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When it comes to treating someone with chronic pain or other conditions that seem to defy a standard treatment approach, words—and the way they are delivered by clinicians—really matter. My research showed the challenges clinicians face when they try to explain adolescent nonspecific persistent back pain to parents using the biopsychosocial model (Hauber et al., 2025). They also struggled to form effective treatment relationships in a triad—not only with their young patient, but also with the parent legally responsible for the patient. Research on adults with chronic pain shows that when they rate their clinicians as having good communication skills, including empathy, the patients’ pain intensity is lower (Licciardone et al., 2024; Ruben et al., 2018).  However, skills training in how to communicate with patients about social stressors, the social aspects of pain, and the biopsychosocial model is either limited in their formal education or not practiced enough to make it feel normal and natural (Thompson et al., 2018; van Dijk et al., 2023).
Left on one’s own, it’s hard to figure out how to explain how psychosocial factors affect pain without making the patient feel invalidated or disbelieved.  On May 8, 2026, I’ll be joining physiotherapists in the UK at the Association of Paediatric Chartered Physiotherapists’ (APCP) Paediatric and Adolescent Spine Course. My role on the day is to teach them about the research on adolescent nonspecific persistent back pain and provide them some practical ways to better use the biopsychosocial model in practice.
The title of my session: Addressing Psychosocial and Communication Challenges in Clinical Encounters with Adolecents with Nonspecific Persistent Back Pain and their Parents. Many of the physiotherapists who attend will be treating patients with acute back pain, as well as the persistent back pain in which I speclialize. However, person-centered communication techniques are relevant in both cases. In acute cases, it’s crucial to rule out red flags, such as difficulty walking or weakness in the legs, problems controlling urination or bowel movement, fever/chills, unexpected weight loss, and numbness in the buttocks, groin, or inner thighs. 3/20/2026 0 Comments Why should you read my PhD thesis?As part of any PhD program, candidates need to perform research and present their work in a huge final document called a thesis (in Ireland and the UK) or dissertation (in the US and some parts of the EU).
Given that this document comprises at least 4 full years of research, these documents are always more than a hundred pages long. Most of them are 200 to 300 pages, including appendices and reference lists. As a doctoral student, I read several PhD theses because (1) they were fascinating to read, and (2) they were directly relevant to my own research on adolescent nonspecific persistent back pain treatment. But why would you, a busy clinician, want to read my thesis? May I humbly suggest three reasons: In the last 15 years, a wealth of qualitative research has been published on what people with chronic pain experience during their healthcare interactions/treatment.
This blog isn’t the right forum for me to undertake a rigorous systematic review of the literature (which takes months when done well). However, if you are interested in learning to communicate more effectively with patients who present with persistent pain, it’s important to have some exposure to what such people are saying when they are asked about their experiences. MacNeela et al. (2015) undertook a massive meta-ethnography—a synthesis of qualitative research to find cross-cutting themes--of 38 separate qualitative articles published between 1994 and 2011 on the subjective experience of people with chronic low back pain. Their findings are worth a look:  I am happy to have the opportunity to present the poster of my thematic analysis of clinician interviews at the first annual German Postdoc Network Conference near Munich, Germany. This poster was originally slated to be presented at the 2025 EFIC (European Pain Federation) Conference in Lyon, France, but major upheavals in travel and funding made it impossible for me to attend that conference.
The number of adolescents with nonspecific persistent back pain appears to be on the rise. Evidence for the rehabilitation of adolescent back-pain patients is limited, and guidance for treating adolescent nonspecific persistent back pain as a biopsychosocial phenomenon may not be widespread.
Therefore, my supervisors and I agreed that a deeper understanding of the practices, perspectives, and beliefs of healthcare practitioners treating this group of adolescents would be an appropriate way to gather on-the-ground experiences of clinicians and inform future intervention research. To do this, I developed an interview guide and undertook individual, semi-structured interviews with 10 clinicians (eight chartered physiotherapists, one nurse, and one psychologist) who currently treat or have treated adolescents with nonspecific persistent back pain. Because this was an exploratory, descriptive study, reflexive thematic analysis was used to code the interview transcripts and generate relevant themes. The five themes that captured the practices, perspectives, and beliefs of interviewed clinicians were: Parents are known to look online for health information, both for themselves and their children. Treatment for adolescent nonspecific back pain is primarily focused on biomedical and structural causes that may not address the root causes of the pain. Thus, parents may seek out health information online when their child has persistent nonspecific back pain to better understand treatment options for the condition.
Support groups on social media are popular with parents of a particular age, and we know that many people of all ages seek health information by scrolling socials. But studying social media in a rigorous way is incredibly difficult. Therefore, we stuck to websites that are easily searchable. To determine what a parent might see when they seek treatment advice online, I and my colleagues undertook a descriptive cross-sectional analysis of websites, with additional assessments of website credibility and readability. |
