L12 - COGNITIVE ORIENTED STRATEGIES

Question 1

What is the focus of psychologically informed therapies?

Answer 1

How communication skills can be used to minimize the impact of chronic pain

It serves as a middle way between traditional biomedical care and mental health treatment.

Question 2

What does Cognitive Behavior Therapy (CBT) integrate?

Answer 2

Both cognitive and behavioral strategies

CBT addresses maladaptive thought patterns and promotes adaptive coping mechanisms.

Question 3

What are the applications of CBT?

Answer 3

• Chronic pain management
• Anxiety
• Depression
• Behavioral change in rehabilitation

Question 4

Define Cognitive Functional Therapy (CFT).

Answer 4

A PT-based approach integrating cognitive, behavioral, and functional components to address pain and movement dysfunctions.

Question 5

What is the primary aim of CFT?

Answer 5

Help patients with LBP identify and overcome modifiable factors that break the cycle of pain-related disability.

Question 6

What is mindfulness in the context of stress reduction?

Answer 6

A state of conscious presence of mind, experiencing the moment, oneself, and the environment.

Question 7

List the goals of mindfulness-based stress reduction.

Answer 7

• Improves functional capacity
• Improves pain management
• Improves quality of life
• Change in subjective perception of pain
• Reduction of chronicity

Question 8

What does Acceptance and Commitment Therapy (ACT) encourage?

Answer 8

Acceptance of unavoidable experiences while committing to values-driven actions.

Question 9

What are cognitive strategies?

Answer 9

Sets of mental and behavioral processes consciously implemented to achieve set goals and solve problems.

Question 10

How do cognitive strategies enhance health outcomes?

Answer 10

By leveraging the patient’s cognitive processes for motor performance, pain management, and rehabilitation.

Question 11

What is mental imagery/visualization?

Answer 11

Visualizing successful performance or reduced pain to enhance outcomes.

Question 12

What is the main mechanism through which pain perception is influenced?

Answer 12

Pain is influenced by attention, interpretation, beliefs, expectations, cognition, emotion, coping strategy, and pain behavior.

Question 13

What is the fear-avoidance model?

Answer 13

Description: Painful injury may result in catastrophizing & fear, leading to avoidance of certain movements, which leads to more avoidance, dysfunction, depression & ultimately more pain

Question 14

What psychological processes are featured in the fear-avoidance model? Describe mechanisms et strategies

Answer 14

• 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

Question 15

What does the stress-diathesis model highlight?

Answer 15

A person predisposed to pain has it worse due to high levels of stress and limited coping resources.

Question 16

What is the self-efficacy model?

Answer 16

It highlights the role of belief in one’s ability to manage pain.

Question 17

What is the acceptance/contentment model focused on?

Answer 17

• 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

Question 18

What is a key principle in the assessment phase of chronic pain management?

Answer 18

Psychological factors impacting pain outcomes are not routinely assessed.

Question 19

What is a common complication in pain management related to emotional health?

Answer 19

Depression or a history of depression complicates pain management.

Question 20

Fill in the blank: Pain is a perception generated by the _______.

Answer 20

brain

Question 21

What should be tailored in treatment planning for chronic pain?

Answer 21

Treatment planning should account for individual differences in beliefs and attitudes about pain.

Question 22

What is the role of acceptance in improving pain outcomes?

Answer 22

Acceptance and self-management improve pain outcomes.

Question 23

What is a strategy for managing chronic pain based on the mis-directed problem-solving model?

Answer 23

Cognitive-behavioral therapy to shift focus from pain to solutions.

Question 24

What is problem-solving?

Answer 24

structured approaches to tackle pain-related challenges

Question 25

What is cognitive reframing ?

Answer 25

changing unhelpful beliefs & perspectives about pain

Question 26

What is distraction?

Answer 26

redirecting attention to reduce intensity of perceived pain

Question 27

What is self-monitoring ?

Answer 27

Reflecting on behaviors & thoughts patterns to improve self-awareness

Question 28

What is dual-task training?

Answer 28

combining physical tasks with cognitive challenges to enhance rehabilitation

Question 29

What is the key techniques of cognitive strategies ?

Answer 29

Mental imagery / visualization
Problem-solving
Cognitive reframing
Distraction
Self-monitoring
Dual-task training

Question 30

What are the applications of cognitive strategies?

Answer 30

Applications
- Improving motor performance
- Managing chronic pain & reducing emotional distress
- Supporting adherence to rehabilitation protocols

Question 31

Description of pain experience

Answer 31

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

Question 32

Description of pain behaviors

Answer 32

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)

Question 33

Definition of psychosocial pain models

Answer 33

= frameworks for understanding & addressing psychological distress in persistent pain/conditions

Question 34

What are key models of psychosocial pain models

Answer 34

Fear-avoidance model
Mis-directed problem-solving model
Stress-diathesis model
Self-efficacy model
Acceptance / contentment model

Question 35

Description , featured, mechanism & strategies of mis-directed problem-solving model

Answer 35

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.

Question 36

What are featured, mechanisms & strategies of stress-diathermies model?

Answer 36

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

Question 37

What are the features, mechanism & strategies of self-efficacy model ?

Answer 37

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

Question 38

What are the features, mechanisms & strategies of acceptance / contentment model?

Answer 38

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

Question 39

Principles of management

Answer 39

Table