‘All these things don’t take the pain away but they do help you to accept it’: making the case for compassion-focused therapy in the management of persistent pain

Abstract

Background: People with persistent pain are frequently offered a pain management programme (PMP) as part of their care plan. Cognitive behavioural therapy (CBT) principles often underpin PMPs and has a good evidence base; nevertheless, more recent systematic reviews have suggested that its effectiveness is limited. Compassion-focused therapy (CFT) is a form of ‘third-wave CBT’ that offers an alternative and complementary view of pain, encouraging the person to be alongside their experience of pain and respond to it using skills of compassion they have learnt. Method: The current research explored the effectiveness of a 12-week CFT group for people who experience persistent pain. Research interviews explored CFT members’ experiences of the CFT group. Feedback was collected on the facilitators’ experience of running the group and questionnaire data collected on participants’ mood, pain disability, acceptance of chronic pain and levels of self-criticism and self-reassurance. Results: Interviews were analysed using interpretative phenomenological analysis that revealed five master superordinate themes representative across all interviews. These were then triangulated with data from the questionnaires and facilitator feedback. Conclusion: In people whose persistent pain was compounded by a significant psychological component, a CFT group approach helped reduce feelings of isolation, improve ability to self-reassure, learn new ways of coping and develop a growing acceptance of the limitations associated with their pain. The possible implications for future clinical practice are considered.

Mindful Self‐Compassion program for chronic pain patients: A randomized controlled trial

“…Evidence-based psychological theories and treatments to manage chronic pain (CP) have shifted from 'first-wave' behavioural approaches (Fordyce, 1976) to 'secondwave' cognitive-behavioural approaches (McCracken & Turk, 2002) and then to 'third-wave' -mindfulness, compassion (Gooding et al, 2020;Kabat-Zinn et al, 1986) and contextual-behavioural approaches (Hayes et al, 2006;McCraken, 2005).…”

Efficacy of an ACT and Compassion-Based eHealth Program for Self-Management of Chronic Pain (iACTwithPain): Study Protocol for a Randomized Controlled Trial

“…Recently, some studies suggested that ACT interventions also promote self-compassion ( Yadavaia et al, 2014 ; Luoma and Platt, 2015 ), a non-judgmental and mindful approach to one’s pain and suffering ( Neff, 2003 ), which presents known links with pain regulation systems, such as heart-rate variability ( Rockliff et al, 2008 ), and oxytocin-endorphin systems ( Rockliff et al, 2011 ). Self-compassion has been the focus of growing attention in CP due to its protective role against depressive symptomatology in this condition ( Carvalho et al, 2019 ), its negative association with pain disability ( Wren et al, 2016 ), and the promising results showing the positive effects of compassion-based interventions in CP ( Chapin et al, 2014 ; Ziemer et al, 2015 ; Parry and Malpus, 2017 ; Gooding et al, 2020 ).…”

An update on the management of chronic pelvic pain in women

“…Acceptance and commitment therapy is a behavioural therapy focused on developing psychological flexibility through a range of strategies, while mindfulness‐based interventions focus on: developing a relationship with experience characterised by present moment focus; decentring and an approach orientation; and support the development of qualities such as compassion, wisdom and greater self‐regulation. Additionally, compassion focused therapy, originally developed with the purpose of treating depression with high levels of shame, may be particularly helpful for those with persisting pain which is compounded by a significant psychological component [53].…”