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Printable Handouts
Navigable Slide Index
- Introduction
- Psychological intervention trials for chronic pain
- Systematic reviews
- Delivering CBT to chronic pain patients
- How good is the evidence?
- Myth number 2
- Post-hoc analysis of systematic reviews
- Delivering psychological interventions
- Maximizing psychological interventions
- NICE guidelines 2009
- "Yeah, sure"
- Screening and matching
- StartBacK trial
- The StartBack tool distress sub-scale (high risk)
- Findings
- How well did each risk-group do?
- High risk group at 12 months
- High risk group
- Where are we now?
- Summary of evidence on psychological intervention
- Kind of trials we no more need
- Back to the drawing board
- CBT: we don't see the world as it is
- CBT- changing the way we think and behave
- The CBT process
- Identifying maladaptive beliefs
- When the core belief is not a result of bias
- CBT seeks change in interpretation of the world
- Example of ACT
- Acceptance and commitment
- CBT vs. ACT
- ACT for populations with pain
- The on-going problem
- What for whom?
- What we have learned so far
- Conclusion
- Final message
Topics Covered
- Psychological intervention trials for chronic pain
- Maximizing psychological interventions
- The use of cognitive-behavioural (CBT) approaches
- Acceptance and commitment therapy (ACT)
- A comparison of CBT to ACT
Links
Series:
Categories:
Therapeutic Areas:
Talk Citation
Pincus, T. (2015, July 30). Psychological treatment for people with musculoskeletal pain 2 [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved December 6, 2024, from https://doi.org/10.69645/WKAA1762.Export Citation (RIS)
Publication History
Financial Disclosures
- Prof. Tamar Pincus has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
Psychological treatment for people with musculoskeletal pain 2
Published on July 30, 2015
42 min
Other Talks in the Series: Back Pain Management
Transcript
Please wait while the transcript is being prepared...
0:04
There is now a large body of
evidence on interventions that
really did offer psychological
treatment to people
with chronic pain and low
back pain within this.
There were several
systematic reviews.
Most of the trials included
cognitive behavioral therapy,
not necessarily delivered
by a psychologist.
0:29
The systematic reviews report
that the effect size is shrinking.
In other words, the
original systematic review
that looked at all of this reported
an effect size of around 0.5,
which is a respectable moderate
effect size for improvement.
But as trials get better,
the effect size gets smaller,
and it's now only around 0.2.
We're getting much
better at doing trials.
The authors of the most recent
systematic review in 2012
report that the methodology
is improving all the time.
However, the delivery of treatment,
what is actually given to patients,
is not improving.
The dose is still diluted.
Fidelity and integrity
are not evident.
1:17
The conclusion from
systematic reviews
is that cognitive behavioral
therapy is effective.
It improves mood.
It changes beliefs.
It increases social
and work engagement.
It decreases disability, and
it improves function, a little.
This is disappointing, considering
that the psychological obstacles
to recovery are robust, and we
would think that psychological
interventions that try and tackle
these would show a medium to large
effect size, but they don't.