Evaluation of cognitive behavioral interventions and psychoeducation implemented by rehabilitation specialists to treat fear-avoidance beliefs in patients with low back pain: a systematic review
Abstract
Objectives To systematically locate, critically appraise, and synthesize the available evidence regarding the effectiveness of cognitive behavioral therapies (CBTs) and psychoeducation that can be implemented by rehabilitation specialists to treat fear-avoidance beliefs in patients with acute, subacute, and chronic low back pain (LBP).Data sources Electronic databases (CINAHL, PubMed, Psychology and Behavior Sciences Collection, SPORTDiscus, PsycINFO) were searched from inception to September 2017.Study selection Assessment of methodological quality was completed using the Physiotherapy Evidence Database (PEDro) scale. The Strength of Recommendation Taxonomy was used to evaluate the quality of evidence.Data extraction Study sample, subject demographics, CBT and/or psychoeducation intervention details, data collection time points, outcome assessments, statistical analysis, results, and conclusions were extracted from each study. In addition, effect sizes were calculated.Data synthesis Five high-quality studies (PEDro ≥6) were included. All included studies evaluated fear-avoidance beliefs. CBTs and psychoeducation strategies designed to target patient-specific fears demonstrated clinically meaningful results, while psychoeducation methodologies were not as effective.Conclusions There is inconsistent, patient-oriented evidence (grade B) to support the use of CBTs and/or psychoeducation strategies by rehabilitation specialists to treat fear-avoidance beliefs. Patient-centered and personalized CBTs were most effective to treat these psychosocial factors in patients with LBP when compared with a control treatment.
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Four reviews focused specifically on cognitive and/or behaviour-based approaches that were delivered by non-psychologists.
“Four reviews focused specifically on cognitive and/or behaviour-based approaches that were delivered by non-psychologists.50 61 64 82”
From Impact of healthcare interventions on distress following acute musculoskeletal/orthopaedic injury: A scoping review of systematic reviews (2024) · cites this paper as [61]
Four reviews focused specifically on cognitive and/or behaviour-based approaches that were delivered by non-psychologists, such as physiotherapists and other rehabilitation-focussed allied health clinicians.
“In systematic reviews of psychological interventions, clinicians delivering interventions were typically psychologists, however, four reviews focused specifically on cognitive and/or behaviour-based approaches that were delivered by non-psychologists, such as physiotherapists and other rehabilitation-focussed allied health clinicians.50 61 64 82”
From Impact of healthcare interventions on distress following acute musculoskeletal/orthopaedic injury: A scoping review of systematic reviews (2024) · cites this paper as [61]
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- Authors
- Baez, S., Hoch, M. C., & Hoch, J. M.
- Affiliations
- University of Kentucky (US)
- Corresponding author
- Baez, Shelby
- Venue
- Archives of Physical Medicine and Rehabilitation
- Publisher
- Elsevier BV
- Published
- 2018-11
- Volume
- 99
- Issue
- 11
- Pages
- 2287-2298
- ISSN
- 0003-9993 (ISSN-L)
- OpenAlex
- W2771322945
- Cited by
- 51
- References
- 33
- Citations by year
- 2026: 10 · 2024: 6 · 2023: 3 · 2022: 10 · 2021: 9 · 2020: 6 · 2019: 4 · 2018: 3
- FWCI
- 0.45
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Physical Medicine and Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- cognitive behavioral therapy, psychoeducation, fear-avoidance beliefs, low back pain, rehabilitation specialists, patient-centered care, personalized interventions, psychosocial factors, chronic low back pain, acute low back pain, subacute low back pain
- MeSH terms
- Adult, Avoidance Learning, Fear, Female, Humans, Male, Middle Aged, Cognitive Behavioral Therapy, Treatment Outcome, Low Back Pain, Young Adult
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