Title: Psychologically-informed practice for treating people with pain
Date: 4-5 July 2020
Course leaders: Lisa Roberts, Steven Vogel and Tamar Pincus
About the course
This two day course aims to introduce into practice evidence-based techniques and skills that can improve quality of life for people with pain. It is relevant to a wide range of practitioners who encounter people with pain including chiropractors, nurses, osteopaths and physiotherapists.
The course will help practitioners to enhance building rapport and the therapeutic alliance with their patients as well as equip them with practical skills to use in practice.
Recent clinical guidance and research has emphasised the need for practitioners to apply a biopsychosocial model of care. Whilst many practitioners are comfortable with the bio aspect of the model, integrating psychological and related communication skills into practice is more challenging. This course will provide introductory skills and an awareness of potential psychological tools to enable practitioners to be more confident in delivering an integrated biopsychosocial model of care to their patients.
The course comprises a series of mini-lectures and practical sessions. Core skills related to effective communication will be the focus of the first day and behavioural change principles and practice the focus of the second day.
There will be opportunities to experiment with using new skills in experiential sessions as well as opportunities to discuss challenging cases in a supportive environment. Practical sessions will be balanced with theory and reviews of relevant evidence.
The course is delivered by a multidisciplinary team of UK leaders in the field with professional backgrounds in physiotherapy, osteopathy and psychology.
Osteopathic practice standards (updated) and other CPD elements covered
A) Communication and patient partnership A1, A2, A3, A5, A6
B) Knowledge, skills and performance B1, B2, B3, B4
C) Safety and quality in practice C1, C6
D) Professionalism D2, D3, D10
Communication skills (8hrs)
Communication skills underpin the delivery of psychologically informed practice and are the focus of much of this course. Person centred communication, active listening skills and related communication skills will be presented alongside practical opportunities to develop and reflect on your own approaches. Psychological theory and related practical sessions will give you the opportunity to contextualise your own and new approaches to communicating and caring for patients. Strategies to consider the role of mood, beliefs and behaviours common in people suffering from persistent pain will be discussed alongside psychological approaches to these areas that can be delivered in the context of manual and rehabilitation medicine. On completion of the course you will be better equipped with the communication skills to ensure the best outcomes for your patients.
The course will involve case-based discussions, role play and simulated patient work alongside reflection and peer to peer feedback. The course leaders will also provide feedback on practical activities. This type of activity could be included as evidence of case-based discussion in your CPD record.
- Learn how to enhance the opening of a consultation
- Develop communication and active listening skills
- Practice person centred communication and responding to patient cues
- Learn how to give effective reassurance
- Learn how to introduce psychology to patients using metaphors, grids and other techniques
- Learn how to address distress, frustration and anger in patients
- Develop strategies to overcome fear and avoidance in patients
- Explore beliefs and values of patients and practitioners
- Gain an understanding of effective behavioural change approaches
- To become familiar with the evidence on psychological complexity in people with persistent pain conditions
- To acquire new skills in recognising and eliciting patient concerns
- To become aware of an array of psychological interventions that can be used to help patients better manage their pain
Day 1 Lisa Roberts and Steven Vogel
09:00-09:30 Arrival, registration, coffee
09:30-10:00 Introduction, expectations and aims
10:00-11:00 Meeting and Greeting in consultations - Small Talk
11:30-12:30 Opening questions and interruptions
12:30-13:00 Minimising language
13:45-15:15 Person centred communication, active listening, picking up on cues
15:45-16:15 Introducing psychology to patients
17:15-17:30 Summary and feedback
Day 2 Tamar Pincus
09:00-09:30 Arrival, registration, coffee
09:30-10:00 Remit of today’s programme
10:00-11:30 Behavioural approaches, including behaviour change
11:45-13:00 Cognitive behavioural therapy
13:45-15:15 Introduction to Acceptance and Commitment Therapy
15:30-16:30 Acceptance and Commitment Therapy
16:30-17:30 Summing up, feedback and reflection
Practical sessions will be integrated throughout each day.
The course is suitable for a wide range of practitioners who encounter people with pain, including nurses, osteopaths, chiropractors and physiotherapists.
About the course leaders
Lisa Roberts PhD PFHEA FCSP
Lisa is a Professor at the University of Southampton and consultant physiotherapist at University Hospital Southampton NHS Foundation Trust. She currently holds a National Institute for Health Research senior clinical lectureship, focussing on researching the communication and decision-making that occurs during consultations between physiotherapists and people with back pain, building on her earlier fellowship funded by Arthritis Research UK.
Other current research interests include developing web-based resources for people with back pain; non-specific treatment effects in complementary therapy; families’ experiences of surgery for children with developmental dysplasia of the hip; and rehabilitation through ballroom and Latin American dancing.
Alongside her clinics in the NHS, Lisa leads the clinical effectiveness agenda for 8 professions and has a strategy role within the Trust. She led the team to implement a hugely popular self-referral scheme, enabling Trust staff to access musculoskeletal physiotherapy services.
Lisa was awarded a Fellowship by the Chartered Society of Physiotherapy in 2013 for her work as a leader, clinician, researcher and educator. She is the immediate past President of the Society for Back Pain Research and in 2016 became a principal fellow of the Higher Education Academy.
Tamar Pincus PhD MSc MSc
Professor Tamar Pincus holds a PhD in psychology (University College London), as well as Masters degrees in experimental research methods in psychology (UCL), and epidemiology (Cambridge University). She is a registered practicing practitioner with the Health Professional Council. Her research has embraced a variety of methodologies, including experimental, epidemiological and qualitative. The research has included investigation of attention and recall in pain patients; the psychological predictors for poor outcome in low back pain, and the study of clinicians’ beliefs and attitudes in low back pain.
Tamar’s research has included the investigation of interventions through randomised controlled trials, and throughout she has collaborated closely with researchers from many disciplines, including doctors, physiotherapists, osteopaths, chiropractors and clinical psychologists, from a multitude of institutions, in the UK and internationally. She also convened the international consensus group to establish what factors and measures should be included in prospective cohorts investigation the transition from early to persistent back pain. Most recently her research has focused on delivering effective reassurance to patients in primary care and studying the use of technology to deliver rehabilitation. Her practical work has focused on training practitioners in effective communication skills and fostering awareness of patients’ psychological needs and concerns.
Steven Vogel DO(Hons)
Steven Vogel is Deputy Vice Chancellor (Research) at the University College of Osteopathy in London. Although most of his working time is spent on research and education, he held a clinical post as an osteopath in an NHS primary care setting for over 20 years and more recently maintains a small private practice. His main research interests focus on back pain, clinicians’ beliefs and attitudes and more recently, reassurance, communication and consent, safety and manual therapy. He has experience of qualitative, quantitative and mixed research methods.
Steven’s research work on adverse events and consent has led to the delivery of a wide range of CPD's to manual therapists on communication skills, working in partnership with patients to gain consent and managing risk. He provides one to one learning opportunities to osteopaths addressing concerns about fitness to practice and professional conduct.
Steven was a member of the development groups for the NICE clinical guidelines for persistent non-specific low back pain the current low back pain and sciatica clinical guideline. He is Editor-in-Chief of the International Journal of Osteopathic Medicine.
Selected published works
Allen, M. V., & Roberts, L. C. (2017). Perceived acquisition, development and delivery of empathy in musculoskeletal physiotherapy encounters. Journal of Communication in Healthcare, 10(4), 304-312. doi:10.1080/17538068.2017.1366000
Roberts, L. C., & Burrow, F. A. (2018). Interruption and rapport disruption: Measuring the prevalence and nature of verbal interruptions during back pain consultations. Journal of Communication in Healthcare, 11(2), 95-105. doi:10.1080/17538068.2018.1449289
Ryan, C., & Roberts, L. (2019). ‘Life on hold’: The lived experience of radicular symptoms. A qualitative, interpretative inquiry. Musculoskeletal Science and Practice, 39, 51-57. doi:10.1016/j.msksp.2018.11.005
Ryan, C., & Roberts, L. C. (2018). Investigations for radiculopathy: The patient perspective. A qualitative, interpretative inquiry. Musculoskeletal Science and Practice, 33, 71-76. doi:10.1016/j.msksp.2017.11.005
Geraghty, A. W. A., Stanford, R., Stuart, B., Little, P., Roberts, L. C., Foster, N. E., . . . Yardley, L. (2018). Using an internet intervention to support self-management of low back pain in primary care: Findings from a randomised controlled feasibility trial (SupportBack). BMJ Open, 8(3) doi:10.1136/bmjopen-2017-016768
Langridge, Neil, Roberts, Lisa and Pope, Catherine (2015). The role of clinician emotion in clinical reasoning: balancing the analytical process. Manual Therapy;p. 1-5. Doi:10.1016/j.math.2015.06.007. PMID:26144683
Chester, Emily, Robinson, Natalie and Roberts, Lisa (2014). Opening clinical encounters in an adult musculoskeletal setting. Manual Therapy, Volume:19, (4), p.306-310. Doi:10.1016/j.math.2014.03.011. PMID:24809241
Jones, Lucy, Roberts, L., Little, Paul, Mullee, M., Cleland, J.A. and Cooper, C (2014). Shared decision-making in back pain consultations: An illusion or reality? European Spine Journal;p.1-17.
Roberts, Lisa, Whittle, Christopher, Cleland, Jennifer and Wald, Mike (2013). Measuring communication in physical therapy consultations: a novel approach. Physical Therapy, Volume:93, (4).
Ben-Ami, N., Chodick, G., Mirovsky, Y., Pincus, T., & Shapiro, Y. (2017). Increasing recreational physical activity in patients with chronic low back pain: A pragmatic controlled clinical trial. Journal of Orthopaedic and Sports Physical Therapy, 47(2), 57-66. doi:10.2519/jospt.2017.7057
Ben-Ami, N., Shapiro, Y., & Pincus, T. (2018). Outcomes in distressed patients with chronic low back pain: Subgroup analysis of a clinical trial. Journal of Orthopaedic and Sports Physical Therapy, 48(6), 491-495. doi:10.2519/jospt.2018.7670
Bowers, H., Wroe, A. L., & Pincus, T. (2017). ‘Isn’t it ironic?’ beliefs about the unacceptability of emotions and emotional suppression relate to worse outcomes in fibromyalgia. Clinical Rheumatology, 36(5), 1121-1128. doi:10.1007/s10067-017-3590-0
Canaway, A., Pincus, T., Underwood, M., Shapiro, Y., Chodick, G., & Ben-Ami, N. (2018). Is an enhanced behaviour change intervention cost-effective compared with physiotherapy for patients with chronic low back pain? results from a multicentre trial in israel. BMJ Open, 8(4) doi:10.1136/bmjopen-2017-019928
Holt, N., Mansell, G., Hill, J. C., & Pincus, T. (2018). Testing a model of consultation-based reassurance and back pain outcomes with psychological risk as moderator. Clinical Journal of Pain, 34(4), 339-348. doi:10.1097/AJP.0000000000000541
Serbic, D., & Pincus, T. (2017). The relationship between pain, disability, guilt and acceptance in low back pain: A mediation analysis. Journal of Behavioral Medicine, 40(4), 651-658. doi:10.1007/s10865-017-9826-2
Holt, N. & Pincus, T. (2016) Developing and testing a measure of consultation-based reassurance for people with low back pain in primary care: A cross-sectional study. BMC Musculoskeletal Disorders,17, 1, p.1-15 , 277.
Pincus, T. (2015) Delivering an Optimised Behavioural Intervention (OBI) to people with low back pain with high psychological risk; results and lessons learnt from a feasibility randomised controlled trial of Contextual Cognitive Behavioural Therapy (CCBT) vs. Physiotherapy. BMC Musculoskeletal Disorders
NICE. Low back pain and sciatica in over 16s: assessment and management. 2016.
Holt N, Pincus T, Vogel S. (2015) Reassurance during low back pain consultations with GPs: a qualitative study. Br J Gen Pract ;65(639):e692–701. Doi: 10.3399/bjgp15X686953.
Vogel S, Mars T, Keeping S, Barton T, Marlin N, Froud R, et al. Clinical Risk Osteopathy and Management Scientific Report 2013;(February).
Pincus, T. Holt, N. Vogel, S. Underwood, M. Savage, R. Walsh, D. A. & Taylor, S. J. C. (2013) Cognitive and affective reassurance and patient outcomes in primary care: A systematic review ', Pain.154; 2407-2416.
Daniels, G. and Vogel, S. (2012) Consent in osteopathy: A cross sectional survey of patients' information and process preferences. International Journal of Osteopathic Medicine 15; 3: 92-102.
The UCO regrets that no refunds can be made for cancelled places unless a substitute participant can be found. The UCO cannot guarantee that any course will run. In the event of your course being cancelled, all paid fees and deposits will be refunded in full.