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Table 2 Percentage of occurrences observed of the Essentiala elements of the of the exposure program

From: Pain-related fear in adolescents with chronic musculoskeletal pain: process evaluation of an interdisciplinary graded exposure program

No.Specific elementCategoryPercentageb
PREPARATION PHASEn = 8 sessions evaluated
P2There is good teamwork between the therapists and adolescentE100
P3The adolescent’s concern/fear with regard to activities is being discussedEU100
P6The adolescent assesses the level of perceived threat value of daily activities (PHODA)EU94
P8The aim of the treatment session is explained to the adolescentE88
P9The therapists respond understandingly to the problems expressed by the adolescentE100
P10Photographs of daily activities are being usedEU88
P14A hierarchy is being developed based on the threat value of daily activities (PHODA)EU88
P17It is discussed how parents react to the disability and pain of their child.E13
 Mean proportion of essential preparation phase elements (%) 84
EDUCATION PHASEn = 5 sessions evaluated
E1It is emphasized that in chronic pain no clear relationship exists between pain and injuryE100
E3The adolescent’s concern/fear with regard to activities is being discussedEU100
E4There is good teamwork between the therapists and adolescentE100
E5The aim of the treatment session is explained to the adolescentE80
E9A biomechanical approach to pain is being discouragedE70
E11It is emphasized that pain reduction is not a therapy goalE70
E12The adolescent is being actively involved in the explanation of the therapyE100
E13It is explained that the treatment is aimed at verifying examining cognitionsEU70
E14A bio-psycho-social approach to pain is being explainedE100
E15It is emphasized that all activities are possibleE30
E17The drawbacks of inactivity are being explainedE70
E21The circular model pain-pain cognitions- avoidance – pain is being explainedEU90
E22The therapists respond understandingly to the problems expressed by the adolescentE90
E23It is explained that the aim of the therapy is an increase in activity levelE40
E25The motivation of the parents for the treatment of their child is being checkedE10
 Mean proportion of essential education phase elements (%) 79
TREATMENT PAHSEn = 7 sessions evaluated
T1Homework is being assignedE64
T3The adolescent’s concern/fear with regard to activities is being discussedEU100
T4The aim of the treatment session is explained to the adolescentE86
T5A catastrophizing cognition is being identifiedEU100
T6There is good teamwork between the therapists and adolescentE100
T8A behavioral experiment is being performedEU100
T9The therapists respond understandingly to the problems expressed by the adolescentE93
T11Activities from the hierarchy or based on threat value are being performedEU93
T14Clear agreements are made about the way in which activities should be carried out (e.g. how often, how high the jumps should be, how to bend down)EU50
T15Homework is being evaluatedE44
T21It is discussed how parents react to the activities that the adolescent has started to perform.E29
 Mean proportion of essential treatment phase elements (%) 79
  1. aEssential treatment elements are both Essential-and-Unique (EU) and Essential-but-not-unique (E) treatment elements (Method of Assessing Treatment Delivery, described by Leeuw and colleagues [34])
  2. bThe reported percentage reflects the rating of both raters, therefore for each session evaluated, two ratings were used to calculate the percentage