Samenvatting
Aan pijn gerelateerde angst kan een belangrijke rol spelen in het ontstaan en het blijven bestaan van een chronisch pijnprobleem. ‘Exposure in vivo’-therapie richt zich op het reduceren van deze angst, met als doel de toename van participatie en de afname van ervaren beperkingen. In dit hoofdstuk wordt deze therapievorm uitgebreid besproken. Eerst wordt er ingegaan op de achterliggende theorie, waarna de praktijk aan bod komt aan de hand van drie stappen: (1) afname van de PHODA (photograph series of daily activities), om verwachte schadelijkheid van activiteiten en/of bewegingen in kaart te brengen, alsook om meer inzicht te verkrijgen in catastrofale gedachten en angsten daaromtrent, (2) educatie, waarin er aandacht is voor de neurofysiologie achter pijn en pijngewaarwording, alsook voor het vreesvermijdingsmodel, en (3) Exposure in vivo met gedragsexperimenten, waarbij de patiënt wordt blootgesteld aan situaties die angst oproepen en er gedragsexperimenten worden uitgevoerd om catastrofale cognities uit te dagen. Tot slot worden verscheidene manieren besproken om de behandeling te optimaliseren.
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de Jong, J., Timmers, I. (2019). Exposure in vivo. In: Verbunt, J., Swaan, J., Schiphorst Preuper, H., Schreurs, K. (eds) Handboek pijnrevalidatie. Bohn Stafleu van Loghum, Houten. https://doi.org/10.1007/978-90-368-2230-5_17
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