Psychologically informed physiotherapy for chronic pain: patient experiences of treatment and therapeutic process.
OBJECTIVE
Psychologically informed physiotherapy is used widely with patients with chronic pain. This study aimed to investigate patients' beliefs about, and experiences of, this type of treatment, and helpful and unhelpful experiences.


METHODS
A qualitative study using Interpretative Phenomenological Analysis of semi-structured interviews.


METHODS
Participants (n=8) were recruited within a national specialist pain centre following a residential pain management programme including 2.25hours of physiotherapy each day. Participants were eligible for inclusion if they had achieved clinically reliable improvements in physical functioning during treatment. Interviews were conducted 3 months post-treatment.


RESULTS
Participants reported differing experiences of physiotherapy interventions and differences in the therapeutic relationship, valuing a more individualised approach. The themes of 'working with the whole of me', 'more than just a professional', 'awareness' and 'working through challenges in the therapeutic relationship' emerged as central to behavioural change, together with promotion of perceptions of improved capability and physical capacity.


CONCLUSIONS
Psychologically informed physiotherapy is an effective treatment for some patients with chronic pain. Participants experienced this approach as uniquely different from non-psychologically informed physiotherapy approaches due to its focus on working with the patient's whole experience. Therapeutic alliance and management of relationship ruptures may have more importance than previously appreciated in physiotherapy.
Bath Centre for Pain Services, Royal United Hospitals NHS Trust, Bath, UK. Electronic address: sarah.wilson65@nhs.net.
S
S
Wilson
Bath Centre for Pain Services, Royal United Hospitals NHS Trust, Bath, UK.
N
N
Chaloner
Bath Centre for Pain Services, Royal United Hospitals NHS Trust, Bath, UK; Department of Psychology, University of Bath, Bath, UK.
M
M
Osborn
Bath Centre for Pain Services, Royal United Hospitals NHS Trust, Bath, UK; Department of Psychology, University of Bath, Bath, UK.
J
J
Gauntlett-Gilbert
D000223:Adaptation, Psychological; D000328:Adult; D059350:Chronic Pain / Q000523:psychology* / Q000534:rehabilitation*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D036301:Qualitative Research; D055815:Young Adult
Chronic pain; Cognitive behavioural therapy; Physiotherapy; Qualitative