Behavioral approaches in the multidisciplinary management of chronic pain: Programs and issues

Psychological, social, and behavioral factors appear to play an important role in determining how patients adapt to chronic pain. There is a growing consensus among physicians that traditional diagnostic approaches to chronic pain must be expanded to address these factors. Innovative, multidisciplinary programs designed to change behavioral and psychological functioning in chronic pain patients have recently been developed. Disciplines involved include nursing, physical therapy, occupational therapy, psychology, psychiatry, anesthesiology, neurosurgery, and orthopedics. These programs are interesting because they successfully treat many chronic pain patients who previously failed to respond to conventional treatments. This article provides a selective review of behaviorally oriented, multidisciplinary, chronic pain treatment programs. It begins with a consideration of the conceptual foundations of these programs-the mechanisms of chronic pain. Basic elements of several major programs as well as outcome data are described. The paper concludes with a discussion of clinical issues important in evaluating these programs. © 1986.

Duke Scholars

Author Francis Joseph Keefe Psychiatry & Behavioral Sciences, Behavioral Medicine & Neur ...