The role of psychological interventions in the management of patients with chronic pain

Abstract

Chronic pain can be best understood from a biopsychosocial perspective through which pain is viewed as a complex, multifaceted experience emerging from the dynamic interplay of a patient’s physiological state, thoughts, emotions, behaviors, and sociocultural influences. A biopsychosocial perspective focuses on viewing chronic pain as an illness rather than disease, thus recognizing that it is a subjective experience and that treatment approaches are aimed at the management, rather than the cure, of chronic pain. Current psychological approaches to the management of chronic pain include interventions that aim to achieve increased self-management, behavioral change, and cognitive change rather than directly eliminate the locus of pain. Benefits of including psychological treatments in multidisciplinary approaches to the management of chronic pain include, but are not limited to, increased self-management of pain, improved pain-coping resources, reduced pain-related disability, and reduced emotional distress – improvements that are effected via a variety of effective self-regulatory, behavioral, and cognitive techniques. Through implementation of these changes, psychologists can effectively help patients feel more in command of their pain control and enable them to live as normal a life as possible despite pain. Moreover, the skills learned through psychological interventions empower and enable patients to become active participants in the management of their illness and instill valuable skills that patients can employ throughout their lives.

Assessment and Treatment of Chemotherapy-induced Peripheral Neuropathy- a Physical Therapy Perspective

“…Relaxation techniques such as deep breathing exercises, Jacobson progressive relaxation, Mitchell's relaxation method, music therapy were shown to be beneficial for chronic pain [143]. Once patient is relaxed, it is imperative that they can understand the whats and hows of their chronic painful state and its management options, for an effective educational intervention [144]. Non-responders to both the above techniques need referral to psychologist or psychiatrist for initiating advanced psychological interventions [145][146][147].…”

Effectiveness of Acceptance and Commitment-Based Therapy (ACT Rehab) on Quality of Life, Severity and Duration of Pain; in Women With Chronic Low Back Pain

“…The inter-disciplinary approach includes administration of analgesics along with physical, occupational, behavioral and psychological therapies [8]. The purpose of most of the existing psychological treatments is to improve the quality of life of patients, as well as to reduce pain [8,9].…”

“…Current psychological approaches in chronic pain management include psychological interventions which aim to achieve better self-management of the pain. It also includes management of behavioral changes, acceptance-based interventions and cognitive changes which are also called rehabilitation methods [8]. Psychological interventions that have been frequently used in this field include mental and physical techniques, behavioral approaches, and cognitive-behavioral treatments.…”

Research Findings Using Mindfulness-Based Interventions for Chronic Pain

“…Pain patients with comorbid mental illness often require psychotherapeutic interventions in addition to medication management [14] [15]. Cognitive behavioral therapy (CBT) has demonstrated effectiveness in the treatment of chronic pain and helps change impractical thinking through recognition of and reduction in harmful thought patterns while also providing enhanced coping skills [16] [17]. CBT utilizes several strategies including, but not limited to, problem solving, pain education, relaxation training, coping skills development, and cognitive restructuring of pain-related beliefs [17].…”