Psychological Interventions for OA

Psychological Interventions for OA 1

The mainstay psychological intervention for OA is cognitive-behavioural therapy. This usually consists of three phases

  1. An education segment in which patients are taught about the biopsychosocial model of pain.
  2. A skills training segment in which patients are trained in a variety of cognitive-behavioural coping skills such as relaxation training, activity pacing, pleasant activity scheduling, imagery techniques, distraction strategies, cognitive restructuring, problem solving and goal setting.
  3. An application phase in which patients practice and apply their newly acquired skills in real life situations.

Other types of treatment include

  • Emotional disclosure
  • Hypnosis
  • Psychodynamic interventions
  • Acceptance and commitment therapy.

A meta-analysis (Dixon et al 2007) reviewed 27 randomised controlled trials which pooled together different psychosocial interventions, without separating cognitive behavioural therapy which constituted 70% of the interventions for patients with both hip and knee pain. The results for improving pain and improving function after 2-12 months had NNT’s of 10 and 12 respectively.

For more information on psychological therapies that can be accessed by GPs, please see:

Cognitive Therapy

Acceptance and Commitment Therapy

Chronic non malignant pain formulation based assessment


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