Table 4 Psychologically informed physical therapy (PIPT) training course content details
| Â | Content description |
|---|---|
Overview | |
 Pain science update | Variability as an inherent feature of the pain experience; psychological factors as indicators to provide explanation of pain-related patient differences |
 PIPT overview | Identification of pain-associated psychological distress and use of targeted treatment approaches as key tenets of PIPT; preventing transition to chronic back pain is a primary outcome goal for PIPT |
 Risk stratification | Patient subgrouping; prognostic risk stratification; STarT Back Screening Tool |
 Targeted treatment | General overview of recommended treatment pathways for STarT Back low, medium, and high risk |
 Cognitive behavioral therapy | Principal CBT assumptions (e.g., treatment to address cognitive, emotional, and behavioral dimensions); CBT components (e.g., goal setting, skill development, monitoring, maintenance); distinction between CBT and PIPT |
 Self-reflection | Reflection on working with patient who is challenging to therapist (recognizing own thoughts, moods, sensations); empowerment through awareness; challenges and opportunities for physical therapist |
PIPT management | |
 Patient-centered communication | |
  Active listening | Examples, roadblocks, strategies |
  Motivational interviewing | Components (acceptance, compassion, evocation, partnership); strategies (open-ended questions, affirmations, reflections, summary) |
  Goal-setting | Collaborative process; assessing patient confidence, commitment, and barriers; SMART goals (specific, measurable, attainable, relevant, time-based) |
 Pain coping skills | |
  Physiologic relaxation | Diaphragmatic breathing methods, progressive muscle relaxation |
  Imagery | Pleasant place imagery |
  Replacing cognitive distortions | Using STarT Back Tool responses to identify and replace unhelpful thinking; treatment time efficiency |
 Patient education | Interactive, online program to help individuals manage pain following an injury |
 Activity-based | |
  Graded exercise | Operant-conditioning model; quota-based dosage system; progression; reward strategies |
  Graded exposure | Phobia model; hierarchical exposure approach; progression based on decreased fear of activity |
 Impairment-based | |
  Clinical practice guidelines | Review of orthopedic section of the APTA Low Back Pain Clinical Practice Guidelines |
 Treatment monitoring | Treatment monitoring concept and suggested methods |
 Challenges and opportunities | Open discussion with reference to peer-reviewed literature surrounding topic |