XXXX . A SAFE approach.

@entity1 @entity1118 @entity2371 @entity158
The efficacy of a multidisciplinary approach for the treatment of @entity1118 has been well documented. A recent randomized prospective trial by Peters and co-workers confirmed that multidisciplinary management of chronic @entity2371 resulted in greater improvement in @entity158 severity, increased employment, and improved functional health scores when compared with a traditional medical approach. Unfortunately, many gynecologists do not have the luxury of working in these types of settings. The SAFE approach allows the busy practitioner to evaluate the nonorganic and organic nature of @entity2371 simultaneously to manage these difficult @entity1 better. Initially, it is important to set up regular weekly visits with a prespecified time limit. During these sessions, one should focus on compliance to treatment recommendations. Components of management that have led to @entity158 reduction should be defined. Over time, these short visits can be spaced to bimonthly and monthly intervals; however, this strategy should not be rushed. If possible, the gynecologist should coordinate the care of difficult @entity1 with a physical therapist and mental health provider who can work in tandem on @entity158 reduction strategies and focused psychotherapy. The gynecologist should focus the @entity1 's attention on improvements in @entity158 reports and in functioning at school or work and reinforce the consistent use of medications, even if the recommended dose is low. Small improvements in health beget larger improvements in daily functioning.
