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Respond to at least two colleagues by explaining how they could use strategies to advocate for a client with a somatic symptom disorder given the reasons for advocacy they described.

Colleague 1: Brooke

Somatic symptom disorders are mental disorders that manifest with physical symptoms that are not always clear to explain with medical diagnosis (APA, 2013).  One specific example of such a disorder is the Illness Anxiety Disorder (F45.21). This disorder is diagnosed when there is a pervasive and impacting preoccupation with having a serious medical condition in circumstances when no predisposition or existing symptomatology indicate there should be medical concern (APA, 2013).  The diagnosed individual will exhibit heightened anxiety regarding their perceived condition.  Furthermore, the diagnosis is classified as either “care-seeking type,” whereby the individual frequently seeks out medical guidance from professionals or “care-avoidant type: whereby the individual avoids medical care despite their ongoing concerns (APA, 2013).

This can present a unique challenge for guiding professionals, as the client is potentially in need of both medical and mental health care.  Therefore, a biopsychosocial assessment is recommended to gain the most thorough, comprehensive picture of the client and their current set of circumstances.  This multi aspect evaluation serves to understand the biological, or physical, contributors to the individual’s somatic diagnosis, while also delving into their perceptions and beliefs (psychological) and their social environment and experiences. When this information is gathered from these varied perspectives, intervention can be designed to target specific areas of need, with the understanding that medical care may be required, concurrently, with mental health support (Dimsdale, Patel, Xin and Kleinman, 2007).

Because of the complexity of such diagnoses, a multidisciplinary approach is deemed most effective when working with such clients.  Because of the psychological involvement in this disorder, psychotherapy aimed at modifying existing thought patterns would be considered sound practice (Kirmayer and Sartorius, 2007).  To expand, cognitive behavioral therapy (CBT) can be applied, increasing the client’s awareness of their current thought patterns, possible triggers and strategies to combat negative thinking.  Additionally, the prescription of medication to address the co-occurring anxiety or other resulting physical symptoms would be provided by a medical professional, such as a psychiatrist. This approach, widely accepted, allows for the client’s case to be viewed through different lenses.

While there is certainly significant validity in approaching such cases through a multidisciplinary team, the professionals required to ensure this effective intervention all have to be “on board.”  This may require advocacy on the part of a social worker to convey the importance of employing this approach.  It can be assumed that while medical doctors may certainly understand the benefit of treating medically based symptoms, they may choose to end their involvement at this point.  A social worker is in a unique position to share the benefits of combining perspectives for the benefit of the client.  Additionally, a social worker can advocate for their client by explaining these benefits and helping the client to explore available treatment modalities.  As with any client, working with those diagnosed with somatic disorders, a social worker can employ advocacy skills on an ongoing basis, in an effort to achieve the most positive outcomes.

 

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders

(5th ed.). Arlington, VA: American Psychiatric Publishing.

Dimsdale, J. E., Patel, V., Xin, Y., & Kleinman, A. (2007). Somatic presentations—A challenge for

DSM-V. Psychosomatic Medicine, 69, 829.

Kirmayer, L. J., & Sartorius, N. (2007). Cultural models and somatic syndromes. Psychosomatic

Medicine, 69, 832–840.

 

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