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Table 1 Summary of patient manual: a transdiagnostic approach for PPS

From: Persistent physical symptoms reduction intervention: a system change and evaluation in secondary care (PRINCE secondary) – a CBT-based transdiagnostic approach: study protocol for a randomised controlled trial

Chapter 1: Explanation of PPS Explanation of i) PPS), ii) commonalities between PPS conditions, iii) CBT.
Chapter 2: Making sense of PPS The impact of PPS on psychosocial functioning.
Making a link between symptoms, behaviours and thoughts.
Chapter 3: Goal setting Identifying goals.
Strategies: goal setting.
Homework: self-help materials (e.g. goal sheets).
Chapter 4: Monitoring your daily life Rationale for keeping daily diaries.
Homework: Keeping daily diaries.
Chapter 5: Activity scheduling Explanation and evaluation of how PPS can reduce activity.
Benefits of increasing activities.
Homework: Increasing pleasurable and enjoyable activities.
Chapter 6: Overcoming barriers to change Strategies to increase motivation.
The impact of stress on PPS.
The benefits of being active.
Strategies to reduce stress levels and increase energy levels.
Explanation and identification of “boom and bust behaviour”.
Chapter 7: Managing unhelpful thoughts and behaviours Identifying unhelpful thoughts and behaviours.
Self-help strategies for managing unhelpful thinking and behaviours.
Identifying sources of social support and unhelpful relationships.
The importance of assertiveness.
Strategies to become more assertive.
Chapter 8: Living with uncertainty & developing acceptance Strategies to cope with uncertainty.
Managing discomfort with acceptance.
Chapter 9: Improving sleep Identifying sleep problems.
Advice on sleep management.
Homework: Sleep management worksheets.
Chapter 10: Responding differently Refocussing attention and distraction.
Basic stress management.
Relaxation techniques.
Chapter 11: Managing and coping with difficult emotions Identifying difficult emotions.
Coping strategies to facilitate the management of difficult emotions.
Chapter 12: Managing progress and managing setbacks The importance of maintaining progress.
Strategies to facilitate the routine application of relevant strategies learned in the manual/during therapy.
Setting short- and long-term goals.
Strategies for managing setbacks.