Pain (Acute Pain And Chronic Pain)
Pain is a complex psychological experience involving sensory and affective components. Human beings are able to reflect upon what they are experiencing, and psychologists often attend to an individual’s cognitions (thoughts, beliefs, images, memories) around their pain—what the pain means for this individual—and suffering that is associated with these cognitions. Evidence-based psychological approaches for pain include acceptance and commitment therapy (ACT), cognitive behavioral therapy (CBT), and hypnosis. Read more
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Activity Diary (Hourly Time Intervals)
Activity diaries can be used for activity monitoring during an assessment phase of therapy, symptom monitoring during therapy, correlating activity wi ...
https://www.psychologytools.com/resource/activity-diary-hourly-time-intervals
Worksheets
Activity Diary (No Time Intervals)
Activity diaries can be used for activity monitoring during an assessment phase of therapy, symptom monitoring during therapy, correlating activity wi ...
https://www.psychologytools.com/resource/activity-diary-no-time-intervals
Worksheets
Activity Menu
Helping clients to choose which activities to target during behavioral activation (BA) can be accomplished in a variety of ways: activity monitoring c ...
https://www.psychologytools.com/resource/activity-menu
Information handouts
Activity Planning
Research suggests that an activity is more likely to be completed if it is planned and scheduled in advance. The Activity Planning worksheet can be us ...
https://www.psychologytools.com/resource/activity-planning
Worksheets
Audio Collection: Psychology Tools For Mindfulness
The Psychology Tools For Mindfulness Audio Collection is the perfect way to introduce your clients to the practice of mindfulness. Developed by a clin ...
https://www.psychologytools.com/resource/psychology-tools-for-mindfulness-audio-collection
Audio
Audio Collection: Psychology Tools For Relaxation
The Psychology Tools For Relaxation Audio Collection is designed to help anyone experiencing stress or heightened physiological arousal. The audio col ...
https://www.psychologytools.com/resource/psychology-tools-for-relaxation-audio-collection
Audio
Avoidance Hierarchy (Archived)
NOTE: An improved version of this resource is available here: Fear Ladder. Older versions of a resource may be archived in the event that they are ava ...
https://www.psychologytools.com/resource/avoidance-hierarchy
Archived
Behavioral Experiment
Behavioral experiments are planned experiential activities to test the validity of a belief. They are one of the most powerful techniques available to ...
https://www.psychologytools.com/resource/behavioral-experiment
Worksheets
Behavioral Experiment (Portrait Format)
Behavioral experiments allow individuals to test the validity of their beliefs and assumptions. They are a core experiential technique for therapeutic ...
https://www.psychologytools.com/resource/behavioral-experiment-portrait-format
Worksheets
Being With Difficulty (Audio)
Being With Difficulty is a mindfulness exercise which gently brings present-moment awareness to bear upon thoughts and feelings that are more difficul ...
https://www.psychologytools.com/resource/being-with-difficulty-audio
Audio
Body Scan (Audio)
The Body Scan is a mindfulness exercise encouraging present-moment awareness, with the sensations of the body being used as an anchor for mindful atte ...
https://www.psychologytools.com/resource/body-scan-audio
Audio
Cognitive Behavioral Model Of Fear Of Body Sensations
Fear of bodily sensations is present in a number of conditions, most notably panic disorder. The Cognitive Behavioral Model Of Fear Of Bodily Sensatio ...
https://www.psychologytools.com/resource/cognitive-behavioral-model-of-fear-of-body-sensations
Information handouts
Combined Relaxation Exercise (Audio)
The Combined Relaxation Exercise is an audio track from the Psychology Tools For Relaxation Audio Collection. It is designed to help anyone experienci ...
https://www.psychologytools.com/resource/combined-relaxation-exercise-audio
Audio
Developing Psychological Flexibility
Developing Psychological Flexibility is a client information handout which can be used to familiarize clients with the ACT model. ...
https://www.psychologytools.com/resource/developing-psychological-flexibility
Information handouts
Emotions Motivate Actions
Many clients find it helpful to recognize the range of actions that are motivated by different emotional states. This worksheet encourages clients to ...
https://www.psychologytools.com/resource/emotions-motivate-actions
Information handouts
Evaluating Unhelpful Automatic Thoughts
The Evaluating Unhelpful Automatic Thoughts guide is written for clients who struggle with negative automatic thoughts. It provides a comprehensive in ...
https://www.psychologytools.com/resource/evaluating-unhelpful-automatic-thoughts
Guides
Exercise For Mental Health
Exercise is an evidence-based treatment for depression and anxiety and research suggests that, in the treatment of depression, exercise interventions ...
https://www.psychologytools.com/resource/exercise-for-mental-health
Information handouts
Externalizing
The Externalizing information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more effectively ...
https://www.psychologytools.com/resource/externalizing
Information handouts
Fear Ladder
The Fear Ladder is a tool for exploring and ranking the contexts or situations in which a client experiences fear. It is designed to help the client a ...
https://www.psychologytools.com/resource/fear-ladder
Worksheets
Health Anxiety Thought Record
Individuals with health anxiety experience clinically significant distress associated with health concerns. This thought-challenging record enables cl ...
https://www.psychologytools.com/resource/health-anxiety-thought-record
Worksheets
Identifying The Meaning Of Body Sensations
Some anxiety disorders (including panic and health anxiety), are concerned with body sensations and symptoms. The Identifying The Meaning Of Body Sens ...
https://www.psychologytools.com/resource/identifying-the-meaning-of-body-sensations
Worksheets
Jumping To Conclusions
The Jumping to Conclusions information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more ef ...
https://www.psychologytools.com/resource/jumping-to-conclusions
Information handouts
Mindful Attention (Audio)
Mindful Attention is a technique for becoming aware of one’s thoughts and experiences, and being able to observe these as transient mental events. ...
https://www.psychologytools.com/resource/mindful-attention-audio
Audio
Mindfulness In Everyday Life (Audio)
Mindfulness In Everyday Life is a short mindfulness exercise which guides clients how to bring present-moment awareness into everyday life. This audio ...
https://www.psychologytools.com/resource/mindfulness-in-everyday-life-audio
Audio
Mindfulness Of Breath (Long Version) (Audio)
Mindfulness Of Breath (Long version) is a mindfulness exercise encouraging present-moment awareness, using the breath as an anchor for the attention. ...
https://www.psychologytools.com/resource/mindfulness-of-breath-long-version-audio
Audio
Mindfulness Of Breath (Short Version) (Audio)
Mindfulness Of Breath (Short version) is a mindfulness exercise encouraging present-moment awareness, using the breath as an anchor for the attention. ...
https://www.psychologytools.com/resource/mindfulness-of-breath-short-version-audio
Audio
Mindfulness Of Sounds And Thoughts (Audio)
Mindfulness Of Sounds And Thoughts is a mindfulness practice exercise that encourages relating to thoughts as ‘just thoughts’ that come and go in ...
https://www.psychologytools.com/resource/mindfulness-of-sounds-and-thoughts-audio
Audio
Pacing For Pain And Fatigue
Pacing is an evidence-based approach to increasing activity and fitness, and in reducing overall pain and fatigue. It is designed to prevent 'boom and ...
https://www.psychologytools.com/resource/pacing-for-pain-and-fatigue
Exercises
Pain Activity Diary
Activity diaries are a crucial information-gathering tool. They can be used for activity monitoring during an assessment phase of therapy, symptom mon ...
https://www.psychologytools.com/resource/pain-activity-diary
Worksheets
Pain Diary
Self-monitoring of thoughts, feelings and symptoms is an essential skill for clients engaged in cognitive behavioral therapy (CBT). In this Pain Diary ...
https://www.psychologytools.com/resource/pain-diary
Worksheets
Progressive Muscle Relaxation
Progressive relaxation training originated in the 1930’s as a treatment for tension and anxiety. Edmund Jacobsen developed a systematic and lengthy ...
https://www.psychologytools.com/resource/progressive-muscle-relaxation
Exercises
Progressive Muscle Relaxation (Archived)
NOTE: An improved version of this resource is available here: Progressive Muscle Relaxation. Older versions of a resource may be archived in the event ...
https://www.psychologytools.com/resource/progressive-muscle-relaxation-edition-1
Archived
Progressive Muscle Relaxation (Audio)
The Progressive Muscle Relaxation exercise guides the listener through a sequence in which muscle groups are tensed and relaxed. ...
https://www.psychologytools.com/resource/progressive-muscle-relaxation-audio
Audio
Raisin Exercise (Audio)
The Raisin Exercise is a short mindfulness exercise encouraging present-moment awareness of the senses, connecting with taste, touch and smell while y ...
https://www.psychologytools.com/resource/raisin-exercise-audio
Audio
Relaxed Breathing Exercise 1 (Audio)
Breathing Exercise 1 guides the listener through simple instructions to make their breathing slower, deeper, and more regular. ...
https://www.psychologytools.com/resource/relaxed-breathing-exercise-1-audio
Audio
Relaxed Breathing Exercise 2 (Audio)
Breathing Exercise 2 uses the imagery of inflating a balloon to help the listener make their breathing slower, deeper, and more regular. ...
https://www.psychologytools.com/resource/relaxed-breathing-exercise-2-audio
Audio
Relaxed Breathing Exercise 3 (Audio)
Breathing Exercise 3 uses the imagery of breathing air of different colours to help the listener make their breathing slower, deeper, and more regular ...
https://www.psychologytools.com/resource/relaxed-breathing-exercise-3-audio
Audio
Relaxed Breathing Exercise 4 (Audio)
Breathing Exercise 4 guides the listener through simple instructions to breathe in a more relaxed fashion. ...
https://www.psychologytools.com/resource/relaxed-breathing-exercise-4-audio
Audio
Sleep Diary
Many clients report that their sleep is disturbed, and this can be a cause or consequence of many mental health conditions. This Sleep Diary enables c ...
https://www.psychologytools.com/resource/sleep-diary
Worksheets
Thinking Versus Sensing (Audio)
Thinking Versus Sensing is a short mindfulness exercise to demonstrate the difference between thinking about our experience and sensing it directly. E ...
https://www.psychologytools.com/resource/thinking-versus-sensing-audio
Audio
Unhelpful Thinking Styles
Human thinking is subject to a number of characteristic biases. In the 1960s, Aaron Beck identified several of these biases which were common in his d ...
https://www.psychologytools.com/resource/unhelpful-thinking-styles
Information handouts
VAS Scale
Visual analogue scales (VAS's) can be used for subjective ratings of emotion or other sensations such as pain. This is a handy VAS scale in the style ...
https://www.psychologytools.com/resource/vas-scale
Exercises
What Does Exercise Do For the Mind And Body?
Exercise is an evidence-based treatment for depression and anxiety and research suggests that in the treatment of depression, exercise interventions l ...
https://www.psychologytools.com/resource/what-does-exercise-do-for-the-mind-and-body
Information handouts
Assessment
- Chronic Pain Acceptance Questionnaire – Revised (CPAQ-R) | McCracken, Vowles, Eccleston | 2004
- Scale download archived copy
- McCraken, L. M., Vowles, K. E. & Eccleston, C. (2004). Acceptance of chronic pain: component analysis and a revised assessment method. Pain, 107, 159-166.
- Illness Perception Questionnaire – Revised (IPQ-R) | Weinman, Petrie, Moss-Morris, Horne | 2002
- Scale download archived copy
- Moss-Morris, R., Weinman, J., Petrie, K., Horne, R., Cameron, L., & Buick, D. (2002). The revised illness perception questionnaire (IPQ-R). Psychology and health, 17(1), 1-16.
- Pain Catastrophizing Scale (PCS) | Sullivan | 1995
- Manual + scale download archived copy
- Sullivan, M. J., Bishop, S. R., & Pivik, J. (1995). The pain catastrophizing scale: development and validation. Psychological Assessment, 7(4), 524.
Intervention
Treatment guidelines
- Guidelines for pain management programmes for adults | British Pain Society | 2013 download archived copy
Treatment manuals
- Life with chronic pain: an acceptance-based approach | Kevin Vowles, Sohn Sorrell | 2007 download archived copy
- Cognitive behavioral therapy for chronic pain – therapist manual download archived copy
- ACT for chronic pain | Lance McCracken | 2015 download archived copy
Information Handouts
- The Pain Toolkit – a helpful toolkit for people who live with persistent pain
paintoolkit.orgarchived copy - Pacing instructions with worked examples
archived copy - Pacing instructions archived copy
Worksheets
- Pain management diary download
Presentations
- Pain management: application of cognitive behavioral methods | Michael Nicholas download archived copy
- Lecture on fear avoidance in chronic pain | Johan Vlayen | 2008 archived copy
- A multidisciplinary facial pain service | Sarah Baker download archived copy
- Acceptance and Commitment Therapy (ACT) and Chronic Pain | Lance McCracken | 2015 download
Recommended Reading
- Acceptance and commitment therapy in the treatment of chronic pain – Dahl & Lundgren download archived copy
- McCracken, L. M., & Vowles, K. E. (2014). Acceptance and commitment therapy and mindfulness for chronic pain: model, process, and progress. American Psychologist, 69(2), 178 download
What Is Pain?
Signs and Symptoms of Acute and Chronic Pain
Pain is a multisensory experience with sensory and affective components. Sensory components of pain describe where the pain is, what it feels like, and how strong it is. Affective components of pain describe how the pain makes us feel. Therapists working with pain patients also find it helpful to assess and work with the behavioral, cognitive, functional, and social effects of pain.
Psychological Models and Theory of Acute and Chronic Pain
Fear-Avoidance Model of Chronic Pain
The fear-avoidance model of chronic pain (Vlaeyen & Linton, 2000) describes a trajectory followed by individuals experiencing acute pain who may become trapped in a vicious cycle of chronic disability and suffering. As a cognitive model it proposes that the appraisals pain patients form concerning their pain can lead to sequences that end in avoidance, deconditioning, and further pain and suffering. The fear-avoidance model of chronic pain is empirically well-supported but it has been argued that the next generation of the model needs to add motivational components including goals and self-regulatory processes (Crombez et al, 2012).
Acceptance and Commitment Therapy (ACT) Model of Chronic Pain
ACT is a transdiagnostic approach to human difficulties that is popular among clinicians working with pain.
“The basic premise of ACT as applied to chronic pain is that while pain hurts, it is the struggle with pain that causes suffering … continuing attempts to control pain may be maladaptive, especially if they cause unwanted side effects or prevent involvement in valued activities, such as work, family, or community involvement” (Dahl & Lundgren, 2015).
References
- Crombez, G., Eccleston, C., Van Damme, S., Vlaeyen, J. W., & Karoly, P. (2012). Fear-avoidance model of chronic pain: The next generation. The Clinical Journal of Pain, 28(6), 475–483.
- Dahl, J., & Lundgren, T. (2015). Acceptance and commitment therapy in the treatment of chronic pain. Retrieved from: https://www.div12.org/wp-content/uploads/2015/06/ACT-in-the-treatment-of-chronic-pain.pdf
- Vlaeyen, J. W. S., & Linton, S. J. (2000). Fear-avoidance and its consequences in chronic musculoskeletal pain: A state of the art. Pain, 85(3), 317–332.