It is based on the hypothesis that inaccurate and unhelpful beliefs, ineffective coping behaviour,
negative mood states, social problems, and pathophysiological processes all interact to perpetuate the illness.8 9 Treatment aims at helping patients to re-evaluate their understanding of the illness and to adopt more effective coping behaviours.7 8 9 An early uncontrolled evaluation of this type of treatment
produced promising results in many patients but was unacceptable to some.10 Two subsequent controlled trials found cognitive behaviour therapy to offer no benefit over non-specific management.11 12 However, the form of cognitive behaviour therapy evaluated may have been inadequate.