Pain management classes for medical patients: Evaluating a psychological treatment program for in-patients

EVALUATION OF A COGNITIVE BEHAVIORAL GROUP PROGRAM FPR A_C_G. Li;ssen ,*, 1::1':'18-;5;= PATIENTS WITH CHRONIC LOW BACK PAIN. F.G. Zitmanl**, Departments of lpsychiatry and Pain Clinic, G' " I University Hospital Leiden, The Netherlands Aim of Investigation: In recent years various cognitive behavioral pain management programs have been developed to rehabilitate patients with chronic benign pain. In the studies published to date, no attention has been paid to components analysis of these often very comprehensive programs (Linton, 19821. In this study our aim is to demonstrate that a components analysis can be approximated in a relatively simple way by systematically taking into account the opinion of the patients about the various parts of the program. It will be argued that through this procedure the effectiveness of these programs can be enhanced. Methods: Four consecutive cognitive behavioral group programs for outpatients with chronic low back pain will be described. Elements of the program are: (multidisciplinary) education, group discussion and relaxation techniques. Each group consisted of about six patients and each consecutive program was adjusted on the basis of the patients' subjective evaluation of the various parts of the former program. Results: The subjective evaluation by the patients of the first program led to convincingly improved results as to up-time, depression and pain locus of control of the second program at post-test and at follow-up as compared to the first program. Data pertaining to the third and fourth program, which are not quite finished at this time, will be presented also. Conclusion: The subjective evaluation by the patients of the various parts of a comprehensive pain management program can provide clues to enhance effectiveness of these programs. Though this conclusion seems trivial, in the literature to date, no such procedure has been described.

PAIN MANAGEMENT CLASSES FOR MEDICAL PATIENTS:EVALUATING A PSYCHOLOGICAL TREATMENT PROGRAM FOR IN-PATIENTS. R.S. Miller, Department of Psychology, Toronto General Hospital, Toronto, Ontario, Canada. Aim of Investigation: Previous research has supported the effectiveness of psychological treatment for chronic pain. This study examines the effectiveness of a brief, innovative treatment program in which cognitive-behavioural and hypnotic strategies for pain management are introduced to groups of medical patients with a variety of pain problems. Methods: A sample of medical in-patients attended one hour Pain Management Classes. Mood, pain ratings, activity level and medication usage were assessed in the week prior to and in the week following the class. The patients' evaluation of hospital care was also assessed following the class. Results: Patients who participated in the treatment program displayed decreases in distress and pain and an increase in activity level following the class. Participants also evaluated the quality of hospital care more positively than a control group of non-participants. Conclusions: The findings suggest that medical patients in a general hospital setting with a variety of pain problems can benefit from attending brief Pain Management Classes in which psychological strategies are introduced. The Pain Management Classes are presented as a cost-effective intervention which can be easily implemented in other general hospital settings. The observation that pain ratings and cognitive and behavioural responses to pain are related is discussed in support of a "Response-Contingent" approach to pain management.