Cognitive Therapy for Chronic Pain
A Step-by-Step Guide
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This go-to manual--now revised and significantly expanded with more than 50% new material--has enabled thousands of clinicians to effectively treat clients with chronic pain. In the face of today's growing opioid crisis, pain self-management techniques are needed now more than ever. The volume shows how to implement 10 treatment modules that draw on proven cognitive-behavioral therapy (CBT) strategies. In a convenient large-size format, it includes 58 reproducible client handouts and assessment tools that purchasers can photocopy from the book or download and print from the companion website. The website also offers access to downloadable audio recordings of relaxation exercises narrated by the author, plus supplemental resources for treating clients with lower levels of literacy.
New to This Edition
*Incorporates over a decade of important advances in pain research and clinical practice.
*Treatment modules that allow clients to enter a group at any point after an introductory session.
*Expanded with motivational enhancement, relaxation, and mindfulness techniques.
*Many new handouts, assessment tools, and therapist scripts, as well as audio downloads.
*Orients and engages clients using state-of-the-art research on how the brain processes pain.
Table of Contents
I. Rationale, Theory, Research, and Assessment
1. Why Consider Cognitions When Treating Chronic Pain?
2. Conceptual/Organizational Model and Treatment Rationale: Cognitive Therapy for Chronic Pain
3. The Research Foundation for Cognitive Treatment of Pain
4. Clinical Assessment of Pain from a Biopsychosocial Perspective
II. A Cognitive Treatment Program for Chronic Pain
Treatment Module 1. The Brain in Pain: Rationale for Cognitive Therapy
Treatment Module 2. The Stress—Judging—Pain Connection
Treatment Module 3. Identifying Automatic Thoughts
Treatment Module 4. Examining Our Thoughts and Creating New Ones
Treatment Module 5. Muscle Relaxation and Coping Self-Statements
Treatment Module 6. Deeper Beliefs
Treatment Module 7. Observing and Letting Go
Treatment Module 8. Writing about Strong Emotions: Another Way of Acknowledging and Letting Go
Treatment Module 9. Assertiveness: A Great Way to Communicate
Treatment Module 10. Putting It All Together
Appendix A. Brief Pain Inventory—Short Form (BPI-SF)
Appendix B. P4 Suicidality Screener (P4)
Appendix C. Pain Catastrophizing Scale (PCS)
Appendix D. Tampa Scale for Kinesiophobia—11 (TSK-11)
Appendix E. Pain Self-Efficacy Questionnaire (PSEQ)
Appendix F. Patient Global Impression of Change Scale
1. Diaphragmatic (Belly) Breathing
2. Passive Muscle Relaxation
3. Mindfulness Relaxation
Beverly E. Thorn, PhD, ABPP, is Professor Emerita of Psychology at the University of Alabama, where she was on the faculty for 30 years, including serving as Director of the Clinical Psychology PhD program for 15 years. She is the recipient of the 2018 Wilbert E. Fordyce Clinical Investigator Award from the American Pain Society, and is a Fellow of the Society for Health Psychology (Division 38 of the American Psychological Association (APA)), the Society of Clinical Psychology (Division 12 of the APA), and the Society of Behavioral Medicine. Dr. Thorn is on the editorial boards of several scientific journals, including Health Psychology, Pain, Journal of Pain, and European Journal of Pain. Her research has focused on investigating the important components of CBT for chronic painful conditions. Since retiring in 2016, she has remained actively involved in dissemination and implementation of CBT for chronic pain with low-income, multiply disadvantaged populations. She also consults in health care settings to help train behavioral health providers to implement CBT for pain management.
"This up-to-date second edition not only provides an overview of the scientific evidence supporting CBT for chronic pain, but also is filled with practical tips for dealing with challenges that typically arise when working with patients. Thorn is an internationally recognized expert who has pioneered novel approaches to implementing CBT with chronic pain sufferers, including those with multiple comorbid conditions. She draws on her rich background of clinical experience and brings the material to life with numerous anecdotes and examples. A wide range of practitioners will find this book very accessible and will learn techniques they can integrate into their daily practice."--Francis J. Keefe, PhD, Department of Psychiatry and Behavioral Sciences and Director, Duke Pain Prevention and Treatment Research Program, Duke University School of Medicine
"Experts in pain management are unanimous in encouraging timely and equitable access to cognitive therapy to address the interrelated public health crises of undertreatment of pain and the opioid epidemic. Thorn’s contribution stands alone in providing a patient-centered guide that can be used in the broadest array of clinical practice settings. It is clear that this book will serve as the gold standard for the field of pain management for many years to come.”--Robert D. Kerns, PhD, Departments of Psychiatry, Neurology, and Psychology, Yale University
"There has been a recent resurgence of interest in nonpharmacological interventions for pain, and this evidence-based book is packed with interventions that really work. Easy to read and understand, the manual includes helpful reproducible materials and real-world examples to offer guidance in the management of pain. The second edition features freestanding modules, incorporates new clinical techniques, and has up-to-date resources and reproducible tools. Thorn emphasizes goal setting and active collaboration to help clients gain control over an otherwise debilitating condition. I highly recommend this book as a 'must have' for seasoned professionals as well as clinicians and students new to the field."--Robert N. Jamison, PhD, Departments of Anesthesia and Psychiatry, Brigham and Women's Hospital, Harvard Medical School
"Grounded in theory and rigorous scientific research, this book is a classic. The second edition incorporates new techniques, including mindfulness meditation, as well as additional tools, such as downloadable client handouts and audio recordings. The treatment modules are now more self-contained, allowing practitioners to integrate and adapt the treatment for a variety of applications and settings. What hasn’t changed since the first edition is the book’s engaging and insightful style. It is obvious that Thorn both understands the science underlying the treatment and has compassionately and effectively delivered it to many clients. This book is the essential reference for providing group or individual CBT to people with chronic pain, and should be part of predoctoral and postdoctoral training for all professionals who plan to work with chronic pain in psychology, social work, nursing, occupational therapy, and other health care disciplines."--Dawn M. Ehde, PhD, Department of Rehabilitation Medicine, University of Washington
"This second edition is extensively revised and represents a seminal contribution to the field of pain treatment. The book is unique in that its methods are so rigorous as to be usable as a scientific protocol for a clinical trial, while at the same time so practical as to be easily implemented in the clinical setting. Thorn translates the science of pain treatment into practice."--Daniel Bruns, PsyD, FAPA, Health Psychology Associates, Greeley, Colorado
"With unprecedented challenges in chronic pain management, there is a growing need for evidence-based, non-pharmacological treatment options. Thorn has delivered a comprehensive, up-to-date guide that meets this need. The book not only covers foundational research and theory, but also presents a wealth of step-by-step practical tools for engaging patients in effective clinical treatment. This is the ultimate one-stop resource for all things relevant to cognitive therapy for chronic pain."--Jennifer L. Murphy, PhD, CBT for Chronic Pain Master Trainer, U.S. Department of Veterans Affairs