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Title: Lessons learned from recent Psychosocial Interventions: Implications for Research
Authors and affiliation: Elaine M Hay 1, Chris J.Main 1, and Danielle van der Windt 2
1 Keele University; Staffs; U.K.
2 EMGO Institute, VU university medical centre ; Amsterdam, Netherlands
Email address: cjmain@gmail.com
Introduction: Research over the last decade has demonstrated the importance of psychosocial factors in the development of chronic musculoskeletal problems (Linton,2000) and in recent years there has been a move to provide primary care interventions within a psychosocial framework, derived from the cognitive-behavioural perspective.
Objective: The purpose of the proposed workshop is four-fold.
- To integrate the findings of these trials with other studies of early psychosocial interventions.
- To offer some additional analyses and reflections on the Keele and EMGO data sets
- To identify the research challenges posed by the findings
- To facilitate discussion with a view to arriving at a consensus on a refocused research agenda for early psychosocial intervention and disseminate the conclusions in the form of an article/editorial
Methods / content: Some years ago Klaber-Moffett et al(1999) found a brief psychosocial intervention to be superior to “treatment-as-usual” in terms of outcome disability scores, although the differences were small. Hay et al (2005) compared manual therapy with a simple individualised pain management approach delivered by physiotherapists trained in a psychosocial interview & intervention strategy, but there was little difference between the two groups in level of disability at one year F.U. Jellema et al (2005) trained a group of G.P.s to manage biopsychosocial risk factors for poor outcome but were unable to demonstrate any effect over treatment as usual.
There are a number of possible explanations for these “negative” results (Jellema et al,2006; Main,2005) which raise a number of fundamental questions about the nature of psychosocial intervention and their evaluation in these trials.Format of WorkshopThe three presenters will offer a brief overview focusing on
- The nature of interventions
- Issues of competency and training in the delivery of interventions
- Choice/development of process/outcome measures
- The methodological options for research design, including screening, targeting within a hypothesis-led framework
The audience will then be allocated to working groups focusing in turn on two of the four topics.
The workshop will conclude with audience report-back, summary of consensus and draft structure of a publication to disseminate the conclusions. |
