In the management of functional somatic syndromes, a cognitive-behavioural group treatment was more effective than enhanced usual care.

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In this study we investigated the interrelationships between the Dynamic Assessment Interview (DAI), the interpersonal process of the assessment interview analyzed with Structural analysis of Social Behavior (SASB), and treatment outcome. The DAI is a semistructured interview and rating procedure designed to evaluate patient suitability for psychodynamic psychotherapy based on the patient's immediate interaction with the assessment interviewer. In the selected sample (n = 20) the DAI ratings showed no significant correlations with the SASB-coded interpersonal process of the assessment interview nor with treatment outcome. The SASB-coded interpersonal process in the assessment interview correlated significantly with interpersonal process early in therapy and was able to predict treatment outcome. It is concluded that the abstract ''inner'' patient characteristics assumed to be of major prognostic importance for psychodynamic psychotherapy might be of limited validity, whereas the patient offered interpersonal process is worth further consideration as a predictor of treatment outcome. Finally, the relatively stressful structure of the DAI interview might have facilitated the prediction of treatment outcome from the interpersonal process in the assessment interview.

Tarbel, Christel, Frostholm, Lisbeth & Rehfeld, Emma. (2016). 'Talking at cross purposes: negotiation of the sick role with a MUS patient as a realt time social process, Tidsskrift for Forskning i Sygdom og Samfund, nr. 24, The physician, thus, has to walk a fine line in the interaction with the patient with MUS. In order to provide high quality care for these patients while at the same time gaining their confidence, the GP has to operate at the intersection of 63 Talking at cross purposes several opposing pressures. Observing the specialist consensus on optimal management of MUS, the GP has to avoid embarking on the "somatic path" of investigation and treatment ad infinitum and instead attempt to reframe and reattribute the patient's understanding of the symptoms (Goldberg et al 1989;Mayou 1991;Fink et al 2002). The pitfall of such reframing is the danger of adopting -or being heard by the patient to have adopted -a unidirectional mind-to-body-model of somatisation of the unexplained physical symptoms (Burton 2003). In sum, and at the risk of oversimplifying, the GP must take serious the medically unexplained symptoms without making use of the usual somatic interventions, and at the same time provide emotional support without psychologising. Medically unexplained symptoms (MUS) challenge our perception of illness. As a consequence, a MUS-patient's legitimised entry into the sick role, as defined by Parsons, poses a problem for physicians and patients alike. The encounter between patients with MUS and physicians therefore can be frustrating for both parties. The present study is a single case analysis of such an encounter in primary care. Using the microanalytical method of conversation analysis, this study aims to provide a contextualised description of both the patient's and the physician's different orientations to the purpose of the encounter. This approach locates the source of the frustration in the participants' incompatible interactional projects. The patient is oriented towards the emotional and life world aspects of Theoretical prerequisitesPertinent to the above described difficulties of both patients and physicians in the encounter about MUS, is the problem of legitimacy, i.e. of being recognised as being legitimately ill. This problem was initially formulated by Parsons and crystallised in the now well-known concept of »the sick role« (1951). Taking his point of departure in a capitalist moral economy, Parsons perceived of illness as a dysfunctional disturbance in both a biological and a social sense -the latter because it prevents a person from contributing to the common good (Parsons 1951, p. 430). The sick role, however, is a provision to protect the sick individual in that it "enables conformity within the deviance of illness" (Varul 2010, p. 76) through a set of normative rights and corresponding obligations. Entering the sick role, an individual thus has the right to exemption from normal social duties, e.g. work, but at the same time must resist to take advantage of any "secondary gains", s...