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Clinical Corner

Behavioral Medicine, Part I

Published August 27, 2008 11:29 AM by Carol Kleinman

What is it?

Behavioral medicine is an interdisciplinary field of medicine concerned with the development and integration of psychosocial, behavioral, and biomedical knowledge relevant to health and illness. It focuses on the contribution of psychological and behavioral factors to the onset, progression, and management of disease. Behavioral medicine deals with what people do that affects their health and the way in which different illnesses affect their behavior.

Behavioral medicine is a discipline that uses a biopsychosocial model to motivate and mobilize patients to greater levels of participation in their own care. Treatment typically involves changing habits. These may involve thought patterns, how one deals with emotions, stress, time management, and their own body's functions. Successful integration of behavioral medicine techniques into a comprehensive treatment plan improves patient outcomes by  

  • Increasing patients' participation in their care
  • Mobilizing the body's resources for recovery
  • Creating "learned optimism" by redirecting beliefs and attitudes
  • Changing negative health behaviors and improving treatment compliance
  • Reducing the negative influence of anxiety, anger and depression
  • Increasing patients' sense of control and responsibility for their own health

Who needs it?

Behavioral medicine can be integrated into the care and treatment of patients with a diverse range of conditions; however the approach is most useful with patients with acute or chronic responses to the following conditions:

  • Cancer
  • Cerebrovascular disease
  • Spinal cord injury
  • Cardiovascular disorders
  • Cardiopulmonary disorders
  • Traumatic brain injury
  • Immune system disorders
  • Tension and vascular headaches
  • Irritable bowel syndrome
  • Sleep disorders
  • Eating disorders

Patients can also be aided with focused symptom resolution through the use of  behavioral medical techniques which are especially useful in the non-pharmacologic treatment of

  • Pain
  • Sleep disturbance
  • Hypertension
  • Delayed healing
  • Difficulty with ambulation
  • Drug regimen side effects
  • Surgical recovery
  • Coping difficulties
  • Depression
  • Anxiety
  • Dependence on analgesic medication

Many specific interventions are available as part of the practice of behavioral medicine. Patients must be evaluated individually to assess their current physical and mental state and to identify personal strengths and limitations. A specific treatment plan is then designed that incorporates and capitalizes on each patient's unique response to his or her illness or injury.

Among the techniques that may be used include:

  • Stress management
  • Relaxation-rehabilitation exercises
  • Guided imagery and cognitive-behavioral techniques for pain management
  • Immune system improvement through guided imagery
  • Brainwave neurofeedback
  • Neuromuscular retraining through cognitive rehearsal
  • Cognitive retraining for depression, illness perception, and anxiety
  • Hypnosis
  • Sleep management techniques
  • Motivational interventions
  • Thought modification
  • Problem solving therapy

 

posted by Carol Kleinman
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