Application of choice theory and reality therapy in the guidance of schoolchildren suffering from psychosomatic diseases

In the course of his or her work a school doctor frequently comes across children who say they have headaches, dizziness, feelings of weakness, stomach pains, nausea, stabbing pains around the heart, rapid heart rate, a lack of air, disturbed menstrual cycle, but without any diagnosed somatic changes, which indicates the psychosomatic nature of the disturbances. At the Department for School medicine in Metković the theory of choice and reality therapy have been used with these children. Twenty adolscents were dealed with (12 girls and 8 boys from 13 to 18 years of age). After 5 sessions 30% stopped mentioning their symptoms, and after the 15th session the symptoms ceased completely in 10 adolescent girls and 6 boys, and did not reappear over the following year. The therapeutic approach – the transformation process – into the person the psychosomatic patient would like to be, is presented using the case of an eighteen-year-old high school girl who presented with mentstrual cycle disturbances, emaciation, hand tremours and anxiety. There is a brief presentation of the case of a fifteen-year-old boy who came with headaches, pressure in his chest and dizziness, and who had previously undergone about twenty medical procedures in primary and secondary health care, with no results. In his case, family therapy was used successfully. We conclude that a knowledge of choice theory and reality therapy makes counselling work in school medicine more effective and makes it possible to avoid unnecessary medical intervention.