Psychologically informed practice - How far we’ve come and how far we haven’t with Steven Vogel

The Words Matter Podcast with Oliver Thomson

Welcome to another episode of The Words Matter Podcast.

In this episode I speak with Steven Vogel. Steven is Deputy Vice-Chancellor (Research) at the University College of Osteopathy and Editor in Chief of the International Journal of Osteopathic Medicine.

He has twice been a member of National Institute for Health and Clinical Excellence (NICE) Guideline Development Groups formulating NICE clinical guidelines for back pain and sciatica.

Steven led the large Clinical Risk Osteopathy and Management (CROaM) study which examined adverse events and outcomes related to osteopathic interventions.

His main research interests focus on back pain, clinicians’ beliefs and attitudes and more recently, reassurance, communication and consent, safety and manual therapy, patient reported outcomes, self-management rehabilitation strategies used in practice with people with low back pain, and the effects of cognitive and affective reassurance.

In this episode we talk about:

• What constitutive ethical and professionally agnostic musculoskeletal care (see Steve's paper here).
• The early research into psychology of LBP, of which he was a crucial part (see here here and here).
• The cyclical nature of current arguments (hands on/of/psycho/manipulation etc).
• The different levels (fizzy drink scale) of psychologically-informed practice, and the psychological processes involved in clinical practice.
• The challenges of developing these skills in clinicians, and the questions up for debate such as 'what does it mean to be BPS orientated' and 'what sorts of training bests develops those competencies'?
• The frequent situation where psychological interventions have high face validity, make sense to us an clinicians but show small effect sizes when clinically trialled.
• We talk about his seminal 2013 systematic review work on cognitive and affective reassurance.
• Signs of progress and lack of progress of for PIP
• The challenge of measuring BPS-ness and the empirical actions and observable behaviours associated with such a clinical orientation.

Steven is is perhaps the most measured, rational and composed individual I know. He remains totally zen even when being faced with some the highest intellectual dishonesty in the manual-physical-osteopathy spheres.

It was an absolute pleasure speaking with Steve about his seminal work as a pioneer of psychologically-informed musculoskeletal care, and reflect on how far we have come and how much further we have still to go.

Find Steven on Twitter @UCODVC_Research

If you liked the podcast, you'll love the Words Matter online course in effective language and communication when managing back pain - ideal for all MSK therapists and students (discounts for students available)

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