The role of cognitive‐behavioural therapy in the management of pain in patients with sickle cell disease

Abstract

Painful crisis is the most common manifestation of sickle cell disease and accounts for the second greatest number of admissions with an average length of stay of 7 days in central London. Despite this frequency of admissions, the management of pain is fraught with problems. This is not surprising since the psychological challenges presented by sickle cell disease are manifold, resulting in significant psychological distress for some individuals. This paper considers the literature on the psychosocial impact of sickle cell disease, and the American research evidence which suggests that pain management strategies that incorporate a psychological intervention can significantly reduce psychological distress as well as hospital admissions. Britain has been slow to incorporate psychology in the pain management strategies, and we have embarked on research to fill this gap. Although this research constitutes work in progress, an argument is put forward for utilizing the cognitive-behavioural perspective in the management of pain in sickle cell disease and we conclude by giving a brief summary of pilot work which is both the foundation and justification for the current ongoing research.

The psychosocial experience of people with sickle cell disease and its impact on quality of life: Qualitative findings from focus groups

“…In general the majority of people with SCD cope very well and lead active and productive lives (Gil et al, 1989;Thomas, Wilson-Barnett, & Goodhart, 1998). However, this sample represented frequent users of hospital services and this must be taken into account when considering the results of this research.…”

A randomized controlled pilot study feasibility of a tablet‐based guided audio‐visual relaxation intervention for reducing stress and pain in adults with sickle cell disease

“…, Thomas et al . ). However, previous studies have not used GR as a standalone stress reduction intervention, making it difficult to directly compare the present findings to previous reports.…”

Outcome results of self-efficacy in children with sickle disease pain who were trained to use guided imagery

“…Cognitive behavioral therapy serves as the foundation and justification for a pilot study with resulting decreases in psychological distress and hospital admissions of patients with SCD (Thomas, Wilson-Barnett, & Goodhart, 1998). A longitudinal, multi-center, randomized controlled trial in London evaluated cognitive behavioral group therapy (CBT) for management of SCD pain in 59 person's ages 15 to 35 years (Thomas, Dixon, & Milligan, 1999).…”