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Table 1 Details of the contents of the cognitive behavioural intervention group sessions

From: Treatment compliance and effectiveness of a cognitive behavioural intervention for low back pain: a complier average causal effect approach to the BeST data set

Session number

1

2

3

4

5

6

Assessment

      

ā€‚History taking including current problems and eliciting beliefs on LBP and activity

ā€‚Collaborative goal setting with plan to start activity goal

ā€‚Exercises chosen collaboratively from options with level negotiated

ā€‚Exercises practised and progression discussed

Understanding pain

āœ“

     

ā€‚Group activity to demonstrate hurt does not equal harm

ā€‚Current thinking on causes of long-term pain explained

ā€‚Discussion on groups experience of alternative treatments for LBP with reference to research evidence and need to self manage

Benefits of exercise

āœ“

     

ā€‚Discussion of physical impact of inactivity or altered activity and how changes impact on pain (disuse syndrome)

ā€‚Discussion on effects of activity/exercise

ā€‚Introduction to LBP model

Pain fluctuations

 

āœ“

    

ā€‚Overactivity/underactivity cycle explained

ā€‚Use of pacing

ā€‚Group problem solving for a specific task that tends to be ā€˜overdoneā€™ e.g. gardening

Working out starting point for exercises or activities

 

āœ“

    

ā€‚How to use baseline setting

How to set goals

 

āœ“

    

ā€‚SMART system used to break down an example goal

ā€‚Feedback from group on how progressing with goals from assessment

ā€‚Group problem-solving problems with goals

Unhelpful thoughts and feelings

  

āœ“

   

ā€‚Styles of unhelpful thinking discussed, including catastrophising

ā€‚Link with unhelpful behaviours

ā€‚Identifying unhelpful thoughts

ā€‚Group problem-solving for challenging unhelpful thoughts

Restarting activities or hobbies

   

āœ“

  

ā€‚Discussion on activities commonly avoided in LBP

ā€‚Fear avoidance cycle

ā€‚Group problem-solving out of cycle

ā€‚Development of specific goals relating to restarting activities

When pain worries us

    

āœ“

 

ā€‚Effect of attention to pain explored through group activity

ā€‚Hypervigilance cycle used to link unhelpful thoughts and behaviours

ā€‚Group problem-solving out of cycle

ā€‚Discussion on the use of medication/distraction/alternating activities

Coping with flare-ups

     

āœ“

ā€‚Discussion on causes of flare-ups

ā€‚Plan of what to do in and out of flare-ups

ā€‚Revision of topics over previous sessions and questions

  1. LBP, lower back pain.