New approaches towards chronic pain: patient experiences of a solution-focused pain management programme

Abstract

Research has suggested that Solution-Focused Brief Therapy (SFBT) may be effective in facilitating meaningful change for those living with chronic pain. This study aimed to further this understanding through exploring the experiences of people living with chronic pain, who had attended an 8-week solution-focused pain management programme. The design of this study was conducted in consultation with a service-user advisory group, and employed a qualitative and interpretative design rooted in critical community psychology, participatory research frameworks and emancipatory disability research. Five participants opted-in to the study following an opportunity sampling method of persons who had attended a programme in the last 18 months. Interviews were transcribed verbatim and analysed using inductive thematic analysis. Five main themes were identified: 'Accessing the pain management programme', 'A solution-focused group', 'The solution-focused clinician', 'Solutions and changes' and 'Challenges and improvements'. Clinical and research implications of the findings are discussed. Summary points1. There has been an international proliferation of pain management programmes (PMPs) aimed at helping those with chronic pain to live well, despite an unremitting condition. 2. Arguably, the most popular psychological approaches used within PMPs are informed by cognitive behavioural therapy (CBT). 3. Despite a supportive evidence base for psychological approaches in pain management, there is a recognised need for further research into alternative approaches and their effectiveness. 4. Emerging research and policy recommendations are beginning to value the expertise of those living with chronic conditions, particularly how these perspectives can be used to develop effective treatments and services. 5. SFBT is an approach aimed at achieving a patient's goals or 'preferred future' through identifying and utilising their expertise. SFBT may have significant efficacy in helping those with chronic conditions to live improved, meaningful lives.

A qualitative study exploring the effects of attending a community pain service choir on wellbeing in people who experience chronic pain

“…39,40 Preliminary outcome data from the PMP delivered by the SF-informed pain management service have suggested statistically and clinically significant improvements in self-efficacy, functioning and wellbeing, 41 along with psychological and behavioural improvements which enabled individuals 'to live better in the presence of pain'. 42 While the evidence for SF PMPs is limited at present, these studies indicate growing support for this approach. Fundamentally, SF principles reflect PMP guidance 30 which stipulates that these programmes should enable individuals to 'live well' despite chronic pain by supporting them to develop self-management plans based on personal resources.…”

Positive Psychological Interventions and Chronic Non-Cancer Pain: A Systematic Review of the Literature

“…Two studies (Dargan et al 2014;Larsen et al 2015) reported qualitative themes which reflected improvements relevant to positive psychological constructs (e.g., flourishing). Dargan et al (2014) described themes relating to participants' experiences of attending a PPI.…”

“…Two studies (Dargan et al 2014;Larsen et al 2015) reported qualitative themes which reflected improvements relevant to positive psychological constructs (e.g., flourishing). Dargan et al (2014) described themes relating to participants' experiences of attending a PPI. One theme (i.e., 'Accessing the programme') reflected the initial effects that being invited to take part in the PPI had upon the individual, in terms of inducing a feeling of hope within participants that the intervention may lead to increased sense of control and greater independence.…”

Telemonitoring in Chronic Pain Management Using Smartphone Apps: A Randomized Controlled Trial Comparing Usual Assessment against App-Based Monitoring with and without Clinical Alarms

“…Another problem related to the current model of care in chronic pain refers to decision-making in the face of unwanted events. Specifically, the current approach to care requires patients to judge when an undesired event is problematic and what is the preferred action to take in the face of that event [ 30 , 31 , 32 ]. This approach is problematic, as some patients may tolerate serious or even urgent problems (e.g., tachycardia, severe drowsiness, or persistent vomiting, diarrhea or urine retention) for too long, while others may seek care for symptoms that are less urgent or not problematic (e.g., very mild or short-term).…”