Ms. j age 42, has been coming to the mental health clinic for 2 years for her nerves. She has only seen her primary healthcare provider for prescription medication. The care provider referred her to the nurse's new "stress management group" because she is experiencing side effects from all the medications that have been tried. The psychiatrist has diagnosed her with somatic disorder and wants her to learn to manage her nerves without medication. At the first meeting with the nurse, Ms. was preoccupied with chest pain and bloating that had been ongoing for the past 6 months. Her chest pain is constant and sharp at times. The pain does not prevent her from going to her job but does interfere with meal preparation at night for her family and her ability to have sexual intercourse. She has numerous other physical problems, including allergies to certain perfumes, dysmenorrhea, ovarian polycystic disease, chronic urinary tract infections, and rashes. She is constantly fatigued and has frequent leg cramps. She states that she is too tired to prepare dinner for her family. On days off from work, she takes a nap in the afternoon, sleeping until the evening. She is unable to fall asleep at night. She believes that she will soon have to have her gallbladder removed because of occasional back pain and nausea that occur several hours after eating. She is not enthusiastic about a stress management group and does not believe that it will help her, but has agreed to consider it, while insisting that the psychiatrist continue prescribing her diazepam.

1. How would you prioritize Ms. J's physical symptoms?

2. What strategies would you use in the group to help Ms. J explore the roots of her stress and fatigue?