Table 2

Turning clinical activities and treatment into self-management support.

PlanningDefining successSupport and guide patients towards their individual value-based goals.Communicate that cure of symptoms is the ultimate goal of treatment.
Clinical assessmentAssess (pain) behaviours, impairments, thoughts, and feelings that facilitate and hinder valued goals.Emphasize a structural diagnosis that does not inform choice of treatment and prognosis, or understanding of pain.
Intervention planProvide evidence-based knowledge to help patients make informed decisions about their care.Decide what is best for a patient or make them believe that their pain will be cured and never return.

DeliveryPatient educationFocus on the benign aspect of low back pain.Focus on structural injury as an explanation of non-specific low back pain.
Manual therapyInclude manual therapy in symptom management if valued by patients and helpful for achieving patient-valued goals.Tell patients that their back pain cannot improve without manual therapy, that something is out of place or that manual treatment corrects spinal abnormalities.
Exercise supervisionUse exercises to help people become confident with natural and varied movements and use exercises to develop problem-solving skills.Tell patients that their back pain cannot improve without specific exercises, and don't make movement difficult by correcting them to achieve a ‘neutral posture’, ‘alignment’, or other clinician determined criteria for moving correctly.

EvaluationDefine success of interventionUse patient-centred goals to define results of the intervention.Use pain measurements to define results of the intervention.