TY - JOUR
AU - P. Simpson
AU - R. Holopainen
AU - R. Schutze
AU - P. O'Sullivan
AU - P. Kent
AU - N. R. Klem
AU - A. Smith
A1 - 
AB - PURPOSE: Cognitive functional therapy (CFT) is a person-centred biopsychosocial intervention for chronic low back pain, with large sustained clinical and economic benefits. This study explored the experiences of physiotherapists delivering CFT in their usual clinical practice after being trained to competency for the RESTORE clinical trial. MATERIALS AND METHODS: A qualitative study design was used. Fifteen primary care physiotherapists were interviewed (seven female, clinical experience 3-25 years). An inductive-deductive content analysis was used, including the Theoretical Domains Framework and socioecological model. RESULTS: Facilitators and barriers were identified within and between individual, micro (clinical interface), meso (health service), and macro (health system) levels. Physiotherapists reported feeling competent and skilled delivering CFT. At the microsystem, this was influenced by time and their evolving professional identity. At the mesosystem, social support within the clinical community and positive patient outcomes facilitated CFT, while disunity in pain management across the health system and inadequate remuneration were barriers. Societal beliefs about pain, shifts in professional identity, and funding models influenced delivery at the macrosystem. CONCLUSIONS: This study highlights multilevel facilitators and barriers that physiotherapists perceive when implementing CFT. Targeting these may help to optimise the implementation of this promising intervention, thereby contributing to better patient outcomes.; Ensuring that physiotherapists are trained to competency in cognitive functional therapy (CFT) empowers clinicians with the necessary skills and confidence to effectively treat a broad range of musculoskeletal pain patients in usual clinical practice.Building communities of practice that facilitate peer review and reflection builds skills and prevents drift from the competencies of delivering CFT.Creating clinical environments that support both privacy for sensitive patient disclosures alongside connectivity and opportunities for self-management is crucial for delivering person-centred care.Addressing challenges with current funding models is essential for improving access to biopsychosocial interventions like CFT.Patient triage and outcome-based funding models that incentivise high-value care could help ensure more equitable, timely, and cost-effective physiotherapy services.; eng
AD - School of Allied Health, Curtin University, Perth, Australia.; Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.; Multidisciplinary Pain Management Centre, Royal Perth Hospital, Perth, Australia.; Bodylogic Physiotherapy, Perth, Australia.
AN - 40298204
BT - Disabil Rehabil
C5 - Education & Workforce
CP - 26
DA - Dec
DO - 10.1080/09638288.2025.2495199
DP - NLM
ET - 20250429
IS - 26
JF - Disabil Rehabil
LA - eng
N2 - PURPOSE: Cognitive functional therapy (CFT) is a person-centred biopsychosocial intervention for chronic low back pain, with large sustained clinical and economic benefits. This study explored the experiences of physiotherapists delivering CFT in their usual clinical practice after being trained to competency for the RESTORE clinical trial. MATERIALS AND METHODS: A qualitative study design was used. Fifteen primary care physiotherapists were interviewed (seven female, clinical experience 3-25 years). An inductive-deductive content analysis was used, including the Theoretical Domains Framework and socioecological model. RESULTS: Facilitators and barriers were identified within and between individual, micro (clinical interface), meso (health service), and macro (health system) levels. Physiotherapists reported feeling competent and skilled delivering CFT. At the microsystem, this was influenced by time and their evolving professional identity. At the mesosystem, social support within the clinical community and positive patient outcomes facilitated CFT, while disunity in pain management across the health system and inadequate remuneration were barriers. Societal beliefs about pain, shifts in professional identity, and funding models influenced delivery at the macrosystem. CONCLUSIONS: This study highlights multilevel facilitators and barriers that physiotherapists perceive when implementing CFT. Targeting these may help to optimise the implementation of this promising intervention, thereby contributing to better patient outcomes.; Ensuring that physiotherapists are trained to competency in cognitive functional therapy (CFT) empowers clinicians with the necessary skills and confidence to effectively treat a broad range of musculoskeletal pain patients in usual clinical practice.Building communities of practice that facilitate peer review and reflection builds skills and prevents drift from the competencies of delivering CFT.Creating clinical environments that support both privacy for sensitive patient disclosures alongside connectivity and opportunities for self-management is crucial for delivering person-centred care.Addressing challenges with current funding models is essential for improving access to biopsychosocial interventions like CFT.Patient triage and outcome-based funding models that incentivise high-value care could help ensure more equitable, timely, and cost-effective physiotherapy services.; eng
PY - 2025
SN - 0963-8288
SP - 7010
EP - 7022+
ST - Physiotherapists' delivery of cognitive functional therapy in clinical practice: perceived facilitators and barriers from a socioecological perspective
T1 - Physiotherapists' delivery of cognitive functional therapy in clinical practice: perceived facilitators and barriers from a socioecological perspective
T2 - Disabil Rehabil
TI - Physiotherapists' delivery of cognitive functional therapy in clinical practice: perceived facilitators and barriers from a socioecological perspective
U1 - Education & Workforce
U3 - 10.1080/09638288.2025.2495199
VL - 47
VO - 0963-8288
Y1 - 2025
ER -