Treating gynecological pain: key factors in promoting body awareness and movement in somatocognitive therapy (SCT). A case study of a physiotherapy student´s treatment approaches.

BACKGROUND: Longstanding gynecological pain affects large numbers of women in the Western world. Somatocognitive therapy (SCT), a hybrid of cognitive psychotherapy and physiotherapy, is an evidence-based approach that has been successfully applied in the treatment of women suffering from such disorders, for example chronic pelvic pain (CPP) and provoked vestibulodynia (PVD), both demanding pain conditions. The curriculum of Oslo Metropolitan University's Mensendieck physiotherapy bachelor's program includes SCT training for the management of PVD. PURPOSE: The purpose of this study is to describe and explore the content of a SCT session based on a body and mind approach as performed by a physiotherapy student at a student outpatient clinic. METHODS: A video-based case study of the student-patient encounter was undertaken midway through an SCT treatment course and subjected to content analysis. FINDINGS: Three categories illustrating the learning process of body awareness, associated with the three-phase SCT were identified: 1) demystifying genital and chronic pain; 2) concentration, and body and mind experiences; and 3) patience, persistence, and willingness to change. CONCLUSION: The observation of the somatocognitive therapy session illustrates the value of an empathic relationship with the patient, in order to encourage her to explore body sensations and become familiar with the vulvar area. The therapy engages the patient in understanding pain mechanisms, thus educating her to overcome the fear of pain.