| dc.description.abstract | Background: The low to moderate effect sizes of current psychotherapeutic treatment of patients with somatic symptom disorder (SSD) may be improved by insight into factors that impact individual therapeutic goal attainment. Professional knowledge is often not included in the limited studies available on this topic.
Objective: To develop a list of factors assumed to act as barriers and facilitators of therapy success for patients with SSD from the professionals' perspective, and to have professionals sort these factors according to how commonly they occur on a scale of individual to general factors.
Method: This pilot study used a concept-mapping procedure. Participants were professionals experienced in working with SSD. Based on a scoping literature review and individual interviews with professionals, a list of factors was derived. Then, two card-sorting tasks were carried out: (1) grouping factors into clusters based on commonality of contents and (2) sorting factors based on how individual to general they appear amongst patients with SSD. A hierarchical cluster analysis (squared Euclidean distances, Ward's method) was used to identify the structure of the first sorting. A one-tailed analysis of variance (ANOVA) with a post hoc comparison according to Student-Newman-Keuls (SNK) was done to analyze the second sorting.
Results: The literature review and 17 interviews led to 55 factors that are considered to play a role in attaining therapy success. Fifteen professionals sorted these factors twice. A cluster analysis of the first sorting task yielded a nine-cluster solution,
which was divided into three overarching groups: individual context, social context, and therapeutic relationship. In the second sorting, the clusters rated more individual were psychopathology, low self-esteem, externalization, system, and societal factors, and the clusters rated more general were experiences of self and body, resilience, structure, and therapeutic relationship. A significant difference (p < .001) between these two groups of clusters was found.
Conclusion: The overview of nine clusters that influence patients in attaining therapy success from the perspective of clinicians, and the frequency with which they appear in patients with SSD, provide a first step in addressing the diversity of SSD patients. This insight may enable therapists to enhance the assessment of vulnerabilities and strengths of patients in order to develop more personally tailored care, thereby increasing therapy success. | |
