Advances in Psychiatric Treatment (2009) 15: 146-151. doi: 10.1192/apt.bp.107.004606
© 2009 The Royal College of Psychiatrists
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A CBT-based approach to medically unexplained symptoms

Catriona Kent and Graham McMillan

Catriona Kent is a psychiatric nurse and cognitive–behavioural therapist working in Glasgow Liaison Psychiatry Service, where she delivers a service using CBT for patients with medically unexplained symptoms. She has also been involved in research in this field. She delivers training in CBT-based self-help interventions to a wide range of primary and secondary care professionals. Graham McMillan is a Psychiatric Consultant currently based at Leverndale Hospital in Glasgow. He has been involved at both undergraduate and postgraduate level in research involving liver biosynthesis and also in the use of outcome measures in psychiatric settings.

Correspondence: Correspondence Dr Graham McMillan, The Stewart Centre, 5 Ardencraig Road, Castlemilk, Glasgow G45 0EQ, UK. Email: Graham. Mcmillan{at}ggc.scot.nhs.uk

This article discusses a cognitive–behavioural therapy (CBT) approach to the treatment of medically unexplained symptoms that is based on the ‘five areas’ model of CBT. We describe a typical course of therapy and some of the common problems encountered during treatment. Emphasis is placed on the practical management of these conditions, and the focus is on symptoms as opposed to cause. We believe that this approach is widely applicable and could be used in a large range of settings to tackle these debilitating conditions. In writing this article we intended to provide an overview of patients with medically unexplained symptoms. The article would be of interest to staff within liaison psychiatry departments looking to set up a medically unexplained symptoms service and general psychiatry teams who may have contact with patients presenting with somatic symptoms. Psychiatric teams without access to a liaison department may also find this article interesting.


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