Concept of secondary gain

The evaluation and treatment of the patient with idiopathic chronic pain traditionally has involved a sequence of studies first by the internist, then the neurologist, and finally the psychiatrist. This has resulted in an overutilization of costly health care services and may paradoxically have helped to promote symptom chronicity. In keeping with recent developments in the field of psychosomatic medicine, a coordinated biopsychosocial approach is advocated with the identification and amelioration of the multiple determinants of symptom formation in each of these interrelated sub-systems. A case is presented in which the application of this holistic approach appeared to help curtail the overuse of health care services and at the same time helped to diminish psychosocial reinforcers in the form of secondary gain.

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Secondary Gain

Encyclopedia of Behavioral Medicine ◽

10.1007/978-1-4419-1005-9_101521 ◽

2013 ◽

pp. 1724-1724

Keyword(s):

Secondary Gain

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HIV disease, AIDS, and HIV-associated dementia in a secondary gain context

Neuropsychology of Malingering Casebook ◽

10.4324/9780203890042-34 ◽

2008 ◽

pp. 362-376

Keyword(s):

Hiv Disease ◽

Secondary Gain

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Session 4: Addressing Barriers to Treatment Success

Helping Families Manage Childhood OCD ◽

10.1093/med:psych/9780199357604.003.0004 ◽

2016 ◽

pp. 33-40

Author(s):

Tara S. Peris ◽

John Piacentini

Keyword(s):

Treatment Success ◽

Barriers To Treatment ◽

Secondary Gain ◽

Treatment Progress ◽

Potential Barriers ◽

Family Problem ◽

Barriers To Change ◽

Low Motivation ◽

At Home

This chapter describes how to assist families as they apply skills learned in earlier treatment sessions to work on specific problems at home. It begins with a review of their progress with the first family problem, and, if appropriate, guides the therapist in helping families pick a new issue to address. The therapist reviews treatment progress and discusses potential barriers to change, including secondary gain, low motivation, and noncompliance. It is important that the therapist monitors and reframes blame that may arise during these discussions. The therapist should make it clear that OCD symptoms/behaviors are not done on purpose, even if there are aspects that appear to work to the child’s advantage. Strategies for addressing these obstacles are discussed and additional interventions applied as necessary.

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