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Table 1 Contents of each of the six sessions

From: Description and design considerations of a randomized clinical trial investigating the effect of a multidisciplinary cognitive-behavioural intervention for patients undergoing lumbar spinal fusion surgery

All sessions commence with a short presentation of the day's session, new participants are introduced, and homework and questions from the previous session are discussed.
  Session A – preoperative
CBT Physical and psychological reactions in stressful situations.
The link between thoughts, feelings, bodily reactions and behaviour.
Preparing for surgery What to expect of the operation and the postoperative course.
Homework Identify and write down thoughts and feelings in relation to painful or stressful situations. Consider and write down alternative and realistic thoughts.
  Session B – preoperative
CBT Causes and consequences of pain. The fear-avoidance belief model and the importance of physical activity in reducing pain.
Preparing for surgery Pleasant activity scheduling and activity pacing.
  Ergonomics - working posture following surgery.
Homework Identify and write down 3 activities you used to enjoy. Plan and go through with them considering your pain level. How did it affect your mood and pain level?
  Session C – preoperative
CBT The link between thoughts, feelings, bodily reactions and behaviour.
Negative automatic thoughts and their role in maintenance of a vicious circle.
  Active and passive coping strategies.
Homework Identify and write down your own coping strategies when in pain and distress.
  Try to use active coping strategies. How did it affect your pain level?
  Session D – preoperative
CBT How to cope with pain and distress in relation to family, friends and work.
Preparing for surgery The experiences of a previously operated patient.
  Legislation and procedures in the authorities when being on sick leave and in relation to return to work.
Homework Say no to 3 tasks, that you would usually agree to do, despite not being comfortable doing it.
  Promt a friend, colleague or family to give you a positive support remark.
  Give a friend, colleague or family a positive remark and notice the reaction.
  Follow-up session 1 – postoperative (3 months)
CBT Reflection of how patients have used the acquired cognitive techniques and coping strategies postoperatively.
Using pacing techniques to restart daily activities, hobbies and work.
Homework Goal setting for the next three months.
Use pacing techniques to achieve one or more of your goals.
  Follow-up session 2 – postoperative (6 months)
CBT Reflection of how patients have used the acquired cognitive techniques and coping strategies during the past 3 months.
Discussion of achievements of previously set goals. Setting future goals.
Coping with flare-ups.
Returning to work – expectations, worries and how to cope with barriers.