Table 4 Physiotherapist Manual
Week | Theme | Topics to address | Learning goals |
|---|---|---|---|
1 | Get started | • Help patient to get started • Ask if they have tried the relaxation technique • Ask if they have completed diary exercise. | • Learn about the relation between thoughts, feelings and behaviour • Learn a relaxation technique |
2 | Goals for the recovery | • Ask if the patient has started to fill in pie chart and the Goal podium. • Remind about relaxation technique and writing exercise. | • Be able to support patient in setting goals and using strategies to cope with pain |
3 | Stress and pain | • Discuss what they consider to be their main stressors • Help to fill in the goal podium and reminder about relaxation techniques and writing exercise. | • Learn about stress and pain, and be able to support patients to change habits |
4 | Lifestyle | • Ask if the patient has completed the exercise about “safety behaviour” • Help to revise the goal podium • Remind about relaxation techniques and writing exercise. | • Learn about safety behaviour and be able to help patient to be aware of how different kinds of lifestyles can contribute to symptoms |
5 | Identifying automatic thoughts | • Discuss how it was to do the exercise about “Inner dialogue” • Remind about writing exercise: Pain triggers and alternative thoughts. • Remind about relaxation techniques | • Be able to help patient to be aware of their own thinking errors and automatic thoughts |
6 | Creating new thoughts | • Ask about what he/she gets out of the information about thinking errors • Ask what experiences he/she had when identifying their own thinking errors • Remind about writing exercise: Emotional expression • Remind about relaxation techniques | • Be able to support patient to identify their own thinking errors and create alternative thoughts |
7 | Becoming more mindful | • Ask if patient experiences having selective attention directed against threat and loss in relation to their OA • Ask what experiences he/she has in relation to the exercise “conscious refocusing” • Remind about the writing exercise: Going deeper • Remind about relaxation techniques | • Learn about Default Mode Network (DNM) and mental habits to be able to support the patient to become more mindful |
8 | Selective attention | • Ask patient what they think about the exercise “Floating leaves” • Remind about the writing exercise: Choose Perspective • Remind about relaxation techniques | • Learn about selective attention and be able to support the patient to be more mindful |
9 | Postponing worry and rumination | • Ask patient if he/she can distinguish between worry and rumination • Ask if he/she can postpone the worry and rumination by creating a “Postponement log” • Remind about writing exercise: Living with loss and changes in life • Remind about relaxation techniques | • Learn about worry, rumination and why worry escalates. Be able to support patient to postpone worry and rumination and make a postponement log |
10 | What next? | • Discuss what the patient has learned, what he/she has achieved and what remains. • Encourage the patient to look back on previous exercises. • Remind about writing exercise: What have I learned • Discuss what to do next | • Be able to support the patient to use what they have learned and to create new goals in life. |
11 | Specialization for physiotherapists | • Understanding the concept • The learning model • Key elements in CBT • Home exercises | • Increase physiotherapist’s knowledge about the elements of the intervention |
12 | Conversation with the participants | • Motivating interview (MI) (video) • MI techniques (video) • Resistance • When users experience challenges • Getting stuck in unhelpful thoughts – encourage meta-perspective • Pitfalls in building alliances • Unhelpful assumptions | • Improve the quality of the interaction between the physiotherapist and the participant |