Although there are now proven behavioral and psychological methods of dealing with and alleviating chronic pain, methods that can supplement or replace drug treatments, these are not always applied in clinical practice. This volume in the new series, Advances in Psychotherapy -- Evidence-Based Practice, provides psychological and medical therapists (and students) with practical and evidence-based guidance on diagnosis and treatment of chronic pain, and does so in a uniquely “reader-friendly” manner. The book is both a compact “how-to” reference, for use by professional clinicians in their daily work, as well as an ideal educational resource for students and for practice-oriented continuing education. The most important feature of the book is that it is practical and “reader-friendly.” It has a similar structure to others in the series, and is a compact and easy-to-follow guide covering all aspects of practice that are relevant in real-life. Tables, boxed clinical “pearls,” and marginal notes assist orientation, while checklists for copying and summary boxes provide tools for use in daily practice. The series has been developed and is edited with the support of the Society of Clinical Psychology (APA Division 12). The Society is planning a system of home study continuing education courses based on the series that an individual can complete on the web. --- from the publisher Table of Contents (preliminary) 1. Description 1.1. Terminology and Definitions 1.1.1. International Association of the Study of Pain Definition 1.2. Classification of Pain 1.2.1. Temporal: Acute vs chronic; Recurrent vs intermittent; Cancer vs chronic noncancer pain 1.2.2. Neurophysiology of Pain Signal Transmission: Nociceptive pain; Neuropathic pain; Central processing 1.2.3. Common Disease States: Low back pain/radiculopathy; CRPS; Peripheral neuropathy; Trigeminal neuralgia; Arthritis/fibromyalgia 1.3. Commonly Used Terms and Concepts 1.3.1. Allodynia; Analgesia; Central pain; Hyperalgesia; Neuralgia; Neuropathy; Nociceptor 1.3.2. Management vs Cure 1.3.3. Addiction vs Tolerance and Dependence 1.3.4. Impairment and Disability 1.4. Epidemiology 1.4.1. Prevalence of pain 1.4.2. Economic impact: Absenteeism; Pain-related healthcare costs 1.4.3. Frequency 1.5. Comorbidities 1.5.1. Sleep disorders; Mood disorders; Suicide; Alcohol and substance abuse; Hypertension 1.5.2. Opioid-related: Tolerance; Dependence; Addiction 2. Theories and Models of Pain 2.1. Cartesian Dualism: The Straight-Through Model 2.2. Gate Control Theory: Affective, cognitive, and sensory dimensions of pain; Ascending and descending modulation 2.3. Biopsychosocial Model: Psychological factors in initiation and maintenance of pain and/or as consequences. 3. Diagnosis and Treatment Indications 3.1. Medical History and Diagnosis 3.2. Psychological History and Diagnosis 3.2.1. Assessment: Medicare requirements; Assessment measures and questionnaires (Turk and Melzack; Handbook of Pain Assessment) 3.2.2. Mental Health: Depression; Symptom overlap (depressive symptoms and pain); Anxiety; Substance abuse; Past vs current; Family history; Mental status 3.2.3. Personality/Coping Style 3.2.4. Stressors/Life Style Changes: Loss of employment/Changes in financial status; Worker compensation and/or litigation; Changes in daily activities; Lack of employment, sports, recreation, hobbies; Impact on interpersonal interactions, spouse and children 3.2.5. Past Medical History: Somatiform disorders; Factitious disorder 3.2.6. Social History: Family history - role of learning/modeling; Sexual abuse 4. Treatment 4.1. Methods of Treatment 4.1.1. Medical Treatments: Medications(nonopioid analgesics, opioid analgesics, others); Procedures (innjections, IDET; vertebroplasty; radiofrequency); Surgery (implantable devices) 4.1.2. Physical Therapy: Correcting musculoskeletal imbalances; Strengthening and stretching; Managing daily activities safely; Assistive devices; General conditioning; Pool therapy 4.1.3. Psychological Interventions: The Cognitive-Behavioral Approach - Role of Cognitions: Beliefs, attributions and expectations; Attention - Behaviors: Development of illness behaviors; The role of learning; Reinforcement of illness behaviors; Role of family; Role of healthcare professionals - General Lifestyle: Up time vs down time; Sleep, eating habits, smoking, exercise; Pacing daily activities; Stress management; Communication skills; Family sessions; - Techniques for managing pain: Diaphragmatic breathing; Relaxation skills; Imagery; Hypnosis; Autogenic training; Biofeedback - Group Therapy 4.2. Mechanisms of Action 4.2.1. Role of Attention 4.2.2. Decrease Catastrophizing 4.2.3. Managing Stress 4.2.4. Decreasing Muscle Tension 4.3. Efficacy and Prognosis 4.3.1. Monotherapies 4.3.2. Multidisciplinary Treatment 4.4. Variations and Combinations of Methods 4.4.1. Alternative Treatment Approaches: Acupuncture; TNS; Chiropractic 4.4.2. Massage 4.5. Problems in Carrying Out the Treatments 4.5.1. Adherence 4.5.2. Patient Participation and Responsibility in Management of Pain 5. Case Vignette 6. Further Reading 7. References 8. Appendix: Tools and Resources
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