ON Chiropractic
Incorporating CBT
E
ach of these studies indicates that
incorporating a CBT component
into chiropractic treatment plans
can be highly beneficial to patients.
In particular, it would appear that a
combination of manual and exercise
therapy with CBT-informed patient
education may be exceptionally useful to
chiropractors, particularly when there is a
high likelihood of chronicity expected.
In the second part of this series on the
benefits of incorporating CBT principles
into chiropractic treatment plans, we
will examine how you can harness this
powerful tool in your practice. There
are many options. Standard referral and
partnership agreements are one way. We
will provide perspectives from leading
CBT practitioners on how to develop
these partnerships and when to initiate
a referral. You may be surprised to read,
though, that these psychologists are keen to
see chiropractors develop some capacity to
provide CBT themselves.
This is another avenue for the
incorporation of this tool that chiropractors
have already begun to explore. Research
supports the training of allied health
professionals in CBT principles in order
to enhance patient outcomes. The Lancet
recently published a study demonstrating
that even a few days of CBT training can
have significant benefits. We will provide
that data for your review. We will also share
the story of one chiropractor who has gone
well beyond that to earn a Master’s Degree
in Counselling Psychology, training that is
now enhancing both his patients’ outcomes
and his own experiences in practice.
Each chiropractor who is considering the
adoption of CBT techniques will need to
recognize the limitations of their expertise
and the critical importance of enhancing
their skillset and referring when necessary.
You will also find a compelling answer
to a question that has challenged providers
across the health care system – how to
identify patients who may benefit from a
counselling component to their treatment.
Studies have found that patients are not
being effectively screened for mental health
related conditions, including depression.
A group of chiropractic researchers has
honed one proven tool down to just a
couple of questions that can be appended
to your standard patient history processes
to identify patients with depression with a
high degree of accuracy.
A
s the understanding of the
psychological impacts of
conditions that chiropractors
treat grows, the profession will seek to
develop enhanced tools for the treatment
of these effects. CBT offers one tool
that has significant support in research
and in practice. In the next issue of ON
Chiropractic we will examine several ways
you can incorporate this technique into
your practice. This will expand your
repertoire of therapeutic approaches and
help your patients achieve and maintain
good health. ON
Recommended Reading
Goesling, J. et al. “Pain and Depression: An Integrative Review of Neurobiological and Psychological Factors,” Current Psychiatry Re-
b
ports 15:421 (2013): 1-8. Online.
Rector, N. “Cognitive Behavioral Therapy: An Information Guide,” Centre for Addiction and Mental Health (2010): 1-47. Online.
Henschke, N. et al. “Behavioral treatment for chronic low-back pain (Review),” The Cochrane Collaboration 7 (2011): 1-125. Online.
l
Hoffman, S. et al. “The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analysis,” Cognitive Therapy Research 36:5 (2012):
n
427-440. Online.
van Hoof, M. et al. “A short, intensive cognitive behavioral pain management program reduces health-care use in patients with chronic
Q
low back pain,” European Spine Journal 21 (2012): 1257-1264. Online.
Hill, J. et al. “Comparison of stratified primary care management for low back pain with current best practices (STarT Back): a randomized
u
controlled trial,” The Lancet 378:9802 (2011): 1560-1571.
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