Treatment outcome of 72 chronic back pain patients was assessed with 4 standardized measures: the McGill Pain Questionnaire, the Audiovisual Taxonomy of Pain Behavior, the Beck Depression Inventory, and the Profile of Mood States. Patients were also rated by their primary nurse on pain behavior, activity, drug-seeking, and sleep. Variables used to predict scores on outcome measures included patients' demographics and MMPI scores. Multiple regression analyses indicated that patients receiving worker's compensation engaged in more pain behavior and rated their pain as more severe, both upon admission and discharge from the pain program. High scores on the MMPI Hy scale were correlated with high self-ratings of pain and several MMPI scales correlated with negative mood. Even though demographic variables predicted admission and discharge scores on a number of treatment outcome measures, there was no relation between demographics and patients' improvement on treatment outcome measures. Patients with high scores on MMPI Hy and D scales displayed greatest admission to discharge improvement on self-rated pain and mood. Results were integrated with findings from previous studies. It was suggested that by distinguishing between overall scores on treatment outcome measures and improvement on these measures, professionals will be in a better position to devise individualized treatment plans for pain patients.

Sixty chronic back-pain patients were administered the audiovisual taxonomy of pain behavior during their first and last weeks in an inpatient multidisciplinary pain clinic. Audiovisual total score provided a useful index of pain behavior with a suitable frequency and reliability, while offering unique variance as a measure of treatment outcome. Patients' pain behaviors upon admission to the pain program were positively correlated with the following background variables: receiving worker's compensation, pounds overweight, and number of back surgeries. Patients' pain behaviors upon completion of the pain program were significantly correlated with their preferences for pain treatment modalities. High levels of pain behavior correlated with a preference for treatments of ice and heat. Low levels of pain behavior correlated with a preference for physical therapy, social work, lectures, and relaxation. It was suggested that treatment outcome in a multidisciplinary pain clinic is more immediately related to patients' coping styles and their choice of pain treatment modalities than to their demographics and personalities.

This paper describes the process and product of an attempt to develop a theory of rehabilitation counseling. Principles of theory construction and theories in fields related to rehabilitation counseling were reviewed, theory elements were defined, and individual formulations were developed by each of the authors and combined into a common product via consensus. This product was then tested for validity against a range of rehabilitation settings. Produced were consistent sets of definitions, tenets, facts, laws, and hypotheses, which are intended to advance theory-building in rehabilitation counseling.

No abstract