title: Physiotherapists report improved understanding of and attitude toward the cognitive, psychological and social dimensions of chronic low back pain after Cognitive Functional Therapy training: a qualitative study.
abstract: OBJECTIVE
  What are physiotherapists' perspectives on managing the cognitive, psychological and social dimensions of chronic low back pain after intensive biopsychosocial training?
  
  
  METHODS
  Qualitative study design using semi-structured interviews to explore physiotherapists' perceptions of their identification and treatment of the biopsychosocial dimensions of chronic low back pain after intensive Cognitive Functional Therapy (CFT) training.
  
  
  METHODS
  Thirteen qualified physiotherapists from four countries who had received specific CFT training. The training involved supervised implementation of CFT in clinical practice with patients. Interviews were audio-recorded and transcribed verbatim. An interpretive descriptive analysis was performed using a qualitative software package.
  
  
  RESULTS
  Four main themes emerged from the data: self-reported changes in understanding and attitudes; self-reported changes in professional practice; altered scope of practice; and increased confidence and satisfaction. Participants described increased understanding of the nature of pain, the role of patient beliefs, and a new appreciation of the therapeutic alliance. Changes in practice included use of new assessments, changes in communication, and adoption of a functional approach. Since undertaking CFT training, participants described a greater awareness of their role and scope of practice as clinicians in identifying and addressing these factors.
  
  
  CONCLUSIONS
  Physiotherapists expressed confidence in their capacity and skill set to manage the biopsychosocial dimensions of chronic low back pain after CFT training, and identified a clear role for including these skills within the physiotherapy profession. Despite this, further clinical trials are needed to justify the time and cost of training, so that intensive CFT training may be made more readily accessible to clinicians, which to date has not been the case. [Synnott A, O'Keeffe M, Bunzli S, Dankaerts W, O'Sullivan P, Robinson K, O'Sullivan K (2016) Physiotherapists report improved understanding of and attitude toward the cognitive, psychological and social dimensions of chronic low back pain after Cognitive Functional Therapy training: a qualitative study.Journal of Physiotherapy62: 215-221].
authors.affiliation: Department of Clinical Therapies, University of Limerick, Limerick, Ireland.
authors.forename: Aoife
authors.initials: A
authors.lastname: Synnott
authors.affiliation: Department of Clinical Therapies, University of Limerick, Limerick, Ireland.
authors.forename: Mary
authors.initials: M
authors.lastname: O'Keeffe
authors.affiliation: Department of Surgery, University of Melbourne, Melbourne, Australia.
authors.forename: Samantha
authors.initials: S
authors.lastname: Bunzli
authors.affiliation: Department of Rehabilitation Sciences, University of Leuven, Leuven, Belgium.
authors.forename: Wim
authors.initials: W
authors.lastname: Dankaerts
authors.affiliation: School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: O'Sullivan
authors.affiliation: Department of Clinical Therapies, University of Limerick, Limerick, Ireland.
authors.forename: Katie
authors.initials: K
authors.lastname: Robinson
authors.affiliation: Department of Clinical Therapies, University of Limerick, Limerick, Ireland.
authors.forename: Kieran
authors.initials: K
authors.lastname: O'Sullivan
mesh_terms: D001291:Attitude of Health Personnel; D003142:Communication; D032882:Comprehension; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017116:Low Back Pain / Q000523:psychology* / Q000628:therapy*; D008297:Male; D059825:Physical Therapists / Q000193:education / Q000523:psychology*; D011369:Professional-Patient Relations; D036301:Qualitative Research
keywords: Biopsychosocial; Low back pain; Physical therapy; Qualitative; Training; Treatment