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Psychological Interventions for Physical Symptoms (PIPS) Toolkit

The webpage provides a range of practical tools for staff to help patients adjust psychologically to long term conditions, or persistent physical symptoms that may or may not currently have a clear medical diagnosis. Some people may present with a set of persistent medical symptoms (e.g. chest pain, dizziness, back pain) for which, after investigation, there is no obvious underlying cause or diagnosis apparent. These symptoms may also present alongside an existing long term condition.

For those with persistent physical symptoms, the journey from symptom development to clear understanding and evidence-based treatment can be an area that all staff can help to facilitate by promoting psychological adjustment. In an attempt to exclude more concerning underlying conditions, GPs and other multidisciplinary staff often undertake a range of medical assessments and interventions. While necessary, these can cause patients to develop unwanted psychological and physical side effects, adding to distress and disability regarding:

  • beliefs about the nature and seriousness of their condition
  • additional pain, fatigue and other symptoms due to pharmacological interventions

In the absence of a clear cause or diagnosis despite persisting symptoms, patients can become increasingly distressed, while fear of what may be generating symptoms often leads to avoidance of daily activities. Further investigations may also place the patient at risk of harm, for instance, due to infection from exploratory operations, and exceeding safe doses of radiation.

As a patient's journey continues, ongoing and worsening distress and disability can further exacerbate symptoms, through a process involving:

  • physical deconditioning
  • greater attention to symptoms
  • increasing sensitivity of normal physical processes in the body
  • the development of unhelpful beliefs about symptoms

Recent attempts focus upon the development of explanatory models for persistent symptoms which combine physiological and psychological processes. These models aim to provide explanations which acknowledge patients' experiences, focusing upon physiological processes which can be contributed to and exacerbated by psychological mechanisms..

Clinical and Health Psychologists within NES Psychology have developed resources consistent with the approach outlined above to enable healthcare professionals working with people with persistent physical symptoms to:

  • explore the factors that may be influencing their patient's symptoms
  • develop a shared understanding of their experiences
  • encourage their patient to self-manage their symptoms

Click here to see a 50-minute video published by RRHEAL which provides a presentation and overview of some of the resources displayed below.

PIPS Toolkit - Resources

PIPS Toolkit - Evaluation

PIPS Toolkit - Contact Details