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| Name | Class |
|---|---|
| Psychotherapie-Ambulanz Marburg e.V. | OTHER |
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Exploration of treatment processes during exposure and cognitive-behavioral therapy in the context of chronic low back pain in a multiple baseline single-case design.
The present study intends to specifically investigate treatment elements during exposure and cognitive-behavioral therapy, which are especially powerful in electing time contingent therapeutic change. hereby, it is the goal to explore further change processes, which play an important role during psychological treatment of individuals with CLBP and high levels of fear-avoidance.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Exposure in vivo | Active Comparator | In the Exposure in vivo (EXP) condition, patients are given a careful explanation of the fear-avoidance model. Patients are encouraged to adopt the model to their individual situation. Factors for the maintenance of chronic pain (such as pain cognitions and pain-related fear) are discussed. Especially, negative consequences of avoidance behavior are highlighted. In preparation of the exposure sessions, patients develop an individual fear hierarchy using the Photo Series of Daily Actives. Subsequently, patients are encouraged to test their fear-avoidance beliefs during behavioral experiments and to reduce avoidance behaviors during individually tailored exposure exercises. |
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| Cognitive Behavioral Psychotherapy | Active Comparator | In the Cognitive Behavioral Psychotherapy (CBT) condition, patients are introduced to several strategies to improve their pain management. The principle of graded activity encourages patients to re-engage in former activities by dividing these activities into smaller steps. Predetermined resting periods are offered as a form to prevent patients from phases of excessive demands followed by long terms of recovery. Progressive muscle relaxation is introduced as a technique to improve the experience of pain. The strategy of attention shifting is presented to change their perception of pain. Maladaptive pain-related cognitions are identified and challenged by cognitive interventions. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Exposure in vivo | Behavioral | 10 sessions based on an individualized fear hierarchy |
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| Measure | Description | Time Frame |
|---|---|---|
| Therapeutic changes during the course of treatment compared to baseline | Specifically developed questionnaire on therapeutic change processes | from baseline phase (1-3 weeks) to intervention phase (5 weeks) |
| Measure | Description | Time Frame |
|---|---|---|
| Pain severity at posttest and follow-up compared to baseline pain severity | Brief Pain Inventory, BPI | from pretest (admission) to posttests (an expected average of 8 weeks after admission) to follow-up (an expected average of 6 months after completion) |
| Pain-related anxiety at posttest and follow-up compared to baseline pain-related anxiety |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Julia Anna Glombiewski | Philipps-University Marburg, Departement of Clinical PSychology and Psychotherapy | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Philipps University Marburg, Department of Clinical Psychology and Psychotherapy | Marburg | 35037 | Germany |
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| Label | URL |
|---|---|
| CV of Principle Investigator | View source |
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| Cognitive Behavioural Psychotherapy |
| Behavioral |
graded activity, relaxation techniques and cognitive interventions |
|
Pain Anxiety Symptom Scale, PASS- D 20 |
| from pretest (admission) to posttests (an expected average of 8 weeks after admission) to follow-up (an expected average of 6 months after completion) |
| Pain catastrophizing thoughts at posttest and follow-up compared to baseline pain catastrophizing thoughts | Pain Catastrophizing Scale, PCS | from pretest (admission) to posttests (an expected average of 8 weeks after admission) to follow-up (an expected average of 6 months after completion) |
| Perceived harmfulness of daily activities at posttest and follow-up compared to baseline perceived harmfulness of daily activities | Photo Series of Daily Actives, Phoda | from pretest (admission) to posttests (an expected average of 8 weeks after admission) to follow-up (an expected average of 6 months after completion) |
| Pain-related avoidance behavior at posttest and follow-up compared to baseline pain-related avoidance behavior | Behavioral Avoidance Test, BAT Back | from pretest (admission) to posttests (an expected average of 8 weeks after admission) to follow-up (an expected average of 6 months after completion) |
| Change from baseline in global pain disability at posttest and follow-up compared to baseline global pain disability | Pain Disability Index, PDI | from pretest (admission) to posttests (an expected average of 8 weeks after admission) to follow-up (an expected average of 6 months after completion) |
| Change from baseline in specific pain disability at posttest and follow-up compared to baseline specific pain disability | Quebec Back Pain Disability Scale, QBPDS | from pretest (admission) to posttests (an expected average of 8 weeks after admission) to follow-up (an expected average of 6 months after completion) |
| Emotional distress at posttest and follow-up compared to baseline emotional distress | Hospital Anxiety and Depression Scale, HADS | from pretest (admission) to posttests (an expected average of 8 weeks after admission) to follow-up (an expected average of 6 months after completion) |
| Biological stress markers distress at posttest and follow-up compared to baseline biological stress markers | collection of salivary cortisol using SaliCaps during the behavioral test, collection of hair samples | from pretest (admission) to posttests (an expected average of 8 weeks after admission) to follow-up (an expected average of 6 months after completion) |