Welcome back to the Pain Science Education Podcast with Tawny Kross

In today’s episode, Dr. Tawny Kross, a physical therapist who integrates psychology into her practice, discusses the fusion of psychology and physical therapy, known as psychologically informed physical therapy, and its essential role in pain management. Dr. Kross shares insights from her work at the VA Medical Center and in her private practice, highlighting the importance of a whole person approach to pain care. We discuss the challenges and benefits of integrating cognitive behavioral techniques into physical therapy and improving pain literacy. Tune in to learn how to enhance pain care through a psychologically informed approach and gain valuable insights into the evolving landscape of physical therapy.

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The Power of Psychologically Informed Physical Therapy with Tawny Kross, PT, DPT

Let’s learn about how to enhance pain care through a psychologically informed approach with Dr. Tawny Kross

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Okay, let’s learn about how to enhance pain care through a psychologically informed approach with Dr. Tawny Kross. Hey there, Tawny. Thanks for joining me this week.

Thank you for having me.

I’m excited to chat with you. I know we’re going to talk about lots of different topics. I don’t know, probably under the umbrella of maybe whole person care and psychologically informed care, of course, is kind of guide a lot of this episode today. But first, I want you to give our listeners and our viewers, just an overview of the things you do, because I know you kind of wear two different hats or multiple hats. And I think it’s interesting how you’re working both like within the healthcare system, and with outside of healthcare system.

Yeah, it’s actually been very interesting for me to see as well. So I work full time at the VA hospital that’s local to me. And in that setting, I am working oftentimes alongside in a group space program with a pain psychologist. And separately, I also see patients one to one where I work on a more integrated approach with physical therapy. And then outside of that, I have my own private practice that I am in part time. And that’s definitely more along the lines of an integrated whole person approach to pain and health.

Interesting. So within the VA, you work in a team with a pain psychologist or with a psychologist, and you run a group program together.

Yes, we do.

And then you also see patients kind of in a one on one setting within the VA system. And then you have your own practice that you’re building on the outside, where you have kind of your own approach, I guess I would, I would imagine to treating chronic pain.

Yes, there’s a little bit more licensure on what I can do in my own practice, because obviously, in a hospital setting, I’m respecting kind of the regulations and rules of what they want me to do. Yeah.

Oftentimes, when we kind of venture into private practice, we have more flexibility and we have more kind of influence and control over the things that we do. So I think that’s great. So I know, within both all these roles that you’re talking about, I know you provide psychology informed care. Not a new term, of course, in the physical therapy literature, not a new term. for this podcast, probably psychology informed care is hopefully becoming not a new term, even for people that live with chronic pain, who are looking for symptom relief and things like that. I know that you’ve said that you believe that really all physical therapists or physiotherapists should be using some form of psychology informed care. And there’s lots of different, you know, forms of that. Why do you think that this really should be kind of mainstream treatment at this point?

Making Psychologically Informed Care Mainstream

Yeah, so number one, obviously we know that pain is complex and successful approaches in pain management, chronic pain, needs to be at a biopsychosocial, at least, or whole person level. And I think you might’ve mentioned before that physical therapists are concerned that we are taking physiotherapy in the direction of providing mental health care. And for the sake of comfort, we might prefer approaches stay within the behavioral health and mental health space. But if you look at on the mental health side of things, there’s a lot of surveys that show that psychologists and therapists have low confidence and low perceived competency to address physical pain. And in the psychology world, there’s actually a lack of psychotherapists with pain training. Pain psychology is not a recognized specialty by the American Psychological Association, and it has no formal standing within the organization right now. The psychologist that I work with, the pain psychologist, mentioned that a lot of her colleagues that are not involved with pain, their most common misconception is that she’s just a general psychologist that treats pain, But there’s a very specialized thing that she does, and it is pain psychology. And I think because of this, there’s an issue with navigating referrals nationwide. And if I think about the physical therapy side of things, PTs get referred for pain all the time. And so for me, that’s like, OK, you should be incorporating mental and behavioral interventions on pain. But if you’re too uncomfortable to work with these types of approaches, they’re just waiting for some mental health provider to fill that gap. And there’s a lack of those mental health providers. So I guess what really happens is when PTs are not comfortable with integrating something like mental health, the people that they’re trying to help end up not getting that help.

So interesting, because I think as a profession, physical therapists are very altruistic, they want to help their patients, They want to alleviate pain in their patients. They want to see their patients recover. But there is definitely a segment, I think, of our population of our profession that is like, well, I’m not really sure that this is for me. I’m not really sure I want to do this. And this is something that the mental health providers do. And you kind of eloquently said in the beginning that there have been studies that look at psychologists, just general psychologists who graduate from probably a PhD program here in the United States. And they have relatively low education on pain education specifically. But of course, that’s not just psychologists. That’s also licensed clinical social workers, licensed mental health counselors or LPCs. All of those professions are considered mental health providers, but very few of them have any kind of standard pain education in their schooling, where we do actually, as physical therapists, a lot of CAPTI, the Commission of Accreditation of Physical Therapy Education Programs, has standardized that there should be paying content in various parts of our of our curriculum that’s in school and our profession, but of course I think kind of where it gets a little sticky, if you will, is that physical therapists, they almost like it’s like on one side of the fence. It’s like, no, I don’t want to do this. Or if I do decide to do this, I have to know as much as a psychologist, so to speak. And really, what we’re kind of advocating for is the blend of the two, right? Because when you blend things together, multimodal interventions together, is where you see the success and kind of the magic happening, if you will. Talk to us about the research around psychological informed care, because I know there’s been kind of really good standardized, randomized control trials. And there’s also been some pragmatic trials that maybe say some other things. When you read the research and when you appraise it, what does it kind of tell you about the field of psychologically informed physical therapy?

The Research Around Psychologically Informed Care

So there was a difference from what I was reading on explanatory clinical trials, where they were taking people through just teaching teaching about pain and investigating this in a in a more research based setting. And then there was more pragmatic trials, like what does this look like in the real world. And it seemed like the the ones that were pragmatic actually had less promising outcomes. And there was then less real world implementation of that.

So you know, implementation is totally different than… Because you can learn something. You can go take courses, you can test out on it, and have a certain amount of skill. But then when it comes time to implement it into your practice setting, sometimes the practice setting isn’t set up in a way that supports that implementation. Is that something that you’ve seen?

Yeah, I would say especially true for the hospital that I work in, advocating for myself to be able to take a stand and say, hey, I want to practice these tools, these elements. This is how I want my framework of my practice to look like. I’ve gotten people to say, no, we’re not going to fund you for this education, or we’re not going to, I don’t want to see this. How are you going to account for your time? This isn’t physical therapy. So there’s a little bit of that. And then there’s also, I think, the portion of, how to actually implement what I’ve learned, which took a lot of growth. It was like, okay, how do I marry these two pieces of movements and all these mental health or behavioral interventions that I have also started to practice?

Yeah. I always love when I hear people say, this is not physical therapy, or that’s not physical therapy. And my answer to them is always physical therapy is a profession. Physical therapists are professionals, but physical therapy in itself is not a treatment, right? So psychologically informed care is a treatment or psychologically informed pain care is a treatment, but physical therapy itself is really not a treatment. We’re a profession. So I think it’s really important. I’m sure you’ve had these conversations with colleagues that we keep kind of this flexible perspective about who we are and what we do, because as science and medicine advances, so to speak, we may be called upon either individually, like I think all of us have had kind of a personal calling to change our practice to a more psychologically informed practice, but also based on the evidence and maybe eventually based on clinical practice guidelines that we should, or you may be forced to let’s say, move in that direction. What are your feelings on those topics?

Yeah, I think that, I mean, if it’s not already being driven forward in our guidelines, and I know that you’re a big part of what has changed some of the nutrition and mental health behavioral language in our scope of practice, I think that’s so, so important. Because what I see a lot of is just, essentially, we see this change as a threat. Like, it was like, we’ve defined PT in these borders for so long. Like, how can we imagine anything different? And so most of the time, I think people are just going to be like, yeah, she doesn’t really do PT anymore. I’m like, no, it’s still PT. And the only reason why you’re pushing back against it is because you don’t know what that can look like and how it can actually integrate into your practice. And so if we can make it more normalized, more mainstream, within guidelines, within what schools teach, then it can be at least setting the stone for how this would change for us in a much better way in the long term.

Yeah. And there are clinical practice guidelines coming out specifically on psychologically informed practice for physical therapists. So things like CBT and mindfulness and acceptance and commitment therapy, they’re all going to show up in those guidelines in one form or another. Um, with that in mind, there are lots of different, I think, kind of on-ramps that people can take with regard to training. Um, you know, there’s everything out there from, um, maybe listening to a free podcast and getting some information to obviously signing up for courses or longer certifications and things like that. I know we, we kind of always, at least on this podcast, we kind of fall back on the research a little bit and talk about what is the research shown in this area, as far as training physical therapists. in psychologically informed practice. And then I just kind of want to hear your personal take on some of the things that you’ve studied and how you’ve integrated them into your practice.

Yeah, I would say actually one of the first courses I took was just on pain neuroscience education. So that was like through like therapy, like evidence and motions thing on pain neuroscience with Adrian Lowe. And I really thought that was such a big eye opening piece of the puzzle, like, okay, I need to understand pain science, but I think I’ve heard you mention too, it only takes you a little bit of the way, which I saw a lot in my practice. I’m like, okay, I’m teaching them this and then what? And so there was this constant need for me to grow and grow in like, what am I missing here that could better get the message across and how beyond education and just still working on the great exposure pieces, what am I missing here? And so it didn’t, it took, me getting to the point where I could accept that I could work with some of these mental health behavioral pieces that I fully started to be able to realize with my patients, my clients, the change that they were hoping to see. So, I mean, I’m sure there’s a lot of a lot of other practices out there that are realizing, you know, they can’t just focus on this one thing alone. So maybe in the end, all of us are kind of being more integrative with whatever specialized focus in our movement area or specialized focus in whatever area there someone else’s profession is in.

Tell me what the group looks like that you and the pain psychologist run. Give us a kind of sneak peek into what you do in that setting. I think it’s interesting to kind of break that down a little bit for our listeners.

Behind the Scenes of a Nationally Guided Integrative Program

Yeah, so it is actually a nationally guided integrative program that we’re sort of still building as, you know, what did I say, building as a plane, as we’re flying the plane as it’s being built. And so I serve on the part of the team that focuses on helping with the physical therapy portion of it, although we are expected to be able to cover both sides of the puzzle, especially if when somebody’s out. So our team comprises of a PT and a pain psychologist, along with support of whole health coaches. And so we do, there’s a lot of stuff within it. There’s physical therapy, graded exposure pieces, it’s art themselves, as well as more of the mental portion, which is like looking at your thoughts, reframing thoughts. There’s mindfulness based portions, accepting, accepting what is allowing pain. There’s also, we talk about sleep. We’ve recently integrated, this is more on our end, less the national front. We’ve talked about nutrition. We’re starting to make moves to help people bring in some portions of mindfulness with the somatic tracking pieces from pain processing therapy. So there’s a lot of moving parts. Which is, I think in some ways, I’m not sure it’s always the best way to deliver this because it’s eight weeks of information, like two hours each week. And you’re just dumping so much stuff on people and be like, okay, now integrate and change.

So it’s a two hour, once a week session for eight weeks. Yes. And how do you and your colleague, the pain psychologist, break up that two-hour session? That is a long time for people to kind of hang on. I’m assuming this is, is it virtual or this is live?

There’s both. There’s face-to-face options as well as virtual. We do encourage people to actually move around. We’re like, you know, we have, you have pain, so we don’t expect you to sit for two hours.

Two hours. That’s right. Yeah.

Yeah, how we break it up is, well, depends on what you mean by it, but we usually break it up with a more breathing exercise in the beginning, followed by some physical education pieces, or there’s more mental education pieces. We actually trade off because she has recognized that I bring to table some of mindfulness aspects that she doesn’t already know, doesn’t really feel comfortable with. And then Some other pieces, especially involving maybe trauma-based things or suicide discussions, she’ll facilitate a little bit more. But we’re pretty good about trading off on our different ends.

And is there a break during this two-hour session? Do you break at the first 60 minutes for five minutes, give people a chance to move around, take a water break, things like that?

Yeah, absolutely. Especially if we know they’re gonna be sitting there for two hours long, there’s going to be a bathroom break somewhere in between for somebody.

And then how does, like, are you both evaluating the patient at the start of the program? And then are you tracking outcomes toward the end? How does the process-based measures look at that?

Yeah, so this actually goes into the whole piece of how the outcomes of practical pragmatic trials, what that looks like, this implementation. We are supposed to be tracking, based off the national guidelines, the PEG and the PSEQ-2. But it’s been kind of all over the place when it comes to pre and post measures. They don’t seem to actually give us a fair sense of what has improved or has not improved. For example, we’ll have some patients tell us, oh my gosh, this is a great class. And then you look at your numbers, and you’re just like, what? You said this, and it looks like that. So I think that outcome measures need to change a little bit more. We do screen people at the beginning because what we’ve been finding is that people will say, oh, this person has pain. That means they’re they’re good for this class when they actually have a bunch of big pieces like PTSD and other mental health. parts of the puzzle that actually should really be addressed by general psychology before they come into the class. Otherwise, they really have a hard time hearing the information, much less implementing that on their own.

So, for example, if someone has depression as a primary diagnosis, and maybe the pain is like a secondary comorbid diagnosis, it sounds like you’re recommending that the person go somewhere else, wherever that may be, have some depression care and then come back into the group for pain?

Yeah, because there’s definitely obviously there’s people who have pain and then depression as a result of that pain. Or maybe the depression is there, but it’s not as dominant and secondary. It’s not as dominant, it’s more secondary. So we do recommend, okay, if you can see these general psychologists first, then you’re more likely to see a good change in class. And what we have seen repeatedly is that the ones that have had previous psychological care or concurrent care are the ones that actually do really well in the class.

And are they receiving any concurrent physical therapy care as well?

Generally not. By the time they get referred to the class, it’s after they’ve had repeated trials of chiro, PT, acupuncture, and all the more passive modalities. And they’re kind of at wit’s end. They’re like, okay, let’s see what we can do by getting you into the active management of pain class.

How much of these skills that you use in the pain class, how much of those skills carry over into either the one-on-one work you’re doing at the VA or in your separate private practice.

I’m going to make sure I understand the question. You’re asking how much the skills I’m learning from the class carry over?

Yeah, do you use those skills? Do you find yourself using principles from that class, I guess, throughout all of your patient care, no matter where you’re practicing?

Yeah, I would say I use a lot of it. There was a fair amount of it that I feel like I was already comfortable with before the pain psychologist onboarded. I have to admit, I’m one of the ones that didn’t know what pain psychologists were. I was like, oh, what’s a pain psychologist? And within the framework of the class, what I’ve learned from pain psychology is more around things like communication and like communication with family members and maybe other medical providers, those things I feel like weren’t quite something I thought through as something I could teach for people. But other than that, I would say mindfulness is really huge in what I do. I don’t think, like nowadays, I feel like that’s 75% of a skill that I try to teach people, and then 25% is more on the physical end. And then nutrition pieces kind of fall alongside. I like to have more nutrition pieces. However, what I’ve found is that most people don’t need to be given more information on what to eat. They actually need to work on changing their relationship to food, changing their relationship to themselves, or working on mental health pieces before they can even really be able to practice those other elements.

The Impact of Mindfulness

So from this group that you’re, that you’re running and leading, um, do you find that the mindfulness has maybe a potentially greater impact than let’s say, pain education or greater impact than, um, traditional cognitive behavioral therapy, which does not have any mindfulness in it at all. I know that. I know it’s just kind of like a more of an observation because it’s hard. It’s very difficult to measure some of these things. I’m involved in a study right now, too, and we have like seven measures and I’m looking at some of the results and they just don’t. some of the outcomes of the measures don’t really match what the people report. But when I kind of take a seat back and I think, okay, what are people really responding to positively? Oftentimes, I find that mind-body, mindfulness-based interventions, people generally do respond positively to.

Yeah, I think you’re right. I would say mindfulness is probably the heavier heavyweight that has helping us through it. Because when I think about the pain neuroscience education pieces, while I do throw that in once in a while, it’s actually session one is big on pain neuroscience education. And then we try to repeat sort of the same themes throughout the rest of the class. But what is playing the most consistent part is them practicing mindfulness itself.

Yeah. Something experiential, basically.

Yeah, for sure.

Have to experience something differently. And I think that’s really important because I think the idea of being able to talk someone out of their pain, although I think it’s possible, I think when it comes time to things like starting to move again, and reengage with activities that were feared and painful. The pain education piece kind of has never really delivered. But I hope to deliver. Yeah, I think some of the more exposure based things that you learn in mindfulness really does have a positive impact and helping really helping people change their relationship to pain, I believe.

Yeah. I mean, you mentioned that it was an embodied cognition, right, as them having the ability to experience that. And I would say it sits kind of nicely in the middle. You educate them in the beginning about what’s going on with the pain, and then you have mindfulness itself as an intervention. Because sometimes if you swing right into movement, they, they, it really triggers them. They’re like, no, this thing is hard. Why do I have to do it? But mindfulness itself, you’re not necessarily moving so, so much of the body, but it is experiential. You do practice sensing into the body and all that. And that I think is almost like a graded exposure for them getting into the mindfulness first, before you get to the mindful movement.

Yeah, really well said. I think it’s, you know, if you look at, I don’t know, um, exposing someone to anything that’s feared, like you wouldn’t take them to the, highest level first, you kind of expose them just a little bit in the beginning, which could just be exposure to sensation, many different types of sensation, then starting to integrate that sensation with, with movement and things like that. I know you’ve read Prism. I appreciate you reading the paper. How do you think Prism fits into psychologically informed physical therapy or just psychologically informed practice overall? And I want to make something clear. Some of our listeners are familiar with PRISM, and I’ve been talking about PRISM in various places. And someone said to me at a lecture I gave recently in Massachusetts, oh, PRISM is meant to be delivered by an entire team. And I said, no. I said, actually, if you read the title of PRISM, it’s actually a cognitive behavioral approach for physical therapy practice. So my belief is most of those components, or all of those components, can fit into physical therapist practice if you’re in the right practice environment. Of course, if you’re seeing a person for 10 minutes, that’s going to be really difficult. But I think the types of practice settings that you and I are in, it fits well into. But how do you see PRISM, I guess, informing psychologically informed physical therapy?

Yeah. I think kind of just the same way, like the biopsychosocial model didn’t really, one, integrate things. The psychologically informed physical therapy also doesn’t necessarily fit into the whole person approach. And I think I mentioned earlier, it wasn’t until I started to bring all these different pieces. We looked at them being physically active. We looked at the nutrition. We looked at the sleep. We looked at what their background was, where they are in the social world. We looked at their purposes, all the different pieces of your prison model. Did we start to be able to figure out, or I started to be able to see, like that there was good change that was occurring. I think what PRISM does that psychologically informed care may not do is it brings meaning and purpose and it seems to help, I guess, have more of a collaborative tone with the client, the patient, rather than just having more like a provider, this is what I’m implementing and giving you.

Interesting. That’s really interesting. I never thought about that. Because when you do look at some of the early psychologically informed practice approaches, they actually do like training the physical therapist on like, here’s the one thing you’re going to do today, basically, whether it’s teaching a physical therapist how to reframe a negative thought, or teaching them progressive muscle relaxation. It’s like the one thing they’re doing that session in addition to maybe the exercise program that they’re progressing that day. But I appreciate the observation that you made with regard to purpose and meaning, because everything we do should be collaborative, right? And what we do is not really a protocol with people, and oftentimes protocols fall short.

Yeah, for sure. And I think that’s always surprising to the client that’s coming to see you that hasn’t had any of this before. There’s like, the doctor tells me this, like, lose weight, eat this, like, you know, whatever. And I think it takes them a moment to realize, oh my gosh, I have some say in what this looks like for me and how I do it. And I like to tell people, you are the expert on you. I have training in different things, but until you bring your expertise and your interest, your collaboration into what we’re doing together, we’re missing a huge chunk of the puzzle that actually would drive you forward in life.

How To Adopt Psychologically Informed Care into the Physical Therapy Profession

What do you think needs to happen in the physical therapy profession so that we can adopt psychologically informed care more broadly, because what’s interesting is that psychologically informed care started really in physical therapist pain management, but it has applications for every physical therapy specialty, across the board, pediatrics, neurology, sports, all the places that we have specialty areas, not just pain management.

Yeah. I would say the biggest one is education of the educators. Probably the biggest thing. I have been talking to the Duke DPT program that I graduated from, and a lot of the students that come from there have been telling me, oh, I wish that I learned this in school. And they have basic pain neuroscience education, right? They have, and they get introduced to progressive muscle relaxation or whatever, like more non-PT intervention thing that they’re trying to teach. And it sounds like they’re missing something if pretty much all my students have said, wow, you’re teaching us things that were not taught in school. So if we know that, let’s say, a DPT program only has beginning level concepts of a biopsychosocial model, and maybe the students can learn more by elective, then we’re not really doing the student justice. And we’re continuing to actually feed into this model of PT being PT. And even if you teach them about nociception and nociplastic, you’re not really teaching people how to work with their clients in a whole person way. So I would say definitely educating the educators would be a big part of making this a bigger and more efficient, helpful machine.

What do you say to the therapists out there, the physical therapists out there, any kind of therapist really, who says, all this sounds really exciting. I’m really interested in it. But I feel like the human psyche is really fragile. And I’m really scared that I’m going to do something that could potentially cause someone harm, so to speak. Because oftentimes, as you know, we always talk about fear in our patients. But when I talk to professionals, who are just kind of venturing into the space, I noticed it’s a bit of some like anxiety around this topic, basically, like, you know, they’re going to trigger someone, they’re going to go into a you know, traumatic incidents, so to speak. They’re going to be sued, their license is going to be taken away. Of course, none of those things happen. Physical therapists have probably the lowest medical malpractice out of any licensed health professional. But what do you say to calm people’s kind of fear around this topic?

Well, I think actually that’s the mentality of a lot of students. They’re like, so can I say this? What can I say? What I think comes up for me is, number one, teaching people that they’re a whole person, that there are lots of things that can influence their health and pain, isn’t something that you should worry should be harming them or hurting them in any shape or form. In fact, it likely supports them even more to realize, yes, I am a whole person. And to say that I’m worried about this person being hurt by what I’m saying is actually less of a reflection on you’re hurting them, you’re just uncomfortable with it. And so your worry is more on yourself, not on the other person. And if you know that teaching people and guiding them to a place of psychological behavioral health can be helpful for them, then holding that back and not sharing that is actually what’s hurting them.

As I listened to you, it sounds like you’re very comfortable saying, yes, I’m a psychologically informed physical therapist, or I am a behavioral and mental health physical therapist. And those terms don’t really feel divisive or odd or strange to you at this point.

No it was it took some time to get there and i would say for me it wasn’t that i was afraid to practice this way um i was very excited when i saw all the things you were offering in your own courses like yes this guy’s got stuff like i think the more it was more like a legality thing like can i practice this without being soosh But once we really started to, one, have, was it in 2015 or something that changed with the updating on the scope of practice verbiage? When that changed, as well as just experience with it, I think it really is a matter of practice, like just the same way in body cognition. If you don’t practice this thing, it’s going to feel foreign. So I would say that’s a big part of what makes me feel so comfortable with what I do now and how I describe myself.

Tawny, it’s been great speaking with you about psychologically informed practice, psychologically informed physical therapy. I’m excited to hear all the things that you’re doing both within the VA and in your own private practice outside the VA. Let our listeners and our fellow professionals know how they can learn more about you and reach out to you.

Yeah, I am very active on Instagram. I, I follow other coaches and two and then so I also, I’m happy to respond to people that that send me a DM. I also do have my own coaching program, which if you follow the links on my Instagram, you’re welcome to apply to. And then there’s also really, really easy basic neuroscience stuff, which is foundational at the very beginning, like we covered earlier, that if people wanted to look more into it can be Um, something that you can invest in for a very decent price.

And just let us know what your website is and what your Instagram handle is. And we’ll link to that in the show notes.

Sure. It is dr.tawnykross.com and Kross is with a K. So it’s d r T A W N Y K R O S S, um, .com. And then my Instagram handle is with the dots. So dr.tawny.kross.

Great. So we’ll of course include all those links to, um, Tawny’s website, as well as her Instagram handle. You can go directly to her website at drtawnykross.com. I want to thank her again for joining us and talking about how we can integrate principles of pain psychology into physical therapist practice and how we can grow and overcome these growing pains really in our profession so that people can receive the care they need. I’m Dr. Joe Tatta. At the end of every episode, I ask you to share this with your friends and family on Facebook, LinkedIn, Twitter, Instagram. Of course, Tawny and I are both active on Instagram. So find us with this episode and tag us and we’ll make sure to tag you back and enter into a conversation. I’m Dr. Joe Tatta. Thanks for being here. We’ll see you next week.

Important Links

• Tawny Kross
• @dr.tawny.kross – Instagram

About Tawny Kross

Dr. Tawny Kross graduated with her Doctorate in Physical Therapy from Duke University in 2013. Her journey as a chronic pain specialist and coach evolved from nearly a decade of practice at a Veteran’s Hospital. Because of the complex histories, physical and sexual traumas many Veterans have, in order to better serve and help them heal from chronic pain, Dr. Kross grew her practice, knowledge and breadth of expertise to include nutrition; hypnosis; guided imagery; mindfulness; pain neuroscience education; breathwork; mind-body practices and more. When she’s not working on all things related to chronic pain, she enjoys church; hikes with her two kids and husband; exercise (weight lifting, tennis or running); playing boardgames; reading sci-fi fantasy books; or trying to come up with really bad (or…maybe they’re REALLY good) Mom jokes.