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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
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Therapy tool

Activity Diary Worksheet with hourly time intervals

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/

Worksheet

Activity Diary Worksheet with no 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/

Worksheet

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 Handout

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/

Worksheet

Avoidance Hierarchy (Archived)

Note: This resource has been superseded by the Fear Ladder exercise. The Avoidance Hierarchy exercise has been archived and will remain available whil ... https://www.psychologytools.com/resource/avoidance-hierarchy/

Exercise

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/

Worksheet

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/

Worksheet

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 Handout

Combined Relaxation Exercise

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 Handout

Evaluating Unhelpful Automatic Thoughts (NATs) CBT Guide

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/

Guide

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 Handout

Fear Ladder Exposure Hierarchy Worksheet

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/

Worksheet

Health Anxiety Self-Monitoring Record (Edition 1)

Individuals with health anxiety experience clinically significant distress associated with health concerns. This thought-monitoring record enables cli ... https://www.psychologytools.com/resource/health-anxiety-self-monitoring-record-edition-1/

Worksheet

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/

Worksheet

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/

Worksheet

Mindful Attention Audio

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

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 ‘bo ... https://www.psychologytools.com/resource/pacing-for-pain-and-fatigue/

Exercise

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/

Worksheet

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/

Worksheet

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/

Exercise

Progressive Muscle Relaxation Audio

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

Progressive Muscle Relaxation (Edition 1)

Muscle tension is one reaction to stress and anxiety. This exercise includes instructions for Progressive Muscle Relaxation, a technique for promoting ... https://www.psychologytools.com/resource/progressive-muscle-relaxation-edition-1/

Exercise

Psychology Tools For Mindfulness Audio Collection

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 Audio Collection

Relaxation: Audio Collection

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 Collection

Relaxed Breathing Exercise 1 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

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

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

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/

Worksheet

Therapy Blueprint

Since the publication of this version of the therapy blueprint we have also developed a more sophisticated version: Therapy Blueprint (Universal) A th ... https://www.psychologytools.com/resource/therapy-blueprint/

Worksheet

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 Handout

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 ... https://www.psychologytools.com/resource/vas-scale/

Exercise

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 Handout

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

Information Handouts

  • The Pain Toolkit – a helpful toolkit for people who live with persistent pain paintoolkit.org archived copy
  • Pacing instructions with worked examples archived copy
  • Pacing instructions archived copy

Worksheets

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.

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