Cognitive-behavioral Interventions in Occupational Therapy for Chronic Upper Limb Pain - A Qualitative Study

Aim: Within the framework of the Perezoso research group at the Carinthian University of Applied Sciences, which deals with the interdisciplinary treatment of patients with osteoarthritis, it was necessary to focus on the topic of pain. Therefore, the present research work was conducted. But beyond that, it's also essential for the increasing knowledge and awareness in the field of (chronic) pain especially in occupational therapy but also in other health professions. Background: In the treatment of chronic pain, occupational therapists use cognitive-behavioral therapy interventions (CBT) among other methods. The aim is to learn new behaviors and to question and change negative interpretations and constructions. Possible effects of CBT in chronic pain can be a reduction of pain, anxiety, disease activity, psychological effects and disability on the one hand and an increase in self-efficacy, pain control and quality of life on the other hand. Methods: To find out how occupational therapists apply CBT when treating clients with chronic upper limb pain, a systematic literature search was conducted in various databases. Within the framework of a qualitative research approach, five experts were interviewed using semi-structured guided interviews. The transcription was done according to Dresing and Pehl, supplemented by Rädiker and Kuckartz and was analyzed using the deductive-inductive approach by means of qualitative content analysis according to Elo and Kyngäs. Results: The approach is highly individualized, but aims to incorporate both the biological, social and psychological aspects of chronic pain. Everything from individual or group sessions, inpatient or outpatient stays and different emphases are involved. Pain education, awareness and coping measures are applied. Through the orientation to everyday life, a distinction is made between occupational therapy and other professions. The involvement of relatives is sometimes considered useful, but the final decision should be made by the clients. Discussion and Conclusion: Different pain patterns as well as hardly any current studies, especially in which occupational therapists explicitly apply CBT, only lead to a limited comparability. There is a need for more psychological and interdisciplinary interventions in order to be able to optimally treat clients with persistent pain. An advanced knowledge of pain, conversation management or CBT is considered essential.