatic symptoms. In certain instances, such as recurrent asthma and musculoskeletal pain, it has shown promise in decreasing symptoms’ burden on patients and improving quality of life.

However, there are several potential drawbacks to such an approach in clinical practice. It may prove challenging to provide a tailored treatment protocol to various patient populations with recurrent somatic symptoms and ensure that it produces therapeutic effects.

Recently, a single group feasibility trial involving 33 self-referred individuals with DSM-5 somatization disorder demonstrated that such an internet-delivered exposure based treatment delivered via web platform can be successfully accepted, with high treatment adherence rates, satisfactory treatment satisfaction levels, significant and long lasting improvement within groups, and no serious adverse events.

The treatment consists of a series of modules designed to assess the participant’s somatic symptom domain, type of preoccupation with symptoms and impact of SSD on daily life. These modules are delivered over an 8 week period with online self-report questionnaires administered before and after each one.

In the initial sessions, a therapist will review the diagnosis and explain how exposure-based treatment works. They then guide the participant through some simulated exposure scenarios designed to challenge avoidance behavior and address unhelpful learned responses.

Simulated exposure situations are presented to patients in such a way that they elicit their fears and contradict any preexisting information about the fear. For instance, if someone is afraid of big dogs but the therapist shows them an image of one that doesn’t bite, over time the patient will no longer feel threatened by big dogs.

This approach to treating PTSD has also been found highly effective for treating phobias, such as those related to animals and public places. This may be because it focuses on the patient’s own fear and encourages them to confront any negative associations they may have with an animal or place.

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