Table 1.

Content of the value-based cognitive behavioral therapy program

Session and topic		Aims	Homework/techniques
1-2	Introduction.	To introduce the program. Discuss affected life domains and values. Give insight into the difference between active vs. passive coping.	Discuss important values with the family or a close friend. Complete value template.
	Affected life domains.
	Values and life goals.
	Week-plan.		Activity registration.
3	Pain theory and activity engagement according to values.	To introduce pain models and the bio-psycho-social perspective. Discuss values and activity engagement. Setting new short- and long-term value-based goals. Discuss daily activities and make an exercise plan.	Complete week plan according to planned activities.
			Establish a workout routine.
4	“Road-block” therapy.	To discuss psychosocial barriers for fulfilling goals. Introduce the concept negative reinforcement and the power of habits. Introduce the cognitive ABC model. Setting new realistic measureable goals.	Work with barriers, cognitive, emotional or practical.
	Negative reinforcement.
			Complete week plan according to planned activities.
			Workout.
5	Unfulfilled expectations.	To discuss expectations to oneself and how unfulfilled expectations can affect mood and behaviour resulting in maladaptive coping.	Complete plan B and set realistic goals for the day.
	Having a plan B.
			Complete week plan according to planned activities.
		Learn to work out a plan B.
			Workout.
6	The energy balance and psychological barriers for activity engagement.	Learn to conserve “energy”, prioritise in activities.	Identify energy consuming activities vs. activities that increases energy.
		Discuss psychological barriers for activity engagement.
	Adjust goals.
			Use the ABC model.
		Discuss life values and adjust goals accordingly.	Complete week plan according to planned activities.
			Workout.
7	Psychological barriers.	To work more in depth with individual psychological distress and barriers for activity engagement, for instance depressive symptoms, PTSD, or pain catastrophizing.	Use the ABC model.
			Complete week plan according to planned activities.
			Workout.
8	Psychological barriers.	To work more in depth with individual psychological distress and barriers for activity engagement. Work out an exposure hierarchy of feared activities.	In vivo exposure.
			Complete week plan according to planned activities.
			Workout.
9	Activity engagement and return to work or relevant activities.	Discuss return to work or relevant activities. Work with fear-avoidance beliefs and catastrophizing.	In vivo exposure of work related activities.
			Complete week plan according to planned activities.
			Workout.
10	Long-term goals and values.	To discuss progress and values. Set long-term goals and work out a plan for setbacks and maintenance of progress.	Discuss long-term goals and plan with a close relative or friend.