Talking about the taboo: how perceptions regarding women’s health inform cognitive behavioural therapists’ practice with women experiencing chronic pelvic pain

Amber Rae Alker
In: The Cognitive Behaviour Therapist · 2025 · vol. 18 · doi:10.1017/s1754470x25100342 · W7106241254
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study explored how cognitive behavioral therapists' perceptions of women's health and healthcare influence their practice with women experiencing chronic pelvic pain, revealing themes of gender, therapeutic roles, and relationship building.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-08 ⓘ

This qualitative study interviewed UK CBT therapists using in-depth, semi-structured interviews and thematic analysis to examine how therapists’ perceptions about women’s health shape their practice when working with women experiencing chronic pelvic pain (CPP). Drawing on a contextualist epistemology, the authors report that pain is influenced by beliefs and emotions, and that gendered assumptions and perceptions can contribute to underestimation, communication difficulties, and psychological consequences such as shame and self-blame, although the paper acknowledges subjectivity as a limitation inherent to qualitative research and its standpoint. The study’s stated focus is on how CBT clinicians’ views affect treatment approach, with an explicit caveat that training for CBT therapists does not directly address CPP or gender-mediated effects. Relevance to endometriosis: the introduction cites clinicians’ attitudes toward women with endometriosis (including dismissive, “hysterical” framings and questioning patients’ pain experiences) as an example of the care discourse that affects women with CPP, though the paper’s main topic is CBT therapists’ perceptions and treatment practices for CPP.

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Abstract

Abstract Chronic pelvic pain (CPP) has exceptionally high co-morbidities with common mental health conditions and is often associated with gendered healthcare inequalities. This study aimed to investigate the ways in which cognitive behavioural therapists’ (CBT therapists) perceptions, understandings, and assumptions regarding women’s health and healthcare influence their therapeutic practice with women experiencing CPP. In-depth semi-structured interviews were conducted with 21 CBT therapists working in a variety of healthcare settings. Transcribed interviews were analysed using a mixed inductive and deductive thematic analysis (TA). Three themes were developed: the gendered nature of CPP , the role of CBT , and building relationships. Therapists treated CPP as a distinctly gendered condition, which may lead to male therapists being viewed as less able to empathise with those suffering from CPP, and CPP in trans clients being left undiscussed. Therapists displayed varied understandings of the role of CBT with CPP clients and discussed how standard CBT training under-recognises the importance of women’s health in therapy. They identified trust as a key barrier to mental health care in women with CPP, highlighting relationship-building as a priority with this client group. This study demonstrates the impact that therapists’ own perceptions regarding women’s health has on their treatment approach with CPP, underscoring the importance of reflective practice in this area. It also highlighted significant gaps in the literature relating to approaching gendered topics such as CPP with trans clients, and a need to integrate women’s health issues into core CBT training and long-term conditions (LTC) training. Key learning aims (1) To understand key difficulties facing women experiencing chronic pelvic pain. (2) To identify how clinician perspectives regarding women’s health can affect clinical practice with this client group. (3) To learn from other clinicians what has worked well and what has been difficult when working with this client group.

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Condition tags

chronic_pelvic_pain

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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