Taking the psycho out of psychosomatic: using systemic approaches in a paediatric setting for the treatment of adolescents with unexplained physical symptoms

Clin Child Psychol Psychiatry. 2008 Oct;13(4):531-42. doi: 10.1177/1359104508096769.


Difficulty expressing emotional distress verbally is widely thought to underlie the presentation of physical symptoms which cannot be explained in medical terms. Children presenting with so called psychosomatic symptoms therefore bridge both the medical and psychological domains and create a conundrum for professionals from either field if working with them alone. A multidisciplinary rehabilitative approach has long been considered the treatment of choice for children exhibiting chronic physical problems. However, there has been little focus on the use of this approach with children diagnosed as suffering from nonorganic physical symptoms, or on the nuts and bolts of the psychological interventions which have been found beneficial. This article outlines a psychological model which has been integrated into a multidisciplinary team approach with good outcomes. The unique features of each case means that evidence for treatment is limited and relies upon such examples of good practice.

MeSH terms

  • Adolescent
  • Chronic Disease
  • Cognitive Behavioral Therapy* / methods
  • Cognitive Behavioral Therapy* / organization & administration
  • Combined Modality Therapy
  • Comprehensive Health Care / organization & administration*
  • Female
  • Humans
  • Models, Organizational
  • Pain / psychology
  • Pain / rehabilitation
  • Patient Care Team*
  • Psychophysiologic Disorders / rehabilitation*
  • Rehabilitation / methods
  • Rehabilitation / organization & administration
  • United Kingdom