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Table 2 An overview of the content of the cognitive-behavioral intervention based on Linton (2005)[22]

From: Effectiveness of a cognitive-behavioral group intervention for knee osteoarthritis pain: protocol of a randomized controlled trial

Session

Focus

Skills

Objectives

1

Causes of pain and the prevention of chronic problems

Problem solving

•To provide information about the causes of pain.

 

Applied relaxation

•To provide information about the risk of chronic pain problems.

 

Learning and pain

•To help participants in identifying relevant factors in one’s own pain problem.

 

•To train problem-solving and relaxation skills.

•To teach pain control techniques.

2

Managing your pain

Activities, maintain daily routines

•To provide information about the relationship between activity and musculoskeletal pain.

Scheduling activities

•To help participants in understanding fear avoidance behavior.

Relaxation training

•To teach participants to identify goals for a satisfying activity level.

•To teach management skills: scheduling, pacing, graded increase.

•To teach cognitive skills to minimize problems with activities.

•To introduce stress and stress management.

3

Promoting good health, controlling stress at home and at work

Warning signals

•To provide information how pain problems may be prevented.

 

Cognitive appraisal

•To provide information how to utilize thoughts and behaviors in preventive efforts.

 

Beliefs

•To teach how to apply various skills (relaxation, activity management, beliefs, pauses etc.) as coping.

•To help the participants to identify targets for developing coping strategies.

•To teach applied relaxation as coping strategies.

4

Adapting for leisure and work

Communication skills

•To provide opportunities to receive reinforcement for correct ”coping” approximations from the group.

 

Assertiveness

 

Risk situations

•To provide information about how workplace and family may be influenced by the participant’s pain problem.

Applying relaxation

 
 

•To provide information and coping strategies concerning situations where the workplace and family may influence the participant’s pain perceptions.

•To teach assertiveness in using the coping skills learnt.

•To help participants to identify supportive behaviors from others.

•To teach participants to prompt these behaviors to promote positive relationships with family and friends.

•To teach how to apply rapid relaxation to risk situations.

•To teach participants how to employ several coping techniques in social situations.

•To begin to plan a personal coping program.

5

Controlling flare-ups

Plan for coping and flare-ups

•To provide information about flare-ups and maintenance.

Coping skills review

•To teach how to use applied relaxation as coping.

Applied relaxation

•To teach how to apply their skills to cope with flare-ups.

Own program

•To develop a personalized coping program.

 

•To develop a self-care strategy that may reduce the need for healthcare visits.

6

Maintaining and improving results

Risk analysis

•To reinforce appropriate coping behaviors.

Plan for adherence

•To provide information about maintenance and adherence.

Own program finalized

•To teach participants to do risk analysis and enhance adherence.

 

•To teach participants about enhancing and fine-tuning their program.

   

•To evaluate the course and participants’ progress.