ABSTRACT
This chapter explains how to conduct biopsychosocial assessment of chest pain and discusses how to formulate this in a cognitive behavioural therapy (CBT) model. It offers a comprehensive guide to assessing non-cardiac chest pain (NCCP). An experienced cardiologist will provide confidence to the patient in the formulation of NCCP. Paying equal attention to psychosocial and physiological processes reduces concerns about CBT as a psychological approach to a physical symptom. Most people with NCCP understandably have a biomedical model of chest pain, so it is important to begin to reshape expectations about a more biopsychosocial approach early on. The medical assessment is designed to uncover alternative mechanisms for chest pain. Each section of the chest pain cycle can be completed using the specific body sensations, thoughts, emotions, behaviours, social world and protective factors that emerge during assessment and throughout treatment. Psychiatric comorbidities are common in NCCP, and some can even directly cause chest pain.
