Psychological Interventions for Women with Persistent Pelvic Pain: A Survey of Mental Health Clinicians

Abstract

Objective: To establish which psychological therapies mental health professionals use with reference to the treatment of women with persistent pelvic pain conditions. This research investigates overall therapies and specific techniques that clinicians believe are the most effective with this patient group, and the challenges mental health clinicians face in administering interventions. The study aims to suggest improvements to clinical practice and establish directions for targeted future research. Design: Cross-sectional survey design. Methods: An online survey was developed to ask mental health clinicians questions regarding the therapies and techniques they use with women experiencing persistent pelvic pain, their perspective on their practice in this area. The survey was advertised on relevant social media and professional websites. Survey results were tabled, and chi-square statistical analyses were undertaken to examine differences in therapy use according to country and profession. Results: Mental health clinicians predominantly utilized cognitive behavioral therapy, acceptance and commitment therapy and associated techniques for women with persistent pelvic pain conditions. The results of the chi-square analyses showed that psychologists were more likely to use cognitive behavioral therapy or acceptance and commitment therapy, than counsellors who preferred counselling interventions. Chi-square analyses showed that Australian clinicians used acceptance and commitment therapy with a higher frequency than mental health clinicians in other countries. Clinicians provided multiple insights into their experiences working with women affected by persistent pelvic pain and their opinions as to valuable future research directions. Conclusion:Cognitive behavioral therapy, acceptance and commitment therapy, and mindfulness therapies were most commonly used by mental health clinicians working with women with persistent pelvic pain conditions, despite severely limited evidence for the use of these psychological interventions in this client group.

Psychometric evaluation of the Depression Anxiety Stress Scale 8 among women with chronic non-cancer pelvic pain

“…Distress management may considerably affect CPP recovery 2 . This is because a considerable proportion of CPP patients experience excessive levels of distress 2 , 8 , 9 , 16 .…”

“…Distress management may considerably affect CPP recovery 2 . This is because a considerable proportion of CPP patients experience excessive levels of distress 2 , 8 , 9 , 16 . Because resources allocated for disease management are limited 16 , there is a great need for brief measures that may facilitate the identification of highly distressed patients as well as their response to treatment 35 .…”

“…The annual healthcare expenditure of CPP is enormous, exceeding 6.5 billion dollars in Australia 2 . In addition, CPP alters women’s quality of life, reproductive capacity, social relations, work performance, and sexuality.…”

“…Physical and sexual abuse represent a major risk factor for CPP 3 , 8 . Given the traumatic origins of CPP and the distressful course of the condition, CPP is frequently managed within the biopsychosocial model of chronic pain—an approach, which emphasizes the importance of wholistic management of chronic pain conditions “pain itself along with associated psychological and social problems” for more positive treatment outcomes 2 . However, CPP women experience varying levels of psychological distress.…”

“…Greater comorbidity (e.g., depression, poor sleep, fatigue, somatic symptoms) is more common among women who experience higher distress than those with little or no distress 16 . Therefore, careful identification of highly distressed women with CPP through the assessment of psychopathological symptoms is extremely pivotal for designing effective interventions for CPP and evaluating the outcomes of such interventions 2 .…”