Evaluation of a cognitive-behavioural pain management programme with severely chronic pain patients
Cognitive-behavioural group therapy, and self-help materials are frequently used in therapy with chronic pain patients, but have received little systematic investigation when used with severely disturbed chronic pain patients. The present study stands in contrast to others working with more selected groups. Patients investigated here had severe psychological problems, particularly depression in addition to high levels of chronic pain and disability. Self-help materials were provided before group therapy. Therapeutic interventions were evaluated by McGill Pain, Oswestry Disability and Pain Locus of Control Questionnaires, B. D. I., self-recording diary episodes and memory recall test. No significant changes in pain or disability measures were found, but there were significant cognitive changes as assessed by raised control and memory for nonpain words. . Assessments which predicted change were also identified. The need to match interventions to individuals, limitations of group therapy with highly disturbed individuals and the importance of multidisciplinary work for success are noted. The results are discussed within a development of the transitional model described by Karoly and Jensen (1987).