The identification, assessment and management of somatisation in clients of osteopathic practitioners in New Zealand

Background: Somatisation has a high prevalence in all cultures, and can lead to disability and become a socioeconomic problem. In an osteopathic clinical environment, identification and management of somatisation could be important for an osteopathic practitioner as the physical manifestations of somatisation include pain and neurological symptoms, which are common symptoms in patients who seek osteopathic treatment. Furthermore, iatrogenic factors may also contribute to the maintenance and exacerbation of somatisation. Objectives: The aims of this study are to explore and describe: a) How osteopaths in New Zealand identify, assess, and manage somatisation in clients, and their attitudes toward the management of somatisation. b) The kinds of previous education osteopathic practitioners have in relation to somatisation, and their attitudes toward further education related to somatisation. Methods: The present study used a descriptive/explorative survey design and combined quantitative and qualitative methods for data collection and analyses. A total number of 230 New Zealand registered osteopaths who are the members of both New Zealand osteopathic societies were invited to complete the online survey questionnaire. Descriptive and inferential analytical techniques were used for the quantitative data while descriptive and thematic analysis techniques were used for the qualitative data. Results: Out of the 230 osteopaths invited to participate in the study, 40 (17%) completed the survey. The most common assessment tool/method used was tissue palpation followed by verbal communication, cranial rhythm, and standardised assessment tools. The majority of respondents (80%) believe that osteopathy helps clients with somatisation, and agree that they would manage somatisation in their clients in the course of providing osteopathic treatment. Almost half of the respondents (46%), however, reported that it is ‘considerably’ or ‘a great deal’ difficult to manage clients with somatisation. The majority of respondents felt that they did not have sufficient education on how to manage clients with somatisation, and 75% of respondents reported that further education about somatisation would be valuable for their practice. Conclusion: Majority of respondents reported that they encounter clients with somatisation frequently. However, they feel that they have difficulties in managing these clients. Considering a high prevalence of somatisation in clients with musculoskeletal problems and the possible iatrogenic factors that can arise from a practitioner’s lack of knowledge, it is suggested that osteopathic education providers further investigate incorporating learning material on the topic of somatisation into the osteopathic training programme