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If you are a patient with atopic eczema and you would like to use The Combined Approach there are two main options, the self-help programme, and the clinic-based programme.

The self-help programme

Self-help is an important component of The Combined Approach to atopic eczema: it is not a passive treatment. Active patient participation is key to its effectiveness, unless the patient is very young.  With the self-help programme, how much professional input is required will vary from person to person. At least some will be necessary for everyone, as the programme involves medical treatment.

The self-help version of The Combined Approach, "The Eczema Solution" by Sue Armstrong-Brown, was written after she had successfully followed the treatment programme as an out-patient at Chelsea & Westminster Hospital, London. She was delighted by the results and wanted as many people as possible to benefit from the same treatment approach. The self-help programme in her book has the same structure as the clinic-based programme.

First there is a week recommended for base-line counting and analysis of scratching, before starting four weeks for the main treatment phase. Almost all that is needed is her book, and a hand tally counter. Counters can be purchased from any good High Street stationery store, or online - see Shopping Links. Otherwise it is only necessary to organize some input from a primary care team. Ways of approaching a family doctor about this are covered in her book.

However you will also find it useful to read here the article  "Behavioural Dermatology - The combined approach to atopic eczema", and to watch here "Live without Eczema" - The Video. In addition The Forum topics, in Getting Treatment, are also useful to refer and contribute to. Others who have used the approach are available there to make suggestions, give support and celebrate your success.  Although Sue's book emphasizes self-help, the programme aims to change behaviour. The more that can be built-in to achieve this change, the more successful will be the outcome. If there are others around - family, or friends - to discuss the project with, and get support from, so much the better. Tell them about it, show them what you are doing, and explain how they can help.

Please let us know about your experience using the self-help programme. Keep in touch with us and give us an update as time goes by. Come back to this site and see how others are getting on. Sharing experience in this way is very important.

The clinic-based programme


The self-help approach is based on the successful clinic-based format, which in turn is based on the formula originally devised by Dr Peter Norèn and his colleagues in Sweden. It was the publication of their research results that led to the introduction of The Combined Approach at Westminster Hospital in 1989, and later at Chelsea & Westminster Hospital, London. Since then psychologists, dermatologists, psychiatrists, family doctors and nurse practitioners have easily learnt how to use The Combined Approach. Primary Care is ideal for The Combined Approach, with the hospital clinic perhaps reserved for training, and for complex cases.

The clinic-based programme is described here in detail in "Atopic Skin Disease - A Manual for Practitioners". The programme usually involves you working with a nurse or a medical practitioner, but you will be doing most of the work.

At present the clinic-based treatment programme is not widely available. A directory of where it can be obtained is under construction and will be published on this site when it is ready. In the meantime it will be very useful if as many members as possible let us know where the clinic-based treatment programme is available, both here in the UK, and elsewhere, or tell us  in The Forum - Getting Treatment.

If you use the clinic-based treatment programme you will find it useful to refer to all the resources available here, especially The Forum - Getting Treatment. It is important that your experience of atopic eczema, its conventional treatment, and the effectiveness of The Combined Approach is recorded here and discussed with other members, many of whom are practitioners.  They can learn as much from you as they can from Journals and Textbooks.

After completing the clinic-based programme, please keep in touch with us here, and let us know about your progress. Sharing experience in this way is a very useful way of keeping on track.


Dr Christopher Bridgett


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