scholarly journals Can Pain-Related Fear Be Reduced? The Application of Cognitive-Behavioural Exposure in Vivo

2002 ◽  
Vol 7 (3) ◽  
pp. 144-153 ◽  
Author(s):  
Johan WS Vlaeyen ◽  
Jeroen R de Jong ◽  
Patrick Onghena ◽  
Maria Kerckhoffs-Hanssen ◽  
Ank MJ Kole-Snijders
Keyword(s):  
Chronic Pain ◽  
Coping Skills ◽  
Pain Catastrophizing ◽  
Skills Training ◽  
Behavioural Treatment ◽  
Coping Skills Training ◽  
Pain Disability ◽  
Cognitive Behavioural ◽  
Exposure In Vivo

Although cognitive-behavioural treatments of patients with chronic pain generally are reported to be effective, customization might increase their effectiveness. One possible way to customize treatment is to focus the intervention on the supposed mechanism underlying the transition from acute to chronic pain disability. Evidence is accumulating in support of the conjecture that pain-related fear and associated avoidance behaviours are crucial in the development and maintenance of chronic pain disability. It seems timely to apply this knowledge to the cognitive-behavioural management of chronic pain. Two studies are presented here. Study 1 concerns a secondary analysis of data gathered in a clinical trial that was aimed at the examination of the supplementary value of coping skills training when added to an operant-behavioural treatment in patients with chronic back pain. The results show that, compared with a waiting list control, an operant-behavioural treatment with or without pain-coping skills training produced very modest and clinically negligible decreases in pain-related fear. Study 2 presents the effects of more systematic exposure in vivo treatment with behavioural experiments in two single patients reporting substantial pain-related fear. Randomization tests for AB designs revealed dramatic changes in pain-related fear and pain catastrophizing. In both cases, pain intensity also decreased significantly, but at a slower pace. Differences before and after treatment revealed clinically significant improvements in pain vigilance and pain disability.

scholarly journals Nurse practitioners can effectively deliver pain coping skills training to osteoarthritis patients with chronic pain: A randomized, controlled trial

Pain ◽  
2014 ◽  
Vol 155 (9) ◽  
pp. 1743-1754 ◽  
Author(s):  
Joan E. Broderick ◽  
Francis J. Keefe ◽  
Patricia Bruckenthal ◽  
Doerte U. Junghaenel ◽  
Stefan Schneider ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Randomized Controlled Trial ◽  
Nurse Practitioners ◽  
Coping Skills ◽  
Controlled Trial ◽  
Skills Training ◽  
Pain Coping ◽  
Coping Skills Training ◽  
Randomized Controlled

scholarly journals An mHealth Pain Coping Skills Training Intervention for Hematopoietic Stem Cell Transplantation Patients: Development and Pilot Randomized Controlled Trial (Preprint)

2017 ◽  
Author(s):  
Tamara J Somers ◽  
Sarah A Kelleher ◽  
Caroline S Dorfman ◽  
Rebecca A Shelby ◽  
Hannah M Fisher ◽  
...  
Keyword(s):  
Qualitative Data ◽  
Coping Skills ◽  
Controlled Trial ◽  
Skills Training ◽  
Pain Coping ◽  
User Testing ◽  
Treatment As Usual ◽  
Hematopoietic Stem ◽  
Coping Skills Training ◽  
Pain Disability

BACKGROUND Pain is a challenge for patients following hematopoietic stem cell transplantation (HCT). OBJECTIVE This study aimed to develop and test the feasibility, acceptability, and initial efficacy of a Web-based mobile pain coping skills training (mPCST) protocol designed to address the needs of HCT patients. METHODS Participants had undergone HCT and reported pain following transplant (N=68). To guide intervention development, qualitative data were collected from focus group participants (n=25) and participants who completed user testing (n=7). After their input was integrated into the mPCST intervention, a pilot randomized controlled trial (RCT, n=36) was conducted to examine the feasibility, acceptability, and initial efficacy of the intervention. Measures of acceptability, pain severity, pain disability, pain self-efficacy, fatigue, and physical disability (self-report and 2-min walk test [2MWT]) were collected. RESULTS Participants in the focus groups and user testing provided qualitative data that were used to iteratively refine the mPCST protocol. Focus group qualitative data included participants’ experiences with pain following transplant, perspectives on ways to cope with pain, and suggestions for pain management for other HCT patients. User testing participants provided feedback on the HCT protocol and information on the use of videoconferencing. The final version of the mPCST intervention was designed to bridge the intensive outpatient (1 in-person session) and home settings (5 videoconferencing sessions). A key component of the intervention was a website that provided personalized messages based on daily assessments of pain and activity. The website also provided intervention materials (ie, electronic handouts, short videos, and audio files). The intervention content included pain coping advice from other transplant patients and instructions on how to apply pain coping skills while engaging in meaningful and leisure activities. In the RCT phase of this research, HCT patients (n=36) were randomized to receive the mPCST intervention or to proceed with the treatment as usual. Results revealed that the mPCST participants completed an average of 5 out of 6 sessions. The participants reported that the intervention was highly acceptable (mean 3/4), and they found the sessions to be helpful (mean 8/10) and easy to understand (mean 7/7). The mPCST participants demonstrated significant improvements in pre- to post-treatment pain, self-efficacy (P=.03, d=0.61), and on the 2MWT (P=.03, d=0.66), whereas the patients in the treatment-as-usual group did not report any such improvements. Significant changes in pain disability and fatigue were found in both groups (multiple P<.02); the magnitudes of the effect sizes were larger for the mPCST group than for the control group (pain disability: d=0.79 vs 0.69; fatigue: d=0.94 vs 0.81). There were no significant changes in pain severity in either group. CONCLUSIONS Using focus groups and user testing, we developed an mPCST protocol that was feasible, acceptable, and beneficial for HCT patients with pain. CLINICALTRIAL ClinicalTrials.gov NCT01984671; https://clinicaltrials.gov/ct2/show/NCT01984671 (Archived by WebCite at http://www.webcitation.org/6xbpx3clZ)

Behavioural Treatment of Injection, Dental and Medical Phobias in Adolescents: A Case Study

1990 ◽  
Vol 18 (4) ◽  
pp. 311-316 ◽  
Author(s):  
Matthew R. Sanders ◽  
Lyndall Jones
Keyword(s):  
Skills Training ◽  
Self Report ◽  
Major Surgery ◽  
Medical Procedures ◽  
Systematic Desensitization ◽  
Behavioural Treatment ◽  
Coping Skills Training

This case study describes the use of a multi component behavioural programme in the treatment of a 13-year-old girl with multiple phobias of injections, dental and medical procedures who faced major surgery within 6 months. The treatment involved coping skills training, systematic desensitization, in vivo desensitization with participant modelling and homework assignments. Measures of anxiety via SUDS ratings, behavioural approach tests and self-report measures demonstrated the effectiveness of the treatment program and the subsequent maintenance of treatment effects at 8 months follow-up.

scholarly journals Delivery of pain coping skills training program to manage chronic pain related to osteoarthritis: the primary care provider role

2021 ◽  
Author(s):  
◽  
Patricia Obasi
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Care Setting ◽  
Primary Care Setting ◽  
Coping Skills ◽  
Skills Training ◽  
Primary Care Providers ◽  
Pain Coping ◽  
Care Providers ◽  
Coping Skills Training

Osteoarthritis (OA) is the primary form of arthritis that affects a large portion of the Canadian population. With expected increases in OA prevalence over time, the magnitude of outcomes related to inadequate pain control will place further burdens on society and healthcare resources. Pain Coping Skills Training (PCST) is an intervention protocol derived from cognitive behavioural therapy and has traditionally been delivered by clinical psychologists to manage chronic pain related to OA. However, few providers in the primary care setting are trained in PCST. The lack of trained primary care providers creates a barrier to patient access in the community setting, which should be addressed. An integrative literature review has been conducted to identify if primary care providers, who work in primary care settings, can deliver PCST interventions to decrease pain interference and improve quality of life outcomes in adult patients diagnosed with OA. The results are discussed within the context of Canada's primary care practice. Eleven articles were reviewed using Whittemore and Knafl’s approach to the integrative literature review. The results suggest that PCST interventions are both practical and possible among providers that do not possess a background in mental health specialization. Thus, primary care providers are encouraged to obtain educational competency to deliver this effective therapy to manage the adverse psychological effects on chronic pain related to OA. This way, providers can offer a biopsychosocial approach in managing OA while also playing an essential role in improving access to PCST interventions in the primary care setting. Recommendations for facilitating the uptake of PCST interventions are discussed, and specific strategies for its use in primary care are presented.

scholarly journals Pilot study of an internet-based pain coping skills training program for patients with systemic Lupus Erythematosus

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Kelli D. Allen ◽  
Tyler Beauchamp ◽  
Christine Rini ◽  
Francis J. Keefe ◽  
Kim L. Bennell ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Coping Skills ◽  
Pain Catastrophizing ◽  
Skills Training ◽  
Effect Sizes ◽  
Wait List ◽  
Pain Coping ◽  
Coping Skills Training

Abstract Background Patients with Systemic Lupus Erythematosus (SLE) often experience pain and other symptoms that negatively impact quality of life. Interventions that enhance the use of behavioral and cognitive coping strategies may lead to improved outcomes among patients with SLE. Pain coping skills training (PCST) programs have been shown to improve outcomes among patients with other rheumatic conditions, but there have been no trials of PCST among patients with SLE. This study was a preliminary assessment of the feasibility and efficacy of painTRAINER, an automated, internet-based PCST program, among patients with SLE. Methods Participants (n = 60) with SLE from one health care system were randomly assigned with equal allocation to painTRAINER or a wait list control group. PainTRAINER involves 8 modules; participants were instructed to complete one module weekly, along with practice activities for each cognitive or behavioral coping skill. Outcome measures were assessed at baseline and 9-week follow-up, including the Pain Catastrophizing Scale, PROMIS Subscales (Pain Interference, Physical Function, Sleep Disturbance, Anxiety, Depression, Fatigue and Participation), and the LupusPRO questionnaire. Mean changes in outcomes from baseline to follow up and Cohen’s d effect sizes were computed. Results Effect sizes for the painTRAINER group (relative to the wait list group) were small, with changes being greatest for the PROMIS Depression score (d = − 0.32). Among those randomized to the painTRAINER group, 50% accessed the program (“painTRAINER users”). Most of those who did not access the program stated that they did not receive instructions via email. Effect sizes for “painTRAINER users” (relative to wait list) were larger than for the whole painTRAINER group: Pain Catastrophizing d = − 0.60, PROMIS Pain Interference d = − 0.3., PROMIS Depression d = − 0.44, LupusPRO Health-Related Quality of Life d = 0.30. Conclusions PainTRAINER users reported meaningful improvements in multiple physical and psychological outcomes, supporting the potential of PCST programs to benefit individuals with SLE. However, strategies are needed to improve engagement with the program and tailor content to comprehensively address key SLE symptoms and challenges. Trial registration NCT03933839, May 1, 2019.

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