Specific and general therapeutic mechanisms in cognitive behavioral treatment of chronic pain.

Abstract

Adopting an action attitude early in treatment may represent a specific CBT mechanism but with effects held largely in common with 2 general mechanisms.

Pre-surgery physiotherapy and pain thresholds in patients with degenerative lumbar spine disorders

“…The treatment mechanisms change significantly early in the treatment process, and are related to changes in outcomes later in the treatment process (73). The findings have led to the suggestion that greater emphasis should be placed on the treatment mechanisms to improve outcomes (73). The change in attitudes towards more self-management observed by Louw et al (66) may be the treatment mechanism of NE that leads to a lower need for healthcare.…”

“…Both the specific and the general treatment mechanisms have been evaluated in CBT for chronic pain. The treatment mechanisms change significantly early in the treatment process, and are related to changes in outcomes later in the treatment process (73). The findings have led to the suggestion that greater emphasis should be placed on the treatment mechanisms to improve outcomes (73).…”

“…NE is an intervention based on cognitive behavioural therapy (CBT) the specific treatment mechanism of which is to change attitudes towards adopting a self-management approach to the problem (73). This specific treatment mechanism is supplemented by general treatment mechanisms that include patients' evaluation of quality of the working alliance, and patients' expectations of benefits.…”

Meta-analysis of pain and stress in emergency department patients

“…This makes it difficult to access help for people who need immediate medical intervention. For each patient, taken to an emergency department, in accordance with current guidelines, it is decided whether the patient requires emergency diagnostics, hospitalization and surgery on an ad hoc basis or supply within the emergency department of further diagnosis and therapy [2][3][4].…”

A Clinician’s Perspective on Treating Patients Suffering from Insomnia and Pain

“…While the therapeutic and working relationship between patient and therapist has been repeatedly shown to be an essential element no matter the modality of psychotherapy (Fife et al 2014;Weiss et al 2014;Dattilio and Hanna 2012;Flückiger et al 2012;Lasky et al 2012;Constantino et al 2007), working with chronic pain sufferers requires special attention to the nature of this professional connection (Burns et al 2014). Experience as a mental health provider teaches that patients, in general, and chronic pain sufferers, in particular, have been trained through years of interactions with the medical community that treatment for their ailments is largely a passive process: take proscribed medications; have a surgical procedure; go to physical therapy; etc.…”