Hippocrates

Now I’m not going to post a lot about Hippocrates himself, but I want to start todays post by quoting something that he is supposed to have said: ‘There are, in fact, two things, science and opinion; the former begets knowledge, the latter ignorance’.
Hippocrates proposed that if a new treatment was to be tried, we [...]

Effects of disability - diathesis-stress

I’ve posted before on the effects of disability that make coping a challenge - today I want to cover a few more areas. My aim is not to suggest a ‘poor me’ attitude towards people with chronic pain, but instead to highlight how these demands might affect core beliefs. This is an important [...]

For the visual amongst us - CB Worksheet

I’m a very visual person, I love to see what I’m doing, and I use visual imagery a lot in my language and my processing. Many of our clients are also visual - or they’re kinaesthetic - and they need to see and manipulate rather than listen and talk.
At some point while working with [...]

We’re not trained monkeys!

One time I was carrying out some work for a large organisation that wanted to train a lot of people to do some assessment work. It annoyed me for some reason, and I’ve finally hit on the problem (OK, several years too late, but never mind!). The problem was that instead of teaching principles, [...]

Some theory - and how we can put it into practice

Before we start on cognitive behavioural therapy, we need to know what we’re on about - for me in pain management, CBT assumes:

that people are capable of change,
can accept self responsibility for their actions,
that what we think and believe about a situation can affect our emotions and responses, and
that we can implement a whole [...]

Working with cognitive behavioural therapy - Introducing CBT to a client

For a therapy that has great empirical support and can be used by any and all members of the interdisciplinary team, you can’t really go far from cognitive behavioural therapy. Waaaay back in the olden days when I was originally trained as an occupational therapist, CBT was the province of psychologists only - and [...]

Return to work: Clinical judgements and evidence-based decisions

It’s not often that we find an article that draws on clinical knowledge rather than directly from experimental findings, but when we do, it can add something really helpful as in this article by Heidi Muenchberger, Elizabeth Kendall, Peter Grimbeek and Travis Gee.
Now I’m definitely a proponent of evidence-based management - but in very complex [...]

Checking thoughts during activity

Why would we want to work with thoughts?
It’s not always essential to directly address thoughts but many times thoughts become quite unhelpful and prevent the person from engaging in your therapy. It can prevent them from adopting new skills (eg using pacing or even maintaining activity despite pain), or mean that they ‘resist’ therapy [...]

Clear communication - an activity to encourage active listening

People who experience pain can have trouble saying what they want to happen - and difficulty hearing what other people really have to say. OK, I agree it’s a problem for us all - but

pain interferes with the capacity to attend to and process information, and
people with pain are often engaged in systems such [...]

Responding to real but unhelpful beliefs

One of my beefs about cognitive therapy has to be the concept of ‘maladaptive’ or ‘erroneous’ beliefs. For many people experiencing pain, their beliefs are based on experience since developing persistent pain - so we could readily be called out if we suggest that their belief that ‘I always get a flare-up when I [...]