Effectiveness of a CBT-based Rehabilitation Programme (Progressive Goal Attainment Program) for People who are Work Disabled due to Back Pain

Abstract

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.