Table 4.

Theories, therapies and cognitive and behavioural techniques influencing the design of the course

Underlying theories and therapies	Influence on course design	Cognitive and behavioural change techniques used throughout the course as determined by the groups and the facilitators
Biopsychosocial model of medicine Physiology, psychology and the social environment and society play a part in health	Whole course	Plan social support/social change Facilitate social comparison Barrier identification/problem solving Devise behavioural goals Action planning Model/demonstrate the behaviour Provide information on where and when to perform behaviour Provide instruction on how to perform the behaviour Provide opportunity to devise ways of performing the behaviour Learn where and when to perform behaviour Learn how to perform the behaviour Prompt generalisation of a target behaviour Provide information on the consequences of behaviour Reflect on the consequences of behaviour Reflect on where and when to perform behaviour Prompt self-monitoring of behaviour Prompt self-monitoring of behaviour outcome Review of behavioural goals and outcomesStress management Prompt self-talkPrompt use of imagery Prompt practice Emotional control training Environmental restructuring Communication skills Provide feedback Prompt focus on past success Environmental restructuring Teach to use prompts/cues Repetition Use of follow-up prompts Prompt anticipated regrets and setbacks Relapse prevention/coping and planning
Acceptance and Commitment Therapy (ACT) Accepting the here and now and living with it	Pain information Acceptance: the uninvited guest Relaxation and mindfulness
Fear avoidance and catastrophising Pain and fear lead to avoidance behaviour which is not always beneficial	The pain cycle, goal setting and action planning
Attention management Keeping the brain occupied on things other than pain, reduces pain perception	Attention control and distraction Relaxation, breathing, visualisation and imagery Taster sessions (eg, art)
Social cognitive theory Behaviour may be influenced by interaction between personal, environmental factors and own and others’ behaviour	Group work/discussion Reflection Listening skills
Cognitive therapy Recognising the link between thoughts, emotions and behaviour Theory of planned behaviour Based on beliefs about likely consequences of behaviour Rational emotive principles Logical unemotional rationalisation of events, thoughts, emotions	Identifying problems, goal setting and action planning Barriers to change—unhelpful thinking Barriers to change—reframing negatives to positives Communicating with your GP Anger, irritability and frustration: managing emotion Follow-up—managing setbacks
Mind body therapies Muscle relaxation, biofeedback, visualisation and mindfulness techniques	Relaxation and breathing Relaxation and visualisation Relaxation and mindfulness of thoughts
Physical theory and therapies Alexander technique for posture and physical therapy practice on balance and stretch	Posture Balance and stretch Stretch

GP, general practitioner.