Table 1 Overview of somatocognitive therapy as provided in the feasibility study, as per TIDierR criteria
TIDierR items [45] | Description |
|---|---|
Brief name | Somatocognitive therapy for provoked localized vestibulodynia (ProLoVe feasibility study) |
Why | Few RCTs exist, important to develop effective treatments that can easily be applied in primary care. Running a feasibility study is important in preparation for full-scale RCT. |
What | SCT is a multimodal physiotherapy intervention designed to target the multiple dimensions of vulvar pain, utilizing a biopsychosocial approach. A bodily approach is combined with a cognitive restructuring of negative thoughts. Overall, the aim is to improve body awareness to reduce vulvar pain and psychological distress and improve sexual function. |
Materials: Participants | Resources: vulva.no |
Materials: Physiotherapist | Equipment included a treatment bench, mat, pillows, massage balls, mirror, Pilates ball, and educational material. |
Procedures | Initial appointment: Assess participant—take a thorough history (including previous experiences, beliefs, and expectations) and clinical examination (quality of movement, breathing pattern). The main areas of SCT include the following: Therapeutic alliance is an essential component of SCT; patient and therapist are in a close working relationship, agreeing on treatment goals and home assignments. Participants take an active part in the decision-making process about their own treatment and progression. The bodily approach: breathing patterns, maladaptive movement, and postural patterns are addressed in various positions (sitting, standing, walking, and in supine). Through manual techniques and touch, participants are taught various techniques to increase body awareness, improve relaxation, and reduce muscle tension. Education about PVD, chronic pain, stress, and healthy vulvo–vaginal and sexual behaviors. Coping with emotions and thoughts related to bodily experiences. Participants learn to become aware of negative/catastrophizing thoughts and learn how to restructure or accept these thoughts as well as how to overcome fear avoidance behavior. An important aspect is the women’s ability to adapt and to self-manage their condition such as coping with pain and flare-ups. Structured homework promoting the application of learned techniques in daily situations. Gradual exposure to activities associated with pain, desensitization exercises, and exercises to increase the pelvic floor and vulva awareness. Relaxation and breathing exercises. Last session—create a self-management toolbox with participant |
Who provides | Experienced female physiotherapist trained in SCT, the first author of the article. |
How | Each session has a three-phased structure: (1) The conversation, (2) the bodily intervention/exploration, and (3) the home assignment. |
Where | In a closed room with access to the gym, outpatient physiotherapy clinic, Oslo Metropolitan University, Norway Home assignments performed by the participants integrated into ADL |
When and how much | Initial appointment offered to patients after collection of baseline data. The median number of sessions: 12 (min 7; max 15) face to face with a physiotherapist Treatment period: minimum of 13 weeks and maximum of 22 weeks. Each session (including the initial session) lasted up to 60 min. The number of sessions required was personalized. |
Tailoring | The treatment is personalized and tailored to the individual. The patient’s participation and collaboration are important. The treatment principles are the same for all but are adapted to suit the individual’s needs. |