Awareness, Beliefs and Practice of Cognitive Behavioral Therapy (CBT) Strategies for Chronic Pain Management Among Physiotherapists

Abstract

Purpose: To evaluate the awareness, practice and beliefs about CBT strategies for chronic pain management among Physiotherapists. Relevance: Chronic pain can be defined as pain that persists for 3 months or longer and, while not necessarily maladaptive, often leads to physical decline, limited functional ability and emotional distress. CBT has been increasingly used as an effective tool by psychologists in the management of chronic pain that is delivered through individual or group counselling sessions. Cognitive restructuring, relaxation techniques, activity pacing and good sleep hygiene are a few strategies of cognitive behavioral pain management therapies. There is also increasing evidence that supports the use of CBT strategies by Physiotherapists during their treatment for obtaining a positive outcome for chronic pain patients. Method and Analysis: A Google Form was formulated with relevant questions about awareness, practice and beliefs about CBT strategies for chronic pain. The questionnaire was face validated by 3 independent psychologists who practice CBT for chronic pain in their regular practice. This form was then distributed through various Physiotherapy groups in Bangalore via snowball sampling method. The data obtained from the responses were then complied, decoded and quantitatively analysed through content analysis using the SPSS-22. Result: The result showed strikingly contrasting responses from the Physiotherapists, as even though the majority of them were aware of CBT (34.1%), they applied it relatively less (15.3%). Of 63.5% Physiotherapists believed that pain perception is affected by automatic thoughts, while 52.9% agreed that negative thoughts need to be changed into positive coping thoughts. Around 49.4% of Physiotherapists believe in teaching relaxation techniques to their patients with chronic pain. Activity pacing and good sleep hygiene are important, as believed by 25.9% and 47.1% respectively. Physiotherapists (56.5%) accepted that patient needs to be mindful while exercising. Conclusion: Majority of Physiotherapists are aware and have positive beliefs about CBT strategies for chronic pain management. However, comparatively, we can see variations in the application of CBT strategies in their treatment plan. KEY WORDS: Cognitive Behavioral Therapy, chronic pain, Physiotherapy.