Psychological therapies for the management of chronic pain

Abstract

Pain is a complex stressor that presents a significant challenge to most aspects of functioning and contributes to substantial physical, psychological, occupational, and financial cost, particularly in its chronic form. As medical intervention frequently cannot resolve pain completely, there is a need for management approaches to chronic pain, including psychological intervention. Psychotherapy for chronic pain primarily targets improvements in physical, emotional, social, and occupational functioning rather than focusing on resolution of pain itself. However, psychological therapies for chronic pain differ in their scope, duration, and goals, and thus show distinct patterns of treatment efficacy. These therapies fall into four categories: operant-behavioral therapy, cognitive-behavioral therapy, mindfulness-based therapy, and acceptance and commitment therapy. The current article explores the theoretical distinctiveness, therapeutic targets, and effectiveness of these approaches as well as mechanisms and individual differences that factor into treatment response and pain-related dysfunction and distress. Implications for future research, dissemination of treatment, and the integration of psychological principles with other treatment modalities are also discussed.

Effects of a Tailored Positive Psychology Intervention on Well-Being and Pain in Individuals With Chronic Pain and a Physical Disability

“…89 Therapist-delivered cognitive-behavioral therapy and/or guided in vivo exposure treatment carried out in tandem with positive psychology exercises (eg, mindfulness meditation, Acceptance and Commitment Therapy) might be more effective in sustainably reducing pain catastrophizing. 90 It is important to mention that the control group also seemed to benefit from the intervention, given that they reported increases in life satisfaction from pretreatment to posttreatment. Participants in the control group were instructed to be more attentive and to "choose an event or activity during your leisure time, your work or simply doing household chores, it does not need to be something particularly special" and "remember and write down as many details as possible."…”

Psychiatric and Psychological Perspectives on Chronic Pain

“…Given the multiple kinds of psychological therapies and the multiple types of chronic pain that are treated with such therapies, 91 it is difficult to draw overall conclusions about the effectiveness of the therapies. As a broad summary, there is at least some evidence to support all the therapies described by Jensen, 90 and there is robust evidence that CBT, the most widely used psychological therapy, has positive effects on patients with a variety of chronic pain problems.…”

Struggling With Adversities of Life

“…Psychotherapeutic strategies for pain, including Acceptance and Commitment Therapy and various other cognitive behavioral therapies, aim to reduce negative emotions and stress resulting from pain catastrophizing, fear avoidance behaviors, and other maladaptive thoughts that contribute to disabling aspects of chronic pain [13][14][15]. Psychotherapy also aims to promote active coping strategies like pain acceptance, physical activity, and structured relaxation [16,17].…”