A qualitative study of psychodynamic and cognitive behavioural therapists' conceptualisations of medically unexplained symptoms in their clients

Aim: This study explored therapists' conceptualisations of their psychodynamic and cognitive behavioural therapies with clients with medically unexplained symptoms. Method: 12 semi-structured interviews were conducted with experienced psychotherapists, recruited from two National Health Service departments. Interview transcripts were analysed using grounded theory. Findings: Conceptualisations fell into two categories: (1) informal, bottom-up practice driven; (2) formal, top-down theory driven. In the former, therapists from both modalities shared experiential conceptualisations. In the latter, they shared some conceptualisations while retaining others from their theoretical training. Discussion: Therapists conceptualise using inherited theoretical concepts from their respective professional trainings, by developing experiential concepts of their own, and by borrowing and integrating theoretical concepts from other theoretical orientations.