You have arthritis, your joints are sore and stiff and you may be fatigued. So why am I being referred to a psychologist? Does my doctor really think “it’s all in my head?”
The short answer is no. For people living with a chronic painful condition such as axSpA, you can develop natural, but unhelpful ways of coping (thoughts and/or behaviours) with your condition. If your rheumatologist or GP suspects that this may be occurring in your situation, they may refer you to a psychologist to help you change the way you cope with living with axSpA.
Cognitive behavioural therapy (CBT) is a form of talk therapy that helps people identify and develop skills to change negative thoughts and behaviours. By changing these negative thoughts and behaviours, you can change your awareness of pain and develop better coping skills, even if the actual level of pain stays the same.
In cognitive therapy, the psychologist helps you identify and correct any distorted, unhelpful beliefs. Behavioural therapy uses thought exercises or real experiences to help reduce symptoms and improve function. CBT is the combination of these two forms of therapy and uses a problem-solving approach to help you learn new skills or ways to manage with your pain and axSpA.
The effectiveness of CBT is well established. When you begin, the psychologist will evaluate your situation, including your history and your current pain management plan. The therapist will then work with you to design a specific treatment plan.
To help provide pain relief, cognitive behavioural therapy:
How to get started with CBT
Counsellors, psychologists and therapists can all provide CBT, either in one-on-one therapy sessions, small groups or online. Talk to your GP for further advice or visit the Australian Government's Head to Health website for a library of online programs that allow you to practice CBT in your own home.
How to get the most from CBT
To maximise the pain control power of CBT, do the following:
More information on ways to deal with pain is available in our dealing with pain resource.
This resource has been developed based on the best available evidence. A full list of references is available upon request.