Medically unexplained symptoms (MUS) are known to be costly, complex to manage and inadequately addressed in primary care settings. In many cases, there are unresolved psychological and emotional processes underlying these symptoms, leaving traditional medical approaches insufficient. This paper details the implementation of an evidence-based, emotion-focused psychotherapy service for MUS across two family medicine clinics. The theory and evidence-base for using Intensive Short-Term Dynamic Psychotherapy (ISTDP) with MUS is presented along with the key service components of assessment, treatment, education and research. Preliminary outcome indicators showed diverse benefits. Patients reported significantly decreased somatic symptoms in the Patient Health Questionnaire-15 (d = 0.4). A statistically significant (23%) decrease in family physicians’ visits was found in the 6 months after attending the MUS service compared to the 6 months prior. Both patients and primary care clinicians reported a high degree of satisfaction with the service. Whilst further research is needed, these findings suggest that a direct psychology service maintained within the family practice clinic may assist patient and clinician function while reducing healthcare utilization. Challenges and further service developments are discussed, including the potential benefits of re-branding the service to become a ‘Primary Care Psychological Consultation and Treatment Service’.

Objective This study explored whether patients in specialist psychology services made early gains on theoretically relevant therapeutic processes and outcomes after a trial therapy session (one 2- to 3-hour initial Experiential Dynamic Therapy session). Method This practice-based, nonrandomized trial used a pre–post design. Thirty-one patients (23 women, average age of 37) completed standardized measures of symptoms of general distress, interpersonal functioning, self-compassion, and remoralization before and after the trial therapy session. Video recordings of the sessions’ therapy process were rated on the Achievement of Therapeutic Objectives Scale. Results After the trial therapy session, patients reported a significant increase in remoralization and self-compassion and a significant decrease in symptoms of general distress but not interpersonal problems. Process ratings were not significantly associated with improvement on these outcome measures. Conclusions This initial positive effect could be due to the session or an effect of time or placebo. Future research using active control conditions is warranted.

The authors wish to make the following corrections to this paper [1].