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Table 3 Content of each group treatment (CBT, SPP, and HE) session

From: Comparative Efficacy and Mechanisms of a Single-Session Pain Psychology Class in Chronic Low Back Pain: Study Protocol for a Randomized Controlled Trial

Session CBT   SPP HE
1 Welcome and Introduction; CBT rationale and evidence; Pain physiology; Relaxation rationale; Importance of home practice Single session Single 2-h session, Didactic and Skills Acquisition
Didactic: Learn about mind– body science related to pain and PC; learn to identify catastrophizing in the moment; and how to self-treat it.
Skills Acquisition: Developing a plan to apply the learned skills to decrease physiological hyperarousal – diaphragmatic breathing and progressive muscle relaxation – within the context of PC. Improve the regulation of cognition and emotion, including PC reframing and thought restructuring. Developing a plan for implementing these skills in daily life. Identifying typical PC thoughts and practice writing out their reframes.
Participants leave with the following tangibles: (1) self-written, self-crafted, personalized PC cessation plan; (2) 20-min relaxation response audio CD/app; and (3) printed copy of the SPP content to access as needed in their PC cessation plan.
Single 2-h session, Class delivered via a PowerPoint presentation to groups of participants.
Content: Overview of back pain, including common sources and red flag symptoms. Also covers topics including managing a pain flare-up, working with healthcare professionals, evaluating treatments and making informed treatment decisions, and achieving and maintaining a healthy weight through good nutrition and exercise.
Relaxation: Intro to diaphragmatic breathing
2 Goal setting, activation, and pacing (SMART, rest-activity cycle, etc.); Red flags; Coping with flare-ups and creating a flare-up plan
Relaxation: 7-muscle group progressive muscle (PMR) relaxation
3 Role of thoughts and feelings in pain; Intro to CBT and terms; Intro to 3-column thought record
Relaxation: 4-muscle group PMR; fitting diaphragmatic breathing into daily life
4 Evaluating and generating alternate thoughts; Intro to evidence gathering; Intro to 4-column thought record
Relaxation: 4-muscle group PMR; no tension
5 More on evidence gathering and alternate thoughts (more detail); Working with thoughts review
Relaxation: Body scan
6 Thought records review
Relaxation: Walking body scan
7 Review of skills; Trouble-shooting re: thought records; Pain and mood; Pain core beliefs
8 Review of skills; “Signs” not using skills: Creating a plan for maintaining gains and dealing with setbacks; Termination and wrap-up
Relaxation: Guided imagery
  1. CBT cognitive behavioral therapy, SPP single-session pain psychology class, HE health education, SMART specific, measurable, assignable, realistic, time-related, PMR progressive muscle relaxation, PC pain catastrophizing