1st Edition

CBT for Managing Non-cardiac Chest Pain An Evidence-based Guide

    242 Pages 29 B/W Illustrations
    by Routledge

    242 Pages 29 B/W Illustrations
    by Routledge

    CBT for Managing Non-cardiac Chest Pain is an evidence-based guide and workbook for clinicians working with people with non-cardiac chest pain (NCCP). NCCP affects around 25–30% of people in the UK, USA, and Europe and is associated with high levels of health care use and compromised quality of life. This is the first book to describe a treatment programme to fill the gap in care for patients.

    The authors have developed and researched a novel approach that demonstrates how physiological, cognitive, behavioural and social factors all contribute to the negative experience of chest pain. With the help of exercises and downloadable handouts for the patient, the book aims to provide the necessary information and clinical skills and approaches for clinicians to use in health care settings.

    CBT for Managing Non-cardiac Chest Pain will appeal to anyone involved in the care of patients with NCCP, including nurses; general practitioners; cardiologists; acute medical physicians and psychologists.

    PART 1 Introduction 1: What is non-cardiac chest pain? 2: What is coronary disease and how is it excluded? 3: Historical, social and cultural perspectives on NCCP 4: Biopsychosocial approaches to pain 5: The biopsychosocial approach to NCCP 6: Cognitive Behavioural Therapy and NCCP 7: The biopsychosocial assessment for NCCP PART 2 – THE WORKBOOK How to use the workbook Session 1: Understanding chest pain and setting goals Session 2: Paced, mindful, abdominal breathing Session 3: Stress management and relaxation Session 4: Keeping active Session 5: Thinking about chest pain Session 6: Review and maintenance PART 3 – FURTHER RESOURCES Appendix 1: Invitation leaflet for the clinic Appendix 2: Assessment tools Appendix 3: Treatment handouts Glossary of terms


    Dr Elizabeth Marks is a chartered clinical psychologist and accredited CBT practitioner. She works at University College London Hospital and is a Lecturer in Clinical Psychology at the University of Bath. Elizabeth's particular interests lie in enabling people to better manage chronic illness and to reduce the emotional and physical consequences physical health problems, such as chest pain. She has published a number of articles on non-cardiac chest pain.

    Professor Myra Hunter is Emeritus Professor of clinical health psychology with King’s College London. She has specialised in the application of psychology to cardiology, oncology and women’s health and has published over 200 articles and chapters and 7 books. Her clinical research has focused on developing interventions to help people to manage persistent physical symptoms, such as chest pain.

    Professor John Chambers is Professor of Clinical Cardiology and consultant cardiologist at Guy’s and St Thomas’ Hospitals, London. He has a career-long interest in the interactions between physical and psychological processes in non-cardiac chest pain. John has published 8 books and over 300 papers on general medicine, heart valve disease, chest pain and cardiac imaging.

    "This book leads the reader through a biopsychosocial understanding of Non-Cardiac Chest Pain with great clarity and logic, leading to a well integrated presentation of relevant empirically grounded models. The evidence backing this approach to understanding and treatment is then explained in ways which illustrate the flexibly presented intervention strategies for low-intensity working. Clear signposting makes the usually difficult and complicated issue of how to work within stepped care manageable. The detailed workbooks are models of low-intensity guidance within a formulation based framework, combining specific directions with flexibility to respond to the needs of the service user. This should be the definitive text for empirically grounded low intensity treatment of Non-Cardiac Chest Pain; a wonderfully clear, thoughtful and well-written account integrating understanding and intervention in NCCP".

    Paul Salkovskis, Professor of Clinical Psychology and Applied Science, University of Bath and Director, NHS Centre for Specialist Psychological Treatments of Anxiety and Related Problems.

    "Non-cardiac chest pain affects as many as 80% of patients attending chest pain clinics yet treatment is suboptimal. These patients have been consistently shown to continue to report symptoms and functional impairments and to be high users of expensive health care. This timely book addresses this neglected public health problem, and provides clear account of assessment and management. The authors have adopted a multidisciplinary, "stepped care" approach to treatement which has been shown to be effective in reducing chest pain frequency as well as improving behaviour and well being. The book deserves to be widely read by practitioners working in both primary and tertiary care settings. GPs, Emergency room clinicians and cardiologists will find it particularly useful"

    Christopher Bass, Christopher Bass, Consultant in Liaison Psychiatry, John Radcliffe Hospital.