Psychological therapies see Chapter

Cognitive-behavioural approaches are effective and widely used. Brief psycho-dynamic therapy is indicated for a few with more complex or deep-seated problems. Interventions have been used preventively to enhance psychological adjustment in the majority, and prevent psychiatric morbidity in the few. These include monitoring by nurse-counsellors, and supportive/educational group discussions for those with a particular physical condition, either with a professional therapist or on a self-help basis. There is some evidence that such measures reduce psychiatric symptoms, and improve quality of life; however, not all patients want them.

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