This programme links all significant treatment dimensions as well as connecting groups of patients to reduce their sense of isolation. Evidence is presented from the formal evaluation of the programme.

IntroductionMany individuals with persistent pain experience difficulties with sexual function which are exacerbated by avoidance and anxiety. Due to embarrassment or shame, sexual activity may not be identified as a goal for pain management programmes (PMPs). In addition, clinicians can feel that they lack skills and confidence in addressing these issues. MethodsWe sought to develop a biopsychosocial model for helping patients return to sexual activity and manage relationships in the context of pain management, known as 'ReConnect'. The model amalgamates well-established methods from pain management and sex therapy to guide multidisciplinary team members. ReConnect comprises three components: 1)'cognitive and myth-busting', 2)'sensations and feelings' and 3) 'action-experimentation'.We collected self-report data from 281 women and 92 men from our specialist PMP for chronic abdomino-pelvic pain, including questions measuring interference with and avoidance of sex due to pain, and the Multi-dimensional Sexuality Questionnaire (MSQ) to measure anxiety about sexual activity. ResultsThe results show statistically significant improvements for anxiety, avoidance of sex and sexual interference. By using the ReConnect model to structure clinical work, pain management clinicians reported increased confidence in addressing sexual activity goals. ConclusionThe ReConnect model is a framework for clinicians to use to support sexual activity goals. It has demonstrated improvements in clinical outcomes such as anxiety around sex and interference of pain in sexual activity. We e ncourage its application in pain management services in both one-to-one and group sessions, as a method for encouraging pain patients to address this important area of life which can be adversely affected by pain.

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Cognitive behavioural therapy (CBT) is increasingly recognised as an intrinsically appropriate aspect of the treatment of many long-term medical problems. There is a strong evidence base for its use in reducing disability and distress in the context of chronic pain. A CBT approach to pain is often delivered via an in- or outpatient group pain management program, usually led by a clinical psychologist and supported by other disciplines. This chapter provides an introduction to the key ways in which CBT can be used in the treatment of someone with pain.

Psychological factors are a key part of pain perception as articulated in the neuromatrix model of pain. Psychoeducational interventions are of significant value in acute pain management and have reduced pain severity, distress, and length of hospital stay. Mood, beliefs about pain and illness, previous experience of pain, and the behaviour of health care professionals all influence pain perception and response to pain. Helping patients reappraise the threat value of pain through tailored information giving and where needed cognitive behavioural interventions are practical strategies. Attention control methods, including clinical hypnosis, are effective in reducing procedural pain.