Psychological approaches to chronic pain management: Evidence and challenges

C. Eccleston, S.J. Morley, A.C. Williams

Research output: Contribution to journalArticle

  • 65 Citations

Abstract

Psychological interventions are a mainstay of modern pain management practice and a recommended feature of a modern pain treatment service. Systematic reviews for the evidence of psychological interventions are reviewed in this article. The evidence for effectiveness is strongest for cognitive behavioural therapy with a focus on cognitive coping strategies and behavioural rehearsal. Most evidence is available for treatments of adult pain, although adolescent chronic pain treatments are also reviewed. It is clear that treatment benefit can be achieved with cognitive behavioural methods. It is possible to effect change in pain, mood, and disability, changes not achieved by chance or by exposure to any other treatment. However, the overall effect sizes of treatments for adults, across all trials, are modest. Reasons for the relatively modest treatment effects are discussed within the context of all treatments for chronic pain being disappointing when measured by the average. Suggestions for improving both trials and evidence summaries are made. Finally, consideration is given to what can be achieved by the pain specialist without access to specialist psychology resource.
LanguageEnglish
Pages59-63
Number of pages5
JournalBritish Journal of Anaesthesia
Volume111
Issue number1
DOIs
StatusPublished - Jul 2013

Fingerprint

Pain Management
Chronic Pain
Psychology
Pain
Therapeutics
Cognitive Therapy

Cite this

Psychological approaches to chronic pain management : Evidence and challenges. / Eccleston, C.; Morley, S.J.; Williams, A.C.

In: British Journal of Anaesthesia, Vol. 111, No. 1, 07.2013, p. 59-63.

Research output: Contribution to journalArticle

@article{42fd02ca8ac44379b36965211041ac11,
title = "Psychological approaches to chronic pain management: Evidence and challenges",
abstract = "Psychological interventions are a mainstay of modern pain management practice and a recommended feature of a modern pain treatment service. Systematic reviews for the evidence of psychological interventions are reviewed in this article. The evidence for effectiveness is strongest for cognitive behavioural therapy with a focus on cognitive coping strategies and behavioural rehearsal. Most evidence is available for treatments of adult pain, although adolescent chronic pain treatments are also reviewed. It is clear that treatment benefit can be achieved with cognitive behavioural methods. It is possible to effect change in pain, mood, and disability, changes not achieved by chance or by exposure to any other treatment. However, the overall effect sizes of treatments for adults, across all trials, are modest. Reasons for the relatively modest treatment effects are discussed within the context of all treatments for chronic pain being disappointing when measured by the average. Suggestions for improving both trials and evidence summaries are made. Finally, consideration is given to what can be achieved by the pain specialist without access to specialist psychology resource.",
author = "C. Eccleston and S.J. Morley and A.C. Williams",
year = "2013",
month = "7",
doi = "10.1093/bja/aet207",
language = "English",
volume = "111",
pages = "59--63",
journal = "British Journal of Anaesthesia",
issn = "0007-0912",
publisher = "Oxford University Press",
number = "1",

}

TY - JOUR

T1 - Psychological approaches to chronic pain management

T2 - British Journal of Anaesthesia

AU - Eccleston,C.

AU - Morley,S.J.

AU - Williams,A.C.

PY - 2013/7

Y1 - 2013/7

N2 - Psychological interventions are a mainstay of modern pain management practice and a recommended feature of a modern pain treatment service. Systematic reviews for the evidence of psychological interventions are reviewed in this article. The evidence for effectiveness is strongest for cognitive behavioural therapy with a focus on cognitive coping strategies and behavioural rehearsal. Most evidence is available for treatments of adult pain, although adolescent chronic pain treatments are also reviewed. It is clear that treatment benefit can be achieved with cognitive behavioural methods. It is possible to effect change in pain, mood, and disability, changes not achieved by chance or by exposure to any other treatment. However, the overall effect sizes of treatments for adults, across all trials, are modest. Reasons for the relatively modest treatment effects are discussed within the context of all treatments for chronic pain being disappointing when measured by the average. Suggestions for improving both trials and evidence summaries are made. Finally, consideration is given to what can be achieved by the pain specialist without access to specialist psychology resource.

AB - Psychological interventions are a mainstay of modern pain management practice and a recommended feature of a modern pain treatment service. Systematic reviews for the evidence of psychological interventions are reviewed in this article. The evidence for effectiveness is strongest for cognitive behavioural therapy with a focus on cognitive coping strategies and behavioural rehearsal. Most evidence is available for treatments of adult pain, although adolescent chronic pain treatments are also reviewed. It is clear that treatment benefit can be achieved with cognitive behavioural methods. It is possible to effect change in pain, mood, and disability, changes not achieved by chance or by exposure to any other treatment. However, the overall effect sizes of treatments for adults, across all trials, are modest. Reasons for the relatively modest treatment effects are discussed within the context of all treatments for chronic pain being disappointing when measured by the average. Suggestions for improving both trials and evidence summaries are made. Finally, consideration is given to what can be achieved by the pain specialist without access to specialist psychology resource.

UR - http://www.scopus.com/inward/record.url?scp=84880225735&partnerID=8YFLogxK

UR - http://dx.doi.org/10.1093/bja/aet207

U2 - 10.1093/bja/aet207

DO - 10.1093/bja/aet207

M3 - Article

VL - 111

SP - 59

EP - 63

JO - British Journal of Anaesthesia

JF - British Journal of Anaesthesia

SN - 0007-0912

IS - 1

ER -