Treating gynecological pain: key factors in promoting body awareness and movement in somatocognitive therapy (SCT). A case study of a physiotherapy student´s treatment approaches

Background: Longstanding gynecological pain affects large numbers of women in the Western world. Somatocognitive therapy (SCT), a hybrid of cognitive psychotherapy and physiotherapy, is an evidence-based approach that has been successfully applied in the treatment of women suffering from such disorders, for example chronic pelvic pain (CPP) and provoked vestibulodynia (PVD), both demanding pain conditions. The curriculum of Oslo Metropolitan University's Mensendieck physiotherapy bachelor's program includes SCT training for the management of PVD.Purpose: The purpose of this study is to describe and explore the content of a SCT session based on a body and mind approach as performed by a physiotherapy student at a student outpatient clinic.Methods: A video-based case study of the student-patient encounter was undertaken midway through an SCT treatment course and subjected to content analysis.Findings: Three categories illustrating the learning process of body awareness, associated with the three-phase SCT were identified: 1) demystifying genital and chronic pain; 2) concentration, and body and mind experiences; and 3) patience, persistence, and willingness to change.Conclusion: The observation of the somatocognitive therapy session illustrates the value of an empathic relationship with the patient, in order to encourage her to explore body sensations and become familiar with the vulvar area. The therapy engages the patient in understanding pain mechanisms, thus educating her to overcome the fear of pain.

Body image, pain and level of resources among arthritis patients: the moderating role of gender

Arthritis is a highly debilitating group of chronic diseases that affects both physical and psychosocial functioning. The aim of this study was to examine the associations between body image, subjective pain intensity and level of resources described by Conservation of Resources (COR) theory among arthritis patients. In particular, the moderating role of the participants' gender was explored via multiple linear regression analysis. 200 arthritis patients were recruited, including 141 females and 59 males. Body image was evaluated using the Multidimensional Body-Self Relations Questionnaire, subjective pain intensity was measured via the Numerical Rating Scale and level of resources was assessed using the COR evaluation questionnaire. A negative relationship was confirmed between the level of satisfaction with body image and pain intensity among participants. A positive relationship was found between body-image subscales and level of COR resources. These relationships were moderated by the participants' gender, i.e. only among males a positive association between body image and pain and, respectively, body image and resources was found. Enhancing body awareness is an essential part of psychological counselling for patients with arthritis and our study added to the literature by showing how body image may be related to pain and resources in this patient group.

Mindfulness Interventions in Physical Rehabilitation: A Scoping Review

A scoping review was conducted to describe how mindfulness is used in physical rehabilitation, identify implications for occupational therapy practice, and guide future research on clinical mindfulness interventions. A systematic search of four literature databases produced 1,524 original abstracts, of which 16 articles were included. Although only 3 Level I or II studies were identified, the literature included suggests that mindfulness interventions are helpful for patients with musculoskeletal and chronic pain disorders and demonstrate trends toward outcome improvements for patients with neurocognitive and neuromotor disorders. Only 2 studies included an occupational therapist as the primary mindfulness provider, but all mindfulness interventions in the selected studies fit within the occupational therapy scope of practice according to the American Occupational Therapy Association's Occupational Therapy Practice Framework: Domain and Process. Higher-level research is needed to evaluate the effects of mindfulness interventions in physical rehabilitation and to determine best practices for the use of mindfulness by occupational therapy practitioners.