Incorporating Cognitive-Behavioral Therapy with Occupational Therapy: A Comparative Study with Patients with Low Back Pain

Abstract

This paper reports on the implementation of a psychoeducational program utilizing cognitive-behavioral principles. The efficacy of this psychoeducational treatment program in modifying dysfunctional attitudes in patients with chronic low back pain was examined using a two-group pretest posttest design with a follow-up at 3 months. Thirty patients (average age = 44,37, SD = 13.71) participated in the study, with 15 in the psychoeducational treatment group and 15 in the placebo control group. These two conditions were added on to an existing eclectic inpatient pain management program. After assessment on the IPAM (The Integrated Psychosocial Assessment Model), scores were reduced to multivariate composite scores on the factors of “illness behavior,” “depressed and negative cognitions,” and “acute pain strategies.” Results of a group × time repeated measures analysis of variance for the three pain factors revealed a significant main effect for group(F(23,1) = 5.00, p > .04), tempered by a significant interaction between group and time on the ‘depressed and negative’ pain factor(F(23,1) = 4.77, p > .04). Patients in the treatment group improved significantly over time and significantly more than the placebo control group patients at posttreatment. Results provide support for the program in increasing patients' feelings of control over their pain and the use of positive coping strategies, while reducing perceived helplessness, depression, disability, and pain intensity.