Self-efficacy and embodiment associated with Alexander Technique lessons or with acupuncture sessions: A longitudinal qualitative sub-study within the ATLAS trial

Abstract

Background and purposeA large randomised controlled trial found that the provision of either Alexander Technique lessons or acupuncture, for those with chronic neck pain, resulted in significantly increased self-efficacy when compared with usual care alone. In turn, enhanced self-efficacy was associated with significant reductions in neck pain at 6 and 12 months. In this analysis we explore the perspectives of participants within the trial, with the aim of gaining a better understanding of how these interventions had an impact.MethodsWe used a longitudinal qualitative approach; in-depth interviews, informed by a topic guide, were conducted with a sample of the trial population. Participants were interviewed twice: at around six months (n = 30) and twelve months (n = 26) after trial entry. Analysis was guided by the principles of grounded theory, and key themes were developed.ResultsFive key themes emerged: pre-trial experiences of biomedical treatment against which subsequent interventions were compared; emergence of tangible benefits from the interventions; factors that contributed to the observed benefits, notably growing self-care and self-efficacy; a developing sense of embodiment as an integral part of the transformative process; and contribution of these factors to sustaining benefits over the longer term.ConclusionsIn-depth interviews revealed a rich array of experiences. They gave insight into the positive impact of the interventions on development of self-care, self-efficacy and embodiment. These findings complement the quantitative trial data, providing a more nuanced understanding of the factors that underpin the previously quantified improvement in self-efficacy and its association with longer-term reductions in pain.

Individual Differences in Responsiveness to Acupuncture: An Exploratory Survey of Practitioner Opinion

“…Scepticism (24 mentions) is depicted as an undesirable starting-point characteristic which acupuncture treatment can shift—”attitude changes with improvement in their condition” (9.a/114). A reinforcing cycle of improved outcomes with increased buy-in to the system responsible is perceived, and acupuncture’s capacity to potentiate positive change and enhance self-efficacy is acknowledged as it is in current literature [ 47 ]. Respondent 43 (amongst others) is repeatedly concerned with acupuncture’s impact on individuals’ ability to cope , emphasising that this is a more important factor than changes to symptoms, in particular pain levels (see, for e.g., 10.12.c/43 and 10.13.c/43).…”

“…Individual patient diagnosis emerges as a priority with regard to response/non-response, with consensus found across many areas and specifically with regard to depression (see, for example, 11.18.c/4 and 11.18.c/18) that the innate and unique characteristics of each individual patient are the deciding factor with regard to response level. There are repeated pleas for the diagnostic specificity of the medicine (such as Respondent 63’s answers above) and acknowledgement of the non-specific treatment effects known to accompany it [ 47 , 53 , 54 ].…”

Moving With Pain: What Principles From Somatic Practices Can Offer to People Living With Chronic Pain

“…Different somatic forms are reported to have a wide variety of health and well-being benefits for people living with chronic pain. Physical benefits, for example, include flexibility, balance, muscle tone, reduction of days in pain, increased mobility and reduced perception of pain, especially in musculoskeletal pain ( Little et al, 2008 ; Webb et al, 2013 ; Wenham et al, 2018 ; Paolucci et al, 2019 ; Ahmadi et al, 2020 ). A randomised controlled trial (RCT) of Alexander Technique lessons, exercises and massage for chronic and recurrent back pain found that the effect of 24 lessons in the Alexander Technique after 1 year was a “42% reduction in Roland disability score and an 86% reduction in days in pain compared with the control group” ( Little et al, 2008 , p. 4).…”

Using immunisation caregiver journey interviews to understand and optimise vaccination uptake: lessons from Sierra Leone

“…Use of the ICJI approach is also appropriate to embed within a qualitative longitudinal design that recruits one or more cohorts of eligible caregivers to conduct repeat interviews at different time points. 39 One or more data collection teams may be needed depending on the sample design, desired turnaround time to collect the data and other logistical considerations. We recommend that each team be composed of two members-an interviewer and a dedicated notetaker, which is customary in qualitative investigations.…”