Effectiveness of a CBT-based Rehabilitation Programme (Progressive Goal Attainment Program) for People who are Work Disabled due to Back Pain
S. Hayes1, M. Raftery1, A. Murphy2, J. Newell3, E. O Shea4, E. Doherty4, P. Gillespie4, B. McGuire1
1National University of Ireland, Centre for Pain Research and School of Psychology, Galway, Ireland
2National University of Ireland, Discipline of General Practice, Galway, Ireland
3National University of Ireland, HRB Clinical Research Facility and School of Mathematics, Statistics and Applied Mathematics, Galway, Ireland
4Discipline of Economics
Background: To evaluate the effectiveness of a CBT-based active rehabilitation programme in a randomised controlled trial with people who were work-disabled due to back pain. Methods: People (N=110) aged 18+ with non-malignant back pain who were work-disabled and had at least one elevated psychosocial risk factor (pain disability, fear-based activity avoidance, fatigue, depression or pain catastrophising) were randomised to intervention or usual care. The intervention condition comprised 10 weekly individual sessions of structured CBT-based active rehabilitation. Sessions were delivered by a clinical psychologist and focused on graded activity, goal setting, pacing activity and cognitive behavioural techniques to address possible barriers to rehabilitation. Findings: Results showed that those in the intervention group had significant reductions in fatigue, fear avoidant beliefs, and catastrophising post-intervention compared to controls. Those in the intervention group also had higher rates of return to full-time work and improvement in overall work status. Participants reported the therapeutic relationship and enhanced sense of control as particularly important agents of change. Discussion: The results suggest that this type of rehabilitation programme is beneficial in improving return to work outcomes in patients with chronic back pain.