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