L12 - COGNITIVE ORIENTED STRATEGIES Flashcards
What is the focus of psychologically informed therapies?
How communication skills can be used to minimize the impact of chronic pain
It serves as a middle way between traditional biomedical or bio mechanically focused care and mental health treatment.
Enhancement of MSK practice by restoring function, rengaging activity & preventing secondary disability
What does Cognitive Behavior Therapy (CBT) integrate?
Both cognitive and behavioral strategies
CBT addresses maladaptive thought patterns and promotes adaptive coping mechanisms.
What are the applications of CBT?
- Chronic pain management
- Anxiety
- Depression
- Behavioral change in rehabilitation
Define Cognitive Functional Therapy (CFT).
A PT-based approach integrating cognitive, behavioral, and functional components to address pain and movement dysfunctions.
What is the primary aim of CFT?
Help patients with LBP identify and overcome modifiable factors that break the cycle of pain-related disability.
What is mindfulness in the context of stress reduction?
A state of conscious presence of mind, experiencing the moment, oneself, and the environment.
List the goals of mindfulness-based stress reduction.
- Improves functional capacity
- Improves pain management
- Improves quality of life
- Change in subjective perception of pain
- Reduction of chronicity
What does Acceptance and Commitment Therapy (ACT) encourage?
Acceptance of unavoidable experiences while committing to values-driven actions.
What are cognitive strategies?
Sets of mental and behavioral processes consciously implemented to achieve set goals and solve problems.
How do cognitive strategies enhance health outcomes?
By leveraging the patient’s cognitive processes for motor performance, pain management, and rehabilitation.
What is mental imagery/visualization?
Visualizing successful performance or reduced pain to enhance outcomes.
What is the main mechanism through which pain perception is influenced?
Pain is influenced by attention, interpretation, beliefs, expectations, cognition, emotion, coping strategy, and pain behavior.
What is the fear-avoidance model?
Description: Painful injury may result in catastrophizing & fear, leading to avoidance of certain movements, which leads to more avoidance, dysfunction, depression & ultimately more pain
What psychological processes are featured in the fear-avoidance model? Describe mechanisms et strategies
- Coping interpretation featuring catastrophizing
- Emotions: fear, worry, and depression
- Attention: hyper-vigilance
- Behavior: avoidance of movement
Mechanism: activity avoidance leads to physical degeneration & social
isolation => vicious circle
Strategies: Graded exposure to feared activities
What does the stress-diathesis model highlight?
A person predisposed to pain has it worse due to high levels of stress and limited coping resources.
What is the self-efficacy model?
It highlights the role of belief in one’s ability to manage pain.
What is the acceptance/contentment model focused on?
- Coping strategies = dependent on person’s acceptance of current state
- Management with minimizing focus on factors out of control
- Focus on acceptance of current condition
- Become content to manage current state
- Move forward/turn page
What is a key principle in the assessment phase of chronic pain management?
Psychological factors impacting pain outcomes are not routinely assessed.
What is a common complication in pain management related to emotional health?
Depression or a history of depression complicates pain management.
Fill in the blank: Pain is a perception generated by the _______.
brain
What should be tailored in treatment planning for chronic pain?
Treatment planning should account for individual differences in beliefs and attitudes about pain.
What is the role of acceptance in improving pain outcomes?
Acceptance and self-management improve pain outcomes.
What is a strategy for managing chronic pain based on the mis-directed problem-solving model?
Cognitive-behavioral therapy to shift focus from pain to solutions.
What is problem-solving?
structured approaches to tackle pain-related challenges
What is cognitive reframing ?
changing unhelpful beliefs & perspectives about pain
What is distraction?
redirecting attention to reduce intensity of perceived pain
What is self-monitoring ?
Reflecting on behaviors & thoughts patterns to improve self-awareness
What is dual-task training?
combining physical tasks with cognitive challenges to enhance rehabilitation
What is the key techniques of cognitive strategies ?
Mental imagery / visualization
Problem-solving
Cognitive reframing
Distraction
Self-monitoring
Dual-task training
What are the applications of cognitive strategies?
Applications
- Improving motor performance
- Managing chronic pain & reducing emotional distress
- Supporting adherence to rehabilitation protocols
Description of pain experience
Pain experience
- Psychosocial factors contribute to pain experience & development of persistent pain & disability
- Pain has clear emotional & behavioral consequences influencing development of persistent problems & outcome of treatment
- Pain in absence of physical injury due to complex neural & psychological processes
- Pain = perception generated by brain, not direct measure of tissue damage:
o Tissues healed within 3-6 months
o Persistent pain: > 3 months
o Psychogenic / psychosomatic, central sensitization, Phantom pain, Hyperalgesia
- Psychological factors are catalyst for transition acute to chronic cases
Description of pain behaviors
Pain is private, complex experience but can be viewed as a set of behaviors & be analyzed:
- Verbal expressions (complaints, exclamations)
- Non-verbal expressions (facial expression, body postures, movement patterns,
use of assistive devices)
- Emotional responses (irritability, tearfulness)
Definition of psychosocial pain models
= frameworks for understanding & addressing psychological distress in persistent pain/conditions
What are key models of psychosocial pain models
Fear-avoidance model
Mis-directed problem-solving model
Stress-diathesis model
Self-efficacy model
Acceptance / contentment model
Description , featured, mechanism & strategies of mis-directed problem-solving model
Description: worry and narrower view of nature of problem, making it less likely to solve problem
Psychological processes featured:
- Emotions: worry as driving force
- Attention: pain demands attention
- Cognitions: beliefs about cause of pain
- Behavior: attempts to solve problem
Mechanism: hypervigilance to pain symptoms contributes to rumination & failed attempts to escape pain
=> vicious circle
Strategies: Cognitive-behavioral therapy to shift focus from pain to solutions.
What are featured, mechanisms & strategies of stress-diathermies model?
Psychological processes featured:
- Emotions: stress, depression & anxiety
- Behavior: coping strategies & skills
Mechanisms: protective psychosocial factors buffer emotional impact of pain, whereas distress & emotional dysregulation predispose to pain
Strategies: improve stress management shills & social support
What are the features, mechanism & strategies of self-efficacy model ?
Psychological processes featured:
- Cognitive: beliefs concerning controllability of pain
- Behavior: coping skills
Mechanism: fluctuating pain reduces perceptions of control & master over pain
Strategies: improving self-efficacy & management strategies to reduce dependence
What are the features, mechanisms & strategies of acceptance / contentment model?
Psychological processes featured:
- Emotions: anger & frustration
- Cognitive: flexibility in beliefs, life goals & commitment
- Behavior: commitment, pursuing goals
Mechanism: repeated attempts to control or alleviate pain leads to frustration
Strategies: provide realistic treatment goals & encourage patient participation in decision making
Principles of management
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