ACT – some evidence for acceptance & commitment therapy in chronic pain

For a relatively young therapy, ACT has a lot of research to support its use in chronic pain. A very quick search through PsychInfo located 51 studies since 2002 with the keyword ‘acceptance’, and the majority of these (I didn’t count them up!) were related to ACT studies.
I’m not intending to run through a [...]

Safety behaviours – do they maintain kinesiophobia?

Let me start by saying this post is conjecture, but based both on observing patients, and after reading an interesting paper on ’subtle avoidance and safety behaviours relevant to social anxiety’.
First some definitions: I hope you’re all familiar with the term ‘kinesiophobia’, or ‘fear of movement’ – it’s the fear and avoidance of movements that [...]

Functional capacity evaluations – do they predict function in the ‘real world’?

What do you do when a client has a goal ‘to establish functional abilities for work’, spends a lot of time looking at setting baselines at home, develops a good knowledge of how to maintain consistency, starts to work and sustains abilities in a specific workplace, then completes a functional capacity evaluation that says he [...]

A Positive Case Formulation for Chronic Pain

The past couple of days I’ve looked at resilience, strengths and growth as part of assessing a person with chronic pain. The rationale is that although we are often seeking to provide support for deficits, or develop strengths, I wonder whether we always appreciate what people already have used to live with their pain.
To [...]

Tell me what you want, what you really, really want

A theme in almost any reading about health is that treatment should be patient-focused, typically goal-directed and have some sort of measureable impact. Over the past few weeks I’ve been reading about the process of goal setting and motivation, finding that there can be quite some differences between what a therapist sees as a [...]

Goal setting: no easy task

Goal setting is an important part of most treatment planning in rehabilitation – and pain management is no exception. It is thought to help to:

strengthen the therapeutic relationship through collaboration;
focus therapy on areas that the patient wants;
help the patient maintain motivation and adhere to treatment; and
ensure specific outcomes are identified and measured – amongst other [...]

Quickie diagram of the process from assessment to treatment

Perhaps the tail is wagging the dog – a tussle about ethics

As health professionals we are privileged to hold a lot of information about people that we work with. Along with the personal information people give us through interviews, we have information we obtain from questionnaires, the observations we make, and from our reading of historical information the person (and other health providers) has provided. [...]

‘So how do you feel?’ – when should you ask about pain?

If you have ever had to fill out a client charge-out sheet you will know just what a pain it can be to have to record what you’re doing every 10 minutes or so…and if you’ve EVER tried to get a patient to fill out a daily activity diary, daily pain diary – or any [...]

Quality assessment of diagnostic accuracy

I was taking a moment or two to looked through some of my RSS feeds, and came across this post on the quality of diagnostic accuracy.  QUADAS stands for:

Q – Quality
A – Assessment of
D – Diagnostic
A – Accuracy
S – Studies

It’s especially developed for people who use physical assessment, and in this post written by physiotherapist [...]