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Table 3 Structure of the group sessions in the intervention group

From: Effectiveness of a cognitive behavioral intervention in patients with medically unexplained symptoms: cluster randomized trial

1. COGNITIVE REATTRIBUTION
  · Psychological explanation of the symptoms: To explain the objective of the session that is not precisely to heal the symptoms, but rather “to improve doping". To explain that somatization is a common phenomenon resulting from different factors and mechanisms. The patients are asked to talk about the different factors; and stress is introduced as an explanatory element of the symptoms.
  · The importance of the cognitive issue. They give examples on the role of knowledge and the patients are asked to link them to their own experiences. The objective is to show how the behaviors and the attitude toward the symptoms could change the response to them.
2. RELAXATION AND SYMPTOMATIC RELIEF
  · Once the role of stress in the genesis of pain has been described, techniques are introduced where physical exercising and muscular relaxation are combined. The patients are provided with a CD with spoken instructions.
3. BEHAVIOR-ILLNESS
  · The patients are given details on optional treatments and on the correct use of sanitary services. They are also instructed on the mechanisms to control anomalous behavior toward the illness.
4. AEROBIC EXERCISING
  · To encourage physical exercising: to do away with the bad habit of stating that “pain stops me from doing any kind activity” thus, they avoid doing any kind of activity. An ongoing program on physical exercising is outlined.