To date Think-Back has helped over 290 people manage their back pain and saved local Health Authorities around £710,000
Think-Back is based on the principles of Pain Management Programmes which have been shown to be very effective in helping many with chronic pain manage their lives.
Think-Back is currently run in Essex, but can be delivered from a wide range of community and workplace settings.
Think-Back is a 14-hour educational programme that runs over a 7-week period. The fee for the programme is only £265.00 - approximately £19 an hour - representing remarkable value by comparison with most complementary therapy fees.
What the Secretary of State for Health, Alan Milburn MP says about Self-Management
At a recent Expert Patient Programme (EPP) the Secretary of State for Health, Alan Milburn MP commented, as he opened the Partnerships for Successful Self-Management conference at the Royal College of Physicians on Wednesday 28th February.
"First, around one in three people in this country live with a long-term health condition. With reductions in mortality and with people living longer, that figure is set to rise. Second, there is increasing evidence to show that great control by patients over their on care - 'self-management' - benefits people with long-term conditions. It can bring a better quality of life and fewer hospital admissions. And yet third, health care in this county still tends to focus on acute problems at the expense o f managing, and indeed preventing, chronic illness."
(The programme is being successfully used by organisations such as Essex County Council, Chelmsford Borough Council and now Brentwood, Billericay and Wickford Primary Care Trust (PCT) To encourage participants to continue to practice what they have learnt on the programme when it has ended, the fee includes an: -
Think-Back Programme Team: - Aims and Objectives of Think-Back
Pete Moore - Originator of the Think-Back programme.
Kim Brunning - Assistant Development Officer.
Jeanette Munson MCSP SRP
Sue Barrs-Gordon BA (Hons) Grad Dip Phys MCSP SRP
Sandra Waller M.S.T.A.T.
Carol Harding M.S.T.A.T.
Think-Back starts from the principle that living with chronic back pain is a skill to be learnt.
The aim of the programme is for people with back pain to take more control and responsibility for their back problem and to move from 'patient to person.' The emphasis is on rehabilitation leading to an improvement in the quality of life. This involves making physical and psychological changes - long term and permanently.
The specific objectives of the Think-Back self-management programme are:
How does the Think-Back self-management programme work?
The programme consists of: Six consecutive weekly sessions of 120 minutes each with one follow-up session one month after the end of the main programme to monitor change and encourage those who need reinforcement of key messages.
The Think-Back Programme:
Pete Moore or a Think-Back facilitates all Think-Back sessions from week two onwards with a 30 minute debrief prior to the main session - to discuss any problems those attending the programme maybe experiencing.
Professional Health Care providers are employed over the 7-weeks of the programme, to provide the professional input to the programme.
Week 1 Presentation of the Programme and learning Coping Skills: Pacing: is how to perform tasks in a measured and controlled fashion without overdoing and straining.
Goal Setting: helping the patient to identify activities, duties and pastimes to which they wish to return, and teach them ways to attaining these.
Education: provide a sound basic knowledge of the causes of pain. I.e. the Overactivity/underactivity cycle.
Facilitators: Pete Moore and Physiotherapist.
Week 2 Stretching: Learning to Stretch without over-doing.
Facilitator: Physiotherapist.
Week 3 Stretching/Exercise Session: (introduce isometric exercise) - also discuss general life style.
Facilitator: Physiotherapist.
Week 4 Alexander Technique: dealing with posture and poise and show how to use the body correctly.
Facilitator: Alexander Teacher
Week 5 Relaxation Techniques/Stress Management: Sleep difficulties.
Facilitator: Alexander Teacher or Physiotherapist
Week 6 Stretching/Exercise: (introduce dynamic exercise) follow up and to reinforce the importance of pacing, and not over-doing.
Facilitator: Physiotherapist.
4 Week Interval - to enable individuals to put the Think-Back< programme into practice.
Week 7 Follow up session: reinforce the importance of: Stretching, Pacing and discuss any difficulties patients maybe experiencing. Facilitators: Pete Moore and Physiotherapist.
Backup and Reinforcement
Extra follow-up 'refresher' sessions are arranged at six monthly periods for those who want it.
The approach is one of positive expectation and improvement, using the psychological principles of reinforcement of 'helpful and well behaviour' and extinction of negative unhelpful pain behaviours.
For more information please e-mail Pete Moore Here is what recent participants have said:-
End of course quotes from Think-Back programme March to May 2001
KH Cambridge
TK Billericay, Essex
KH Hornchurch, Essex
LB Brentwood, Essex
HJ Ilford, Essex
Think-Back has made me realise that there is light at the end of the tunnel, although I have had to change my life and my thinking. I did not know how to pace or make time for myself. This program has given me the tools to change and now I see the glass as half full. I am making progress in the right direction. Thanks for all your support.
RW Chingford London E4
JG Sidcup, Kent
PM Wickford, Essex
JE Hadleigh, Essex
They are characterised by a history of unsuccessful treatments (from a variety of specialists and health care professionals), numerous investigations, often with medical dependency, sleep problems and gross physical inactivity and/or depression anger, isolation and frustration at the effect of the pain on their lives. This scenario is known as the chronic pain syndrome.
Those who take part in the programme must be motivated enough to make the necessary life-style changes needed to manage or learn the skills essential to rehabilitate themselves. If they are, they can make the move from 'patient to person.' Exclusions from the Think-Back self-management programme.
The programme may not suit all that apply. It is mainly for those who, despite their daily pain, are still mobile.
Those who apply and who are severely disabled are encouraged to seek help from a hospital-based pain management programme where they can receive the more intensive specialist schooling. Measuring outcomes of Think-Back Method
Think-Back students and asked to fill in a simple questionnaire on week one of the programme.
At the end of the 7-week programme students of Think-Back are asked to fill in a similar, but more detailed questionnaire.
The following results are from the 100 course graduates on completion of the Think-Back self-management programme - week 7. The results below are expressed as percentages of all the questionnaires that have been returned to date. August 2000
1. How do you feel about managing your back pain having completed the course?
2. How would you rate the severity of your pain before the course?
3. How would you rate the severity of your pain after the course?
4. Does the pain last as long as it did before?
5. Are your requirements for medication?
6. Has your need to see a doctor/therapist
7. Do you still see your GP; Physiotherapist, Osteopath, Chiropractor, or other health care provider about your pain?
8. Since finishing the programme how often do you now stretch/exercise?
9. Did you set any short or long term goals at the beginning of the programme?
10. How close did you come to achieving them by the end of the programme?
11. How confident are you that you will achieve them or more goals in future?
12. What improvements would you like to see in the programme?
13. Other benefits of the programme include.
Past participants who have taken part in the Think-Back programme have said:
If you would like more information, or would like to take part in our Think-Back self-management programme, please e-mail at: Pete Moore Think-Back Vanessa Diebelius from Hornchurch, Essex who completed the course in April '99 said; " I was suffering from a chronic back condition for the past 10 years. The course helped me to manage my problem, and I can now do more activities than I did before attending the programme. I would recommend the programme to anyone who has had a back problem and wants to manage it and regain control of his or her life.
The Think-Back programme provides a different viewpoint on your long-term back pain. It has provided me with the groundwork for the future and enabled me to start making some changes to my lifestyle, which will help me cope better with the pain, both psychologically and physically.
Think-Back has given me the opportunity to look at my own problems, in my own time, in the privacy of my own home. I can pace myself according to my personal circumstances. It is not competitive, the results I achieve are down to me and nobody else. I am only responsible to myself and not under pressure to achieve results in a given time.
The programme has given me a valuable toolbox to help with all aspects of dealing with back/chronic pain, both physically and psychologically, which has given me the confidence to work with the pain and not to let it control me and my life. Positive thinking has helped and Pete's reminders not to allow negative thoughts dominate sets up better conditions to cope with the pain from day to day. Being in the moment has helped greatly.
My depression has lifted so much, my pain after my operation six months ago has varied due to pacing and learning to stop and rest. My family has noticed the change in me and says that I am now doing so much more.
I came to the Think-Back programme probably with the specific aim of returning to my sporting activaties and with the attitude that I have received, I do really believe that, given time, I shall achieve this aim ad probably the biggest prize I shall gain will be that I shall NOT have the back operation that I thought would be the only answer. Thanks.
Think-Back has taught me to pace myself, plan activities and be more positive. The exercises have helped me to take positive action to combat the pain. I have returned to regular swimming, can walk further and stand long enough to enjoy a normal social life.
I feel much happier with my self since doing the Think-Back programme. I am more tolerant, more supple, less bad tempered and coping much better in general.
Attending the Think-Back programme has reminded me to use pacing, exercise, relaxation and other skills to keep back pain in the background. Unless, all the skills advocated by the programme are utilised on a daily basis, we lose control & pain takes control. The support given throughout the course is also very helpful.
Extra Help
To date, we have successfully organised: -
Who will benefit from Think-Back self-management programme?
People with long term back pain of non-malignant origin where currently there is no known curative treatment.
I. No different 2%
II. More confident 97 %
III. Less confident 1%
IV. Did not answer 00%
On a scale of 1 to 10 1 being no pain 10 being lots of pain
3% were between 1 and 3
45% were between 4 and 7
49% were between 8 and 10
3% did not answer
On a scale of 1 to 10 1 being no pain 10 being lots of pain
30% were between 1 and 3
57% were between 4 and 7
10% were between 8 and 10
3% did not answer
Yes 18%
No 77%
Did not answer 5%
I. Less 35%
II. more 3%
III. the same 43%
IV. stopped medication 16%
V. did not answer 3%
I. decreased 27
II. increased 1%
III. stayed the same 43%
IV. stopped 24%
V. did not answer 5%
Yes 43%
No 51%
Did not answer 6%
I. daily 80%
II. more than once a week 19%
III. less than once a week 1%
IV. monthly 00%
V. never 00%
VI. did not answer 00%
Yes 83%
No 14%
Did not answer 3%
On a scale of 1 to 10, 1 being not at all 10 being completely
14% were between 1 to 3
50% were between 4 to 7
24% were between 8 to 10
12% did not answer
On a scale of 1 to 10, 1 being not at all 10 being completely
1% were between 1 to 3
40% were between 4 to 7
49% were between 8 to 10
10% did not answer
I. a better information pack 1%
II. More speakers 10%
III. less speakers 3%
IV. more medical input 24%
V. a longer programme 28%
VI. a shorter programme 0%
VII. Did not answer 40%
Those who filled in the questionnaire reported...
If you would like more infomation, or would like to take part in the Think-Back self-management programme, please e-mail at: Pete Moore