Experiences of training and delivery of Physical therapy informed by Acceptance and Commitment Therapy (PACT): a longitudinal qualitative study

• Published in: Physiotherapy 2021-09, Vol.112 (NA), p.41-48
• Main Authors: Galea Holmes, Melissa N., Wileman, Vari, McCracken, Lance M., Critchley, Duncan, March, Marie K., Norton, Sam, Moss-Morris, Rona, Noonan, Sandra, Barcellona, Massimo, Godfrey, Emma
• Format: Article
• Language: English
• Subjects: acceptance and commitment therapy; Low back pain; physiotherapy; qualitative research
• ISSN: 0031-9406; 1873-1465; 1873-1465
• DOI: 10.1016/j.physio.2020.12.004

Physiotherapy informed by Acceptance and Commitment Therapy (PACT) is a novel intervention that is related to improved disability and functioning in people with chronic lowback pain. This study explored physiotherapists experiences over time of the PACT training programme and intervention delivery. A longitudinal qualitative study using semi-structured, in-depth, individual interviews at three time points was conducted. A phenomenological approach underpinned the methods. Interviews followed topic-guides developed a priori. Transcribed interviews were coded inductively to generate themes. Data were member checked by participants and validated by two researchers. Eight clinical physiotherapists from three secondary care centres in the United Kingdom (n = 5 female; age, 24 to 44 years; duration of practice, 3 to 14 years) were included. Five themes emerged from the data. Experiential learning techniques were challenging but valued because they bridged theoretical principles and concepts with practice. Ongoing individual and group supervision was beneficial, but required tailoring and tapering. PACT delivery extended physiotherapy skills and practice, including techniques that acknowledged and addressed patient treatment expectations. With experience, participants desired greater flexibility and autonomy to tailor PACT delivery. PACT training and delivery were acceptable to physiotherapists. Existing skills were developed and additional, applicable approaches were provided that addressed psychosocial and behavioural aspects of chronic low back pain.