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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
Pain (Acute Pain And Chronic Pain)
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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

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

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

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

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 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

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

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

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

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

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

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

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

Developing Psychological Flexibility

Acceptance and Commitment Therapy (ACT) proposes that suffering is associated with psychological inflexibility. ACT suggests that to increase psycholo ... https://www.psychologytools.com/resource/developing-psychological-flexibility

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

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

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

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

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

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

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

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

Mindful Attention (Audio)

The Mindful Attention exercise is an audio track from the Psychology Tools For Overcoming PTSD Audio Collection. This audio track was originally recor ... https://www.psychologytools.com/resource/mindful-attention-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

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

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

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

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

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

Pain Diary

Self-monitoring of thoughts, feelings, and symptoms is an essential skill for clients engaged in cognitive behavioral therapy (CBT). In this Pain Diar ... https://www.psychologytools.com/resource/pain-diary

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

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

Progressive Muscle Relaxation (Audio)

Progressive Muscle Relaxation is an audio exercise from the Psychology Tools For Overcoming PTSD Audio Collection. It is designed to help anyone exper ... https://www.psychologytools.com/resource/progressive-muscle-relaxation-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

Relaxed Breathing Exercise 1 (Audio)

Relaxed Breathing Exercise 1 is an audio track from the Psychology Tools For Overcoming PTSD Audio Collection. The aim of this breathing exercise is t ... https://www.psychologytools.com/resource/relaxed-breathing-exercise-1-audio

Relaxed Breathing Exercise 2 (Audio)

Relaxed Breathing Exercise 2 is an audio track taken from the Psychology Tools For Overcoming PTSD Audio Collection. The aim of this breathing exercis ... https://www.psychologytools.com/resource/relaxed-breathing-exercise-2-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

Relaxed Breathing Exercise 4 (Audio)

Relaxed Breathing Exercise 4 is an audio track from the Psychology Tools For Overcoming PTSD Audio Collection. Slow, relaxed, diaphragmatic breathing ... https://www.psychologytools.com/resource/relaxed-breathing-exercise-4-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

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

Unhelpful Thinking Styles (Archived)

NOTE: Two improved versions of this resource are available here: Cognitive Distortions – Unhelpful Thinking Styles (Common) and Cognitive Disto ... https://www.psychologytools.com/resource/unhelpful-thinking-styles-archived

Values: Connecting To What Matters

Values: Connecting To What Matters is a practical self-help guide which introduces the reader a cornerstone of acceptance and commitment therapy (ACT) ... https://www.psychologytools.com/resource/values-connecting-to-what-matters

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

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

Links to external resources

Psychology Tools makes every effort to check external links and review their content. However, we are not responsible for the quality or content of external links and cannot guarantee that these links will work all of the time.

Assessment

  • Chronic Pain Acceptance Questionnaire – Revised (CPAQ-R) | McCracken, Vowles, Eccleston | 2004
    • Scale
    • Reference 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
    • Reference 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.

Information Handouts

  • The Pain Toolkit – a helpful toolkit for people who live with persistent pain | Pete Moore, Dr Frances Cole | 2009
  • Back pain management program: Pacing activities | Cambridge University Hospitals NHS
  • Improve your functioning through effective pacing | Dr Williams, Dr Carey | 2003

Information (Professional)

Presentations

  • Pain management: application of cognitive behavioral methods | Michael Nicholas
  • Lecture on fear avoidance in chronic pain | Johan Vlayen | 2008
  • A multidisciplinary facial pain service | Sarah Baker
  • Acceptance and Commitment Therapy (ACT) and Chronic Pain | Lance McCracken | 2015

Self-Help Programmes

  • When Panic Attacks (Workbook) | Centre For Clinical Interventions | 2023

Treatment Guide

  • Guidelines for pain management programmes for adults | British Pain Society | 2013
  • Life with chronic pain: an acceptance-based approach (Therapist guide and patient workbook) | Kevin Vowles, Sohn Sorrell | 2007
  • Cognitive behavioral therapy for chronic pain – therapist manual | Murphy, McKellar, Raffa, Clark, Kerns, Karlin
  • ACT for chronic pain | Lance McCracken | 2015

Recommended Reading

  • 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

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.