Tag Archives: psychotherapy

Dialectical Behavioral Therapy for Chronic Pain Mgmt

Dialectical Behavioral Therapy for Chronic Pain Management Florence Chaverneff, Ph.D. – September 24, 2016

Still a recent form of cognitive behavioral therapy, dialectical behavioral therapy (DBT) combines dialectics and mindfulness meditation for therapeutic purposes.

The goal with this method is to help patients “gain insight and skills to manage their thoughts, emotions, and behaviors.”

A study presented at the American Academy of Pain Management’s Annual Meeting in San Antonio, Texas, proposed the use of this technique in pain management.

DBT was initially developed in the United States as a treatment complement for patients with the most severe cases of borderline personality disorder (ie, cases of suicidal attempts and ideation).   Continue reading

No need for additional psychosocial therapy treatment

When Added to Opioid Agonist Treatment, Psychosocial Interventions do not Further Reduce the Use of Illicit Opioids: A Comment on Dugosh et al. – PubMed – NCBI – J Addict Med. 2016 Jul-Aug;

This commentary reviews the limitations of the recent literature review by that examined the role of psychosocial interventions with medication for opioid addiction treatment.

The commonly held belief that opioid agonist treatment alone is inferior treatment to such treatment combined with ‘psychosocial’ treatment (which many will understand to mean counseling) is not supported by the research evidence and it results in limitations on the use of these effective medications.   

Below is the review addressed by this commentary:   Continue reading

Values in Modern Clinical Behavior Analysis

In Search of Meaning: Values in Modern Clinical Behavior Analysis | Free full-text PMC article

One of the distinguishing features of human behavior, compared to that of other species, is the extent to which our lives are influenced by values and purpose.

This uniqueness is based on the fact that, unlike other species, we engage in verbal behavior.

Acceptance and commitment therapy (ACT) provides a theory for values and values-based action, based on basic behavioral principles and grounded in a functional analytic theory of language and cognition that we believe provides a strong foundation for creating flexible assessment and intervention strategies related to personal values.   Continue reading

Fear-Avoidance Maintaining Chronic Pain?

Fear-Avoidance Conditioning: Maintaining the Chronic Pain Cycle? – Pain – International Association for the Study of Pain | August 11, 2016

In an article recently published in Pain, researchers at the University of Leuven, Belgium propose a model for the transition from acute to chronic pain, based on fear-avoidance

With this model, which describes the distinct behaviors underlying perpetuation of or breaking from pain, researchers seek to guide pain-related research as well as pain management

In this model, conditioning plays a central role in the maintenance of pain, and authors argue that its disruption may lead to recovery.   Continue reading

Overview of a Psych Therapy for Chronic Pain

An Overview of Dialectical Behavior Therapy | Psych Central

This is a “flavor” of Cognitive Behavior Therapy that’s touted as a treatment for chronic pain by the CDC:

Dialectical behavior therapy (DBT) treatment is a cognitive-behavioral approach that emphasizes the psychosocial aspects of treatment.

The theory behind the approach is that some people are prone to react in a more intense and out-of-the-ordinary manner toward certain emotional situations, primarily those found in romantic, family and friend relationships.  

DBT theory suggests that some people’s arousal levels in such situations

  1. can increase far more quickly than the average person’s,
  2. attain a higher level of emotional stimulation, and
  3. take a significant amount of time to return to baseline arousal levels.   Continue reading

Catastrophizing Debunked as Cause of Pain

The causal status of pain catastrophizing: an experimental test with healthy participants. – PubMed – NCBI Eur J Pain. 2005 Jun

In the current study we report findings on the effects of experimentally induced catastrophizing about pain on expected pain, experienced pain and escape/avoidance behavior during a cold pressor task in a sample of healthy participants

It was hypothesized that increasing the level of catastrophizing would result in a higher level of expected pain, a higher level of experienced pain, and a shorter duration of ice-water immersion. Also, it was hypothesized that these relations might be stronger for participants who already catastrophized about pain prior to the experiment.

The results demonstrated that despite the successful attempt to induce catastrophizing, this neither significantly affected

  • expected pain,
  • experienced pain, and
  • duration of ice-water immersion,

nor were these relations moderated by the pre-experimental level of catastrophizing.  

Of course, because this study is from a decade ago, it will be disregarded.


Catastrophizing: Not a Ploy for Attention

Catastrophizing: Not a Ploy for Attention

Catastrophizing, defined as an exaggerated negative mental set, has consistently shown a negative impact on outcomes in patients with chronic pain and illness.

However, the factors that drive this cognitive distortion remain unclear.

Who gets to decide which “cognitions” are “distorted” when they are related to personal values?

In an effort to elucidate the underlying mechanisms, researchers led by Joan M. Romano, PhD, evaluated 2 models in the context of chronic fatigue, a chronic disabling condition often accompanied by pain.   Continue reading

Values in Modern Clinical Behavior Analysis (ACT)

In Search of Meaning: Values in Modern Clinical Behavior Analysis | Behav Anal. 2009 Spring | Free full-text PCM article

I stumbled across this while looking for more research on acceptance and commitment therapy (ACT). As a psychology nerd, I found this very long and technical analysis of ACT interesting (though my pain-damaged memory will retain only a tiny fraction of it).

One of the distinguishing features of human behavior, compared to that of other species, is the extent to which our lives are influenced by values and purpose.

This uniqueness is based on the fact that, unlike other species, we engage in verbal behavior.   Continue reading

Pain Psychology: A National Call to Action

Pain Psychology: A Global Needs Assessment and National Call to Action –  Authors: Beth D. Darnall, PhD, et al.

Objective. The Institute of Medicine and the draft National Pain Strategy recently called for better training for health care clinicians.

This was the first high-level needs assessment for pain psychology services and resources in the United States.

Design. Prospective, observational, cross-sectional.

Methods. Brief surveys were administered online to six stakeholder groups:   Continue reading

Acceptance, Flexibility Key in Chronic Pain Battle

Acceptance, Flexibility Key in Chronic Pain Battle

As researchers strive to find the right psychotherapeutic approaches to best help patients break destructive thought patterns that perpetuate chronic pain, acceptance and commitment therapy (ACT) and psychological flexibility are gaining favor — and evidence.

researchers showed the importance of acceptance in offsetting patient perceptions of injustice, which are known to be strongly associated with pain-related outcomes

When pain becomes chronic, patients can experience many losses: loss of function, loss of employment, and loss of independence.   Continue reading