Functional illness in primary care: dysfunction versus disease

Williams, Nefyn; Wilkinson, Clare; Stott, N. C. H.; Menkes, David B.

doi:10.1186/1471-2296-9-30

Cited by 22 publications

(17 citation statements)

References 73 publications

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“…Engel's model has been described as 'abstract' (56), and'… lacking operationalisation… ' (57). It has also been suggested that it is difficult for clinicians to deviate from an injury or disease-based model (56). There are numerous factors that impact physical therapists' ability to integrate psychosocial elements into treatment, one being the absence of a model that represents the domain's scope in a detailed and digestible format.…”

Section: Facilitating Application Of Holistic Perspectivesmentioning

confidence: 99%

A review of the psychotherapeutic ‘common factors’ model and its application in physical therapy: the need to consider general effects in physical therapy practice

Miciak

Gross²,

Joyce

2011

Scandinavian Journal of Caring Sciences

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This article explores the common factors model of psychotherapeutic intervention and discusses its relevance for physical therapy practice. The model provides an explanation for why the effects associated with specific technical approaches only minimally explain successful psychotherapy clinical outcomes. It postulates that factors common across diverse interventions (i.e. 'nonspecific' mechanisms) are responsible for a larger component of treatment efficacy. We outline the applicability of the common factors model to physical therapy and provide supportive evidence from evaluation and prognostic research on interventions for conditions seen in musculoskeletal physical therapy practice. The relevancy and consequences of applying the common factors model to physical therapy practice and research are discussed. The continued advance and evolution of the physical therapy profession requires creative and comprehensive analysis of all factors impacting clinical effectiveness. Additional research is needed to more clearly delineate the common factors that are operational in physical therapy practice and to measure their relative impact on clinical outcomes.

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Section: Facilitating Application Of Holistic Perspectivesmentioning

confidence: 99%

A review of the psychotherapeutic ‘common factors’ model and its application in physical therapy: the need to consider general effects in physical therapy practice

Miciak

Gross²,

Joyce

2011

Scandinavian Journal of Caring Sciences

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show abstract

“…But our primary care colleagues can take the idea further. In a thought-provoking paper, Williams et al 6 show that dysfunction is alive, and troublesome, in so many disciplines -whether gastroenterology, psychiatry, psychology, etc. They suggest that rather than classifying our patients' problems by body systems, classification between dysfunction and disease is just as important.…”

Section: Bravo Dysfunction!mentioning

confidence: 98%

Bravo dysfunction!

Ellis¹

2008

International Musculoskeletal Medicine

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“…104 We have previously proposed a classification of illness that includes orthogonal dimensions of pathology and dysfunction. 105 For this purpose, pathology is narrowly defined as pathological processes that cause gross or microscopic structural change that may, but not necessarily, result in disturbance of function. Dysfunction, by contrast, is abnormal functioning of the body, caused by, or manifested as, disturbed physiological or psychological processes independent of known structural pathology (Fig.…”

Section: Relationship Between Pathology and Dysfunctionmentioning

confidence: 99%

Can we be more specific about back and neck pain?

Williams¹

2009

International Musculoskeletal Medicine

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The initial clinical assessment of spinal pain consists of diagnostic triage into: (i) serious spinal pathology; (ii) other pathological entities; and (iii) non-specific symptoms. The non-specific group comprises the major burden of spinal illness. There are two broad approaches to the diagnostic challenge of non-specific spinal pain. One approach is to split the group into sub-groups explained by separate pathophysiological abnormalities. The focus of this work is to describe these proposed abnormalities in greater detail and to discover which clinical features distinguish them. The other approach is to 'lump' all of those with non-specific features into one group, and consider the common psychosocial factors that are relevant to the whole group. A variety of pathological and non-pathological models have been proposed. Pathological models include ligament laxity, facet syndrome, discogenic pain, spondylosis and instability; non-pathological models include a pain-spasm-pain cycle, muscle inhibition and deconditioning and somatic dysfunction. All of these models are problematic and do not fully account for all of non-specific spinal pain. Another approach is to consider these two different approaches together and to consider this non-specific category as orthogonal dimensions of pathology and dysfunction.

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Functional illness in primary care: dysfunction versus disease

Abstract: Background: The Biopsychosocial Model aims to integrate the biological, psychological and social components of illness, but integration is difficult in practice, particularly when patients consult with medically unexplained physical symptoms or functional illness.

Cited by 22 publications

References 73 publications

A review of the psychotherapeutic ‘common factors’ model and its application in physical therapy: the need to consider general effects in physical therapy practice

A review of the psychotherapeutic ‘common factors’ model and its application in physical therapy: the need to consider general effects in physical therapy practice

Bravo dysfunction!

Can we be more specific about back and neck pain?

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