Psychological therapies for the management of chronic and recurrent pain in children and adolescents

Eccleston, Christopher; Palermo, Tonya M.; Williams, Amanda C de C; Lewandowski, Amy S.; Morley, Stephen

doi:10.1002/14651858.cd003968.pub2

Cited by 144 publications

(178 citation statements)

References 63 publications

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“…T he efficacy of CBT in managing chronic pain is supported by the literature, 10,13,26,38,39,49 and there are multiple examples of physical therapists applying CBT principles in the literature. 20,24,29,31,50 However, the use of CBT techniques seems to be underutilized by physical therapists in treating chronic pain.…”

Section: Discussionmentioning

confidence: 99%

“…6,39 CBT also has been identified as an effective intervention for patients with disablement due to persistent musculoskeletal symptoms such as pain. 13,14,39,40 C ognitive-behavioral therapy (CBT) refers to a number of patient-counseling strategies that are intended to change dysfunctional thoughts, feelings, and behaviors. 38,52,53 Although there are many forms of CBT strategies and interventions ( TaBLE 1), all are characterized by a joint theoretical basis in behaviorism and cognitive psychology.…”

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confidence: 99%

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Patient Education Based on Principles of Cognitive Behavioral Therapy for a Patient With Persistent Low Back Pain: A Case Report

Rundell¹,

Davenport²

2010

J Orthop Sports Phys Ther

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feelings, and behaviors. [2][3][4][5]15,16,28,[46][47][48] It also indicates that relationships are dynamic. 3,4,15,16,[46][47][48] Therefore, relationships characterized by problematic behaviors and emotions are modifiable by mitigating dysfunctional thought patterns through directed, systematic, and goal-oriented treatments. 6,15,16 Typically, CBT involves self-reflection of thought processes on the part of a patient that is partially guided by analysis of a patient's thinking by a clinician.This evaluative process is necessary to identify hypothetical cause-andeffect relationships between cognition and problems of behavior and emotion. The evaluation is followed by specific, problem-focused, psycho-educational interventions directed toward the dysfunctional thinking patterns that are identified. Psycho-educational interventions are provided within and between treatment sessions. One common intervention to improve carryover between sessions is cognitive homework, which is intended to continue to facilitate the development of adaptive thought processes in the absence of a clinician. 6,39 CBT also has been identified as an effective intervention for patients with disablement due to persistent musculoskeletal symptoms such as pain. 13,14,39,40 C ognitive-behavioral therapy (CBT) refers to a number of patient-counseling strategies that are intended to change dysfunctional thoughts, feelings, and behaviors. 38,52,53 Although there are many forms of CBT strategies and interventions ( TaBLE 1), all are characterized by a joint theoretical basis in behaviorism and cognitive psychology. This theoretical foundation predicts clinically recognizable interrelationships between thoughts, t STUdY dESIGn: Case report.t BaCKGroUnd: Cognitive behavioral therapy (CBT) is an effective intervention for patients with persistent pain. Recent research indicates that physical therapists self-perceive a lack of knowledge, skills, and time to provide this intervention. The purpose of this case report is to describe how specific CBT strategies can be integrated with multimodal physical therapist management of a patient with persistent low back pain.t CaSE dESCrIpTIon: The patient was a 70-year-old female with activity limitations of walking, standing, and forward bending. Oswestry Disability Questionnaire score was 19/50 and Fear-Avoidance Belief Questionnaire physical activity subscale was 23/24. The Low Back Activity Confidence Scale revealed 19%, 100%, and 84% for function, symptom self-regulation, and exercise, respectively. CBT-based patient education was provided in combination with manual therapy and exercise. CBT techniques included cognitive restructuring, goal setting, activity pacing, problem-solving strategies, graded exposure, encouraging exposure to pleasant experiences, and maintenance strategies.t oUTCoMES: The patient was discharged after 7 visits distributed over 21 weeks. Her Oswestry Disability Questionnaire score was reduced 10% and Fear-Avoidance Belief Questionnaire physical activity subscale score reduced 48%. On ...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Patient Education Based on Principles of Cognitive Behavioral Therapy for a Patient With Persistent Low Back Pain: A Case Report

Rundell¹,

Davenport²

2010

J Orthop Sports Phys Ther

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“…Psychological therapies are effective for primary headache. Recent meta-analyses support relaxation training for recurrent headache; a large positive effect on pain reduction at immediate post-treatment and follow-up was found, whereas there were small and non-significant effects on disability and emotional functioning 26 49. Long-term improvements over more than 3 years after treatment with relaxation, for tension-type as well as migraine headaches, have also been shown.…”

Section: Specific Chronic Pain Conditionsmentioning

confidence: 97%

“…Evidence is limited to estimate the effects of psychological therapies on mood and also for effects on disability in children with headache 26. The inclusion of parents, significantly improves child symptoms for painful conditions immediately post-treatment 27.…”

Section: Principles Of Management and Interventionsmentioning

confidence: 99%

Presentation and management of chronic pain

Rajapakse

Liossi

Howard

2014

Archives of Disease in Childhood

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“…editorial demands), but this does not account for what appear to be brief interventions delivered by relatively inexperienced therapists to chronically distressed patients for any realistic expectation of change to take place" (p 10). This review has recently been updated [19].…”

Section: The Evidence Basementioning

confidence: 99%

Psychology of Chronic Pain and Evidence‐Based Psychological Interventions

Eccleston

2010

Evidence‐Based Chronic Pain Management

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Understanding the psychology of pain and the psychology of analgesic behavior can improve your practice as a pain clinician, enrich your experience of dealing day to day with suffering, and provide you with new ways of thinking about working in pain. I start with the fundamental aspects, exploring the psychological factors that influence and structure the experience of pain, introduce specific psychological models that help one understand patient behavior, and finally focus on the evidence base for psychological interventions for pain.Psychology as an academic subject was born from physiology and philosophy. It has been influenced in its short history by political developments in social science, methodological advancements in biological science, and fashionable attempts to make itself an applied science, offering opinions and expertise in subjects that range from marketing and business to individual change through psychotherapy. It is instructive to bear in mind when reading anything about psychology that as a science it (a) occupies territory not occupied by any other science; that is, the explanation, prediction and control of behavior, (b) its theories draw on a wide range of other sciences, so such explanations can sometimes be based in the behavior of molecules, and other times based in the behavior of populations, and (c) that it slips between deductive and inductive methods, often without comment. What this means is that to the nonpsychologist it can sometimes appear to be freefloating; at its worse it operates only to state the obvious, at its best it displays astonishing perspicacity, providing explanations that enable people to act.Applied to pain, what this means is that it is unhelpful to think of a unitary psychology of pain. There are at least three psychologies that are useful to consider in this chapter. The first we call "cognitive" because it relates to private mental events, experiences of thought or perception. The second we call "social" because it relates to influences on behavior that arise from our evolutionary imperative to behave collectively. The third we call clinical, because it relates to specific attempts to intervene with individuals or groups for a desired health-related outcome. I will briefly introduce what we know about the cognitive, social, and clinical psychologies of pain. Next, the evidence for psychological interventions in acute and chronic nonmalignant pain is reviewed. Finally, we focus on what we don't know that we really need to know, in order to move forwards.First, it is important to revisit briefly the definition of pain, from a psychological perspective.

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Psychological therapies for the management of chronic and recurrent pain in children and adolescents

Cited by 144 publications

References 63 publications

Patient Education Based on Principles of Cognitive Behavioral Therapy for a Patient With Persistent Low Back Pain: A Case Report

Patient Education Based on Principles of Cognitive Behavioral Therapy for a Patient With Persistent Low Back Pain: A Case Report

Presentation and management of chronic pain

Psychology of Chronic Pain and Evidence‐Based Psychological Interventions

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