Table 1 Treatment modules and goals for CBT and IVR-CBT
Week | Coping Skill | Description | Goals |
|---|---|---|---|
0 | None | Baseline assessment | None |
1 | Introduction | Present rationale for treatment, explain pain cycle and introduce goal setting. | - Complete one exercise each day in the “Your Guide to Setting Meaningful Activity Goals” section |
2 | Stretching | Introduce stretching, its benefits, explain acute vs. chronic pain, beliefs about pain and provide suggested stretches to practice. | -Practice stretches provided in the handbook daily |
-Set/ work on meaningful activity goal | |||
3 | Movement, Walking & Body Mechanics | Instructions for walking, body mechanics, increasing activity and preventing injuries. | -Practice body mechanics |
-Increase daily steps +10 % of prior week’s steps | |||
- Set/ work on Meaningful activity goal | |||
-Continue to practice prior week’s skill | |||
4 | Deep Breathing | Instructions for diaphragmatic breathing and its benefits. | -Practice diaphragmatic breathing using CD for 5–10 minutes/day |
-Increase daily steps +10 % of prior week’s steps | |||
- Set/ work on meaningful activity goal | |||
-Continue to practice prior weeks’ skills | |||
5 | Progressive Muscle Relaxation | Instructions for progressive muscle relaxation and its benefits. | -Practice progressive muscle relaxation using CD |
-Increase daily steps +10 % of prior week’s steps | |||
- Set/work on meaningful activity goal | |||
-Continue to practice prior weeks’ skills | |||
6 | Identifying Unhealthy Thoughts | Influence of negative thoughts on pain, activities and mood. | -Practice catching unhealthy thoughts |
-Increase daily steps +10 % of prior week’s steps | |||
- Set/work on meaningful activity goal | |||
-Continue to practice prior weeks’ skills | |||
7 | Balancing Unhealthy Thoughts | Instructions for challenging and changing negative thoughts | -Practice catching and changing unhealthy thoughts |
-Increase daily steps +10 % of prior week’s steps | |||
- Set/work on meaningful activity goal | |||
-Continue to practice prior weeks’ skills | |||
8 | Time-Based Pacing | Instructions for time-based pacing and its benefits. | -Practice time-based pacing by applying it to one activity daily |
-Increase daily steps +10 % of prior week’s steps | |||
- Set/work on meaningful activity goal | |||
-Continue to practice prior weeks’ skills | |||
9 | Sleep Hygiene | Common sleep problems and sleep hygiene tips. | -Practice at least one sleep hygiene tip daily |
-Increase daily steps +10 % of prior week’s steps | |||
- Set/ work on meaningful activity goal | |||
-Continue to practice prior weeks’ skills | |||
10 | Planning for the Future | Relapse prevention; reviewing goals and accomplishments, managing relapse and pain flare ups. | - Complete 1 section of the pain flare prevention handout daily. |
-Increase daily steps +10 % of prior week’s steps | |||
- Set/work on meaningful activity goal | |||
-Continue to practice prior weeks’ skills |