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Treatment Specifics of Cognitively Focused Group CBT for Chronic Pain

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All group sessions (except the first) begin with a pre-session process check and end with a post-session process check (see Figure 25–1). The pre-session process check serves several purposes. First, it encourages participants to think about and practice material learned in the session throughout the week, and it sets an explicit expectation that participants will have done so. Second, it provides an opportunity for the practitioner to determine which concepts taught during the previous week need further clarification. The next session task is to review concepts learned and homework assigned in the previous session. Following homework review, the current session's treatment objectives are presented in the form of brief "mini-lectures," which include pertinent examples. Toward the end of the session, a worksheet is introduced to clarify treatment objectives. As group members begin to work together on the activities covered in the worksheet, each patient is encouraged to provide a relevant example. Following the interactive worksheet activity, the new homework assignment is introduced and discussed. Typically, the worksheet begun in the current session is incorporated into the homework assignment due the following week. Therapists must repeatedly highlight the importance of homework completion so that patients practice the CBT skills and implement them in everyday life. At the end of the session, patients are asked to list ways they could use the current session's material to think and behave differently during the ensuing week. The therapist then uses this post-session process check to determine if individuals understood and were able to apply the major concepts discussed during that session.

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Figure 25–1. Pre-session and post-session process check.

Figure 25–2. Stress–Pain Connection Worksheet.

Figure 25–3. Automatic Thoughts Worksheet.

Figure 25–4. Changing Pain Beliefs Worksheet.
Table Reference Number
Table 25–2. Major objectives of the 10 cognitively focused group cognitive-behavioral therapy sessions

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