I have written this book to help health professionals in their management of people who used to be diagnosed with hypochondria, but whom I think are better described as having health anxiety. I work mainly in general hospital settings and we now know that somewhere between 10 and 20% of all patients attending clinics in general hospitals have pathological health anxiety. It is pathological because it creates enormous suffering and disability and this often goes on for years in the absence of treatment. At present it is unfortunate that most of these people continue to attend clinics in search of a treatment not for their anxiety, but for the disease or diseases that they suspect they might have.

Although there are psychological services for people with health anxiety, only a small proportion of those with the condition are ever seen. This is partly because it is so common, partly because many people feel stigmatised by the suggestion that they might need psychological input for what they suspect is a physical condition, and partly because those who already have a physical disorder but also have abnormal health anxiety are not normally seen by the psychology services. I believe fervently that the best way of managing health anxiety successfully and economically is for front-line staff in medical services to both recognise and treat these patients in the clinics where they present repeatedly. They should be treated by staff who are part of the general services, not referred to a specialised clinic. So general and specialised nurses of all grades, occupational therapists, physiotherapists, dietitians, and support staff with relatively little in the way of formal qualifications, as well as psychologists, can all become competent in both identifying people with health anxiety and giving them advice and treatment. This is not a belief; it has recently been reinforced by evidence from a large randomised trial (Tyrer et al, 2013).

What I hope is that the necessary advice and treatment is given in this book. It is all based on my practice over the past 12 years and work in developing this treatment, and I am indebted to Professor Paul Salkovskis in first showing me the essentials of this important modification of cognitive–behavioural therapy (CBT) that lie at the heart of management.