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9780898625493

Coping with Chronic Pain A Guide to Patient Self-management

by ;
  • ISBN13:

    9780898625493

  • ISBN10:

    0898625491

  • Format: Paperback
  • Copyright: 1993-04-23
  • Publisher: The Guilford Press

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Supplemental Materials

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Summary

Researchers from diverse disciplines have identified chronic pain as a critical national problem. Despite its preponderance, however, definitive diagnosis of benign chronic pain is usually elusive and direct medical intervention is often ineffective. Stressing self-management, Drs. Hanson and Gerber offer an alternative approach to biomedical management or simply "learning to live with it'' by presenting a comprehensive description of an integrated treatment approach for chronic pain sufferers.

The biopsychosocial perspective on the assessment and treatment of chronic pain that is described in this volume is based on the day-to-day operation of an effective outpatient pain clinic that evaluates clients, about 1/3 of whom are treated in an intensive 21-day patient program. The book opens with an explication of a theoretical model and a detailed description of its clinical implementation. The model's application with patients is described with emphasis on the need for a flexible theoretical approach and individualized treatment, which may include psychotherapy as an integral part of the self-management paradigm.

The biomedical and biopsychosocial models are discussed in detail with respect to how they presume pain mechanisms operate, how each views the phenomenology of the pain experience, and what are considered appropriate interventions. It is demonstrated how, rather than focusing on repairing mechanical breakdowns in the body machine, the biopsychosocial model concentrates on the individual with chronic pain. How a person appraises, reacts to, and copes with the problem and its treatment are considered crucial issues. The sociocultural context of the patient is also taken into account.

The evaluation and preparation of patients for self-management training is explicated. Topics include the reciprocal interactions among physical sensations, cognitive factors, emotional responses, overt behavior, and socioenvironmental features. The neurophysiological underpinnings of this model are briefly discussed, common self-management goals are summarized, and essential targets for change such as dysfunctional action tendencies, perceptions of uncontrollability, and self-focused attention are delineated. Complete chapters cover the critical issues of physical activity reconditioning, attentional refocusing, and a non-narcotic preventive approach for acute pain episodes. Another chapter addresses administrative, budgetary, and staff issues for operating a comprehensive pain center.

Providing a flexible and comprehensive approach that is particularly effective for chronic pain sufferers, but is also applicable to all types of illness, this volume will be of value to psychologists, physicians, nurses, social workers, and physical therapists. Ancillary health care professionals and administrators will also find much of interest.

Author Biography

Richard W.Hanson ,PhD, U.C.L.A. , U.S.C.
Kenneth E.Gerber , PhD ,U.C.L.A. ,C.S.U.

Table of Contents

Introduction
1(14)
The Problem of Chronic Pain
2(1)
Low Back Pain
3(5)
The Chronic-Pain Syndrome
8(2)
Overview
10(5)
Models of Pain
15(30)
Acute- versus Chronic-Pain Models
16(3)
Peripheral versus Central Models
19(3)
Disease- versus Illness-Behavior Models
22(5)
Reductionistic versus Systems Models
27(2)
Biomedical versus Biopsychosocial Models
29(2)
Medical versus Self-Management Models
31(3)
Medical Management Approaches
34(10)
Summary
44(1)
Introduction to Self-Management Training
45(35)
Initial Referral Process
46(3)
Preliminary Evaluation Procedures
49(5)
Contrasting Medical and Self-Management
54(3)
Introducing the Biopsychosocial Systems Model
57(16)
Review of Major Self-Management Goals
73(1)
Essential Targets for Change
74(4)
Summary
78(2)
Self-Management of Physical Activities
80(23)
Factors Contributing to Physical Limitations
81(5)
Modulating Physical Activity
86(1)
Discovering True Physical Limitations
87(1)
Initiating a Physical Reconditioning Program
88(4)
Reduce or Eliminate Narcotic Use
92(1)
Discovering Limitations through Trial and Error
93(1)
Activity Modulation
94(4)
Self-Acceptance
98(3)
Summary
101(2)
Coping with Pain through Distraction
103(17)
Explaining How Attentional Processes Work
105(2)
Attention Diversion and Self-Management Training
107(1)
Distracting Activities
108(6)
Cognitive Distractions
114(4)
Summary
118(2)
Coping with Episodes of Intense Pain
120(20)
Prevention
121(3)
Constructive Alternatives for Coping with Pain
124(15)
Summary
139(1)
Managing Stress and Depression
140(28)
Cognition, Stress, and Pain
140(2)
Cognitive Therapy
142(7)
Discovering More Effective Ways of Coping with Depression and Stress
149(3)
Relaxation Training and Tension Management
152(11)
Biofeedback, Hypnosis, and Self-Management
163(3)
Summary
166(2)
The Organization and Management of a Chronic-Pain Program
168(23)
The Pain-Clinic Setting
168(1)
Inpatient versus Outpatient
169(2)
Group versus Individual Treatment
171(2)
The Treatment-Resistant Patient
173(3)
The CPMP Daily Routine
176(3)
Staff Roles
179(4)
The CPMP as a Training Experience
183(1)
Alternatives to Comprehensive Inpatient Pain Progress
184(2)
Program Follow-Up
186(2)
Evaluation of Progress Efficacy
188(2)
Summary
190(1)
Beyond Self-Management Training
191(27)
Pain as a Means of Seeking Help
193(3)
Pain as a Reflection of Earlier Life Events
196(7)
Pain as a Solution
203(2)
Pain as a Solution to Family Problems
205(2)
Choosing Appropriate Treatment Strategies
207(8)
Implications of the Biopsychosocial Model and Self-Management
215(3)
References 218(10)
Index 228

Supplemental Materials

What is included with this book?

The New copy of this book will include any supplemental materials advertised. Please check the title of the book to determine if it should include any access cards, study guides, lab manuals, CDs, etc.

The Used, Rental and eBook copies of this book are not guaranteed to include any supplemental materials. Typically, only the book itself is included. This is true even if the title states it includes any access cards, study guides, lab manuals, CDs, etc.

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