Aims of a Cognitively Focused Cognitive-Behavioral Therapy Approach to Pain Management

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Because chronic pain conditions are rarely curable, the focus of CBT is not on eliminating the pain but on helping patients to enhance their quality of life and minimize the impact of pain on their lives (i.e., to improve function). This treatment focus presents its own challenges because a downward spiral of disability often accompanies chronic pain, with pain leading to distress, withdrawal, and inactivity, which then lead to further dysfunction and eventual disability, promoting even further pain, distress, and so on. Helping patients to maintain their level of functioning or to change their behavior to regain function is a difficult but attainable goal. Appropriate pain self-management behaviors (also referred to as coping behaviors) include restoring or maintaining work and family activities, using the health care system and pain medications appropriately, and engaging in regular, paced physical activity. It is interesting to note that although pain reduction is not a primary aim of CBT, patients often report reductions in pain following treatment (Hoffman et al. 2007; Ostelo et al. 2005; Rains et al. 2005).

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Table Reference Number
Table 25–1. Examples of negative patient pain-related thoughts and beliefs, and subsequent maladaptive behaviors


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