, Problem 4: Psychological Interventions
What kinds of therapy are there for chronic pain?
Turk & Flor: Cognitive-Behavioural Approach to Pain Management
Goals of CBT
• will not eliminate pain but teach patients how to cope with it
• help them see that the pain is manageable rather than overwhelming
• It’s an additional method to be used alongside traditional health care
• Reduce excessive reliance on the health care system
• Alter maladaptive thought patterns
CBT Overview
5 assumptions of CBT
1. We are active information processors
2. Thought can influence mood, affect physiology, have social consequences. Mood, physiology,
environmental factors, behaviour can influence the nature and content of thought
3. Individual and environmental factors reciprocally determine behaviour
4. Ppl can learn more adaptive ways of thinking, feeling, behaving
5. People should be active collaborators in changing their maladaptive thoughts, feelings, behaviours
CBT should flexible, accordingly customized to the patient, different pace for everyone
Phase 1: Assessment
- Interviewing patient, loved ones
- Using self-report measures and observational procedures
- To establish extent of physical impairment
- To find areas of psychological distress
- Establish behavioural goals together: activity level, medication use, health care system, response of
loved ones
- To provide baseline measures to compare the progress and success of treatment
- To provide info about the patient’s perception of the medical condition, previous treatment, current
treatment
- Patient’s work information and goals
- Role of significant others in support and how they may exacerbate bad bhvr
- Start the reconceptualization process by making them aware of the situational variability of pain +
psychological, social, behavioural factors that influence the degree of pain
Phase 2: Reconceptualization
- Reorienting patients from their belief that symptoms are overwhelming + unmanageable to helping
them see that they can be controlled by themselves
- Provides incentive for developing proficiency for various coping skills
- Aims to get the patient to see how their thoughts maintain stress/physical symptoms – patient may
be asked to self-monitor thoughts/behaviours
- Aim to elicit competing thoughts from the patient and reinforces the adaptive nature of these
- Cognitive Errors (often seem in chronic pain patients: related to the emotional difficulties of it) are
identified and they’re asked to come up with new ways of thinking
What kinds of therapy are there for chronic pain?
Turk & Flor: Cognitive-Behavioural Approach to Pain Management
Goals of CBT
• will not eliminate pain but teach patients how to cope with it
• help them see that the pain is manageable rather than overwhelming
• It’s an additional method to be used alongside traditional health care
• Reduce excessive reliance on the health care system
• Alter maladaptive thought patterns
CBT Overview
5 assumptions of CBT
1. We are active information processors
2. Thought can influence mood, affect physiology, have social consequences. Mood, physiology,
environmental factors, behaviour can influence the nature and content of thought
3. Individual and environmental factors reciprocally determine behaviour
4. Ppl can learn more adaptive ways of thinking, feeling, behaving
5. People should be active collaborators in changing their maladaptive thoughts, feelings, behaviours
CBT should flexible, accordingly customized to the patient, different pace for everyone
Phase 1: Assessment
- Interviewing patient, loved ones
- Using self-report measures and observational procedures
- To establish extent of physical impairment
- To find areas of psychological distress
- Establish behavioural goals together: activity level, medication use, health care system, response of
loved ones
- To provide baseline measures to compare the progress and success of treatment
- To provide info about the patient’s perception of the medical condition, previous treatment, current
treatment
- Patient’s work information and goals
- Role of significant others in support and how they may exacerbate bad bhvr
- Start the reconceptualization process by making them aware of the situational variability of pain +
psychological, social, behavioural factors that influence the degree of pain
Phase 2: Reconceptualization
- Reorienting patients from their belief that symptoms are overwhelming + unmanageable to helping
them see that they can be controlled by themselves
- Provides incentive for developing proficiency for various coping skills
- Aims to get the patient to see how their thoughts maintain stress/physical symptoms – patient may
be asked to self-monitor thoughts/behaviours
- Aim to elicit competing thoughts from the patient and reinforces the adaptive nature of these
- Cognitive Errors (often seem in chronic pain patients: related to the emotional difficulties of it) are
identified and they’re asked to come up with new ways of thinking
