CBT for Chronic Pain
The biopsychosocial model is currently the paradigm from which all health care professionals are expected to manage patients with persistent pain conditions. This 8-week interactive web-based course teaches providers who work with people with chronic pain the fundamental cognitive and behavioral skills for psychologically informed pain care. Pain professionals are now expected to recognize associated psychosocial distress (i.e. yellow flags) and to develop a plan of care accordingly. Research illustrating the benefit of CBT techniques for patients with persistent pain has led physical therapists to explore their use. A 2018 systematic review in the journal of Disability Rehabilitation found that with additional training, physical therapists can deliver effective cognitive and behavioral interventions.
A cognitive-behavioral approach includes techniques that target both physical and psychosocial symptoms related to pain and provides patients with lasting skills to manage symptoms on their own. This combined method has been used in a variety of settings delivered by different health care professionals and has been shown to produce long-term effects on patient outcomes. Cognitive-behavioral interventions involve a structured approach that focuses on the relationships among cognitions (thoughts), emotions (feelings), and behaviors. Evidence suggests that a cognitive-behavioral model integrated with physical therapy improves functioning and quality of life for a variety of chronic pain conditions.
This course is designed to provide PTs and PTAs with the essential cognitive behavioral skills necessary for the treatment of chronic pain. The course focuses on empirically supported pain science education, behavioral self- management, cognitive restructuring, relaxation training, fear of movement and increasing physical activity. The use of stress reduction as a vehicle to address negative thoughts and emotions will be explored as an adjunct to the cognitive model. By the end of this course, practitioners will understand the importance of the cognitive model for pain care and integrate it into physical therapy practice.
Week 1 – Introduce the cognitive model for pain care
Week 2 – Deep relaxation and recovery training
Week 3 – Pain catastrophizing and negative automatic thinking
Week 4 – Challenging negative automatic thoughts and contracting alternatives
Week 5 – Creating coping self-statements
Week 6 – Emotions and their influence on pain
Week 7 – Activity, exposure, and pacing
Week 8 – Integrating the cognitive model into a physical medicine practice
End of Week 8 – Mandatory 90-Minute Live Coaching and Mentorship Call
By the end of the course, participants will be able to:
1. Explain the evidence supporting a cognitive approach to pain care.
2. Demonstrate evidence-based cognitive-behavioral strategies that can be integrated into the care of patients with musculoskeletal pain.
3. Explain the stress-pain connection as it relates to HPA axis activation.
4. Explain the stress-judging-pain connection as it relates to the cognitive model.
5. Explain the three domains of pain catastrophizing (magnification, rumination, helplessness).
6. Identify one self-reported patient measure for pain self-efficacy and one for pain catastrophizing.
7. Utilize cognitive restructuring to assist clients in reframing their perspective on their pain experience.
8. Develop three patient self-coping statements related to overcoming pain.
9. Explain how to guide a patient through a progressive muscle relaxation technique.
10. Design a graded activity hierarchy and pacing intervention for a patient with chronic low back pain.
Who Should Take This Course?
This is continuing education and professional development course for physical therapists, physical therapists’ assistants and rehabilitation professionals who work in pain care. Content is not intended for use outside the scope of the learner's license or regulation.
Joe Tatta, PT, DPT
Dr. Tatta is the Founder of the Integrative Pain Science Institute, a company dedicated to reinventing pain care through education, research, and professional training. A unique combination of physical therapist, nutritionist, and ACT trainer, he has 25 years of experience in physical therapy, integrative models of pain care, leadership and private practice innovation. He holds a Doctorate in Physical Therapy, is a Board-Certified Nutrition Specialist and has trained in Acceptance and Commitment Therapy. He is chair of the Physiotherapy SIG at the Association for Contextual Behavioral Science, the parent organization of Acceptance and Commitment Therapy. He also volunteers for the New York Physical Therapy Association Opioid Alternative Task Force. Dr. Tatta is the author of the book, Heal Your Pain Now and host of The Healing Pain Podcast. Dr. Tatta is also adjunct assistant faculty member Doctor of Physical Therapy Program at the State University of New York Health Science Center in New York City.