A three-dimensional treatment programme for chronic pain.

Abstract

The treatment of chronic pain contains several problems such as ineffectiveness, side effects and drug dependence. The concepts of respondent and operant pain are introduced, together with a general operant learning model for analysis and treatment of psychological problems. To make a psychological analysis of pain, evidence for learned pain behaviour must be assessed, reinforcers for treatment revealed, goal behaviours set up, and support in the environment secured. In the further analysis, account must be taken to a) time pattern of pain, b) pain behaviour, c) reactions from the environment, d) pain activators, e) pain reducers, f) the effect of tension versus relaxation on pain, and g) changes in the family structure necessary because of the pain problem. A three-dimensional operant treatment programme for chronic pain is presented. It consists of 1) reduction of medication, 2) increase of activity, and 3) reduction of pain behaviour. Results, supporting the efficacy of the model, are presented.