EP8.57 Bridging the Gap: Provider Perspectives on Integrating Cognitive Behavioral Therapy into Orthopaedic and Rehabilitation Care

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ID: 331374
2026
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Abstract
Abstract Background More than one in four adolescents and young adults with hip conditions experience severe psychological distress. Cognitive Behavioral Therapy (CBT) targets psychological and behavioral contributors to pain and dysfunction. As multidimensional screening tools for psychological distress become more common in orthopaedic practice, the next critical step is to ensure that patients are connected with effective interventions that support their recovery. Methods To inform potential integration of CBT into orthopedic and rehabilitation care, providers across multiple clinical roles at a specialty orthopaedic hospital completed a structured electronic survey. Items assessed CBT familiarity, comfort using CBT techniques, perceived patient outcomes, barriers to implementation, and desired resources. Descriptive statistics were calculated, and responses were analyzed by provider role. Results Seventy-seven providers completed the survey: physicians (n=11), advanced practice providers (APPs) (n=22), athletic trainers (n=21), physical therapists (PTs) (n=9), physical therapy assistants (PTAs) (n=4), nurses (n=5), and medical assistants (n=5). Most respondents reported limited CBT exposure (71% not familiar or only somewhat familiar) and 95% reported no formal training. Despite this, willingness to incorporate CBT was high (66%), and 78% rated CBT as moderately to very effective for improving anxiety, coping, and engagement in daily activities. Barriers to implementation included lack of training, time constraints, low confidence, and limited organizational support. Role-specific trends emerged: athletic trainers demonstrated high interest despite low familiarity; APPs and PTs/PTAs showed moderate familiarity with variable confidence due to time, billing, and productivity pressures; physicians favored referral-based models; and nurses and medical assistants were limited by scope-of-practice constraints. Conclusions Despite strong interest in CBT-informed care, most providers report limited training, low confidence, and unclear role boundaries, thus limiting direct delivery within orthopedic and rehabilitation visits. Findings support the need for a team-based model integrating mental health professionals, at least until orthopaedic and rehabilitation providers receive additional training and time to incorporate CBT into their clinical routines for patients with young adult hip pathology.
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Authors Amanda Paulson, Michael Willey, Robert W. Westermann, Courtney Seffker, Tony Pennuto
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.437
URL
https://doi.org/10.1093/jhps/hnag043.437
Keywords Keywords not found

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