Despite the prominence of clergy in providing human services, and the work-related stressors they experience, clergy health and coping responses have rarely been the focus of psychological research. We report two studies. In the first, we evaluated responses of 398 senior pastors to three open-ended questions regarding personal coping, structural support for their work, and remediation efforts in times of distress. In the second study, Christian mental health professionals and Christian education professionals identified Protestant Christian clergy who exemplify emotional and spiritual health. Twenty-six participated in individual 30-minute interviews. Respondents emphasized the importance of being intentional in maintaining balance in life and developing healthy relationships. They also value a vital spiritual life, emphasizing both their sense of calling into ministry the importance of spiritual disciplines, and an ongoing awareness of God's grace. We suggest ways that Christian mental health professionals can support pastors in preventive and remedial roles.

The abuse of prescription drugs is an insidious complication among patients with chronic pain. This study examines cognitive intellectual functions in patients with chronic pain who are using prescribed analgesics, sedatives and hypnotics. A comprehensive battery of psychologic tests measuring intelligence, learning, memory, sensory-perceptual integrity, motor skills and general adaptive abilities was administered to 47 subjects. The subjects were patients admitted to a chronic pain management program, and they were divided into drug-dependent, drug-abusing and non-drug-abusing groups according to strictly defined criteria. Findings indicated that the prescribed use of these medications for pain over a prolonged time is detrimental to the cognitive function of such patients and complicates their clinical management.

In a pain management program (200 patients), a group of daily users of oxycodone compound (29 patients) and a subgroup who were taking a "high dose" of oxycodone compound (13 patients) were compared with a group of 171 non-users of oxycodone compound. A significantly lower treatment success rate was observed in the users (P = 0.04) and high-dose users (P = 0.03). A similar trend was seen in preliminary data available in a larger sample (514 patients). Continued study of these findings is necessary. Meanwhile, in patients with chronic pain, there should be cautious use of this compound.

Between September 1979 and October 1982, 408 patients with chronic benign pain were evaluated for admission to a pain management program. Of the 408 patients, 249 completed the program; the success rate at the time of dismissal was 70% among these 249 patients. Of the 239 patients who entered the follow-up study, 87% responded to either a mailed questionnaire or a follow-up telephone call by an independent reviewer at the time of 3 year follow-up; the improvement had been maintained by 46.6% of the successfully treated patients (or a third of the original participants). The present finding is strikingly similar to that in a previous study from this institution - an indication of the long-term efficacy of the multidisciplinary pain management program. Further search for modifications for the existing program is indicated to accommodate the needs of patients who fail initially or cannot maintain the improvement.

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