Self Help Books: A behavioural assessment approach to chronic pain


Today’s self help book is published by one of the more prolific publishers of psychological self help – it’s from the New Harbinger Publications stable of self help books.

The Chronic Pain Care Workbook; A self-treatment approach to pain relief using the behavioural assessment of pain questionnaire is written by Michael J Lewandowski, a clinical psychologist with years of experience working with people experiencing chronic pain. He has developed the pain assessment tool used in the book, called the Behavioural Assessment of Pain assessment, which has been used internationally for pain assessment, and forms the basis of self discovery for people working through the workbook.

Like most chronic pain workbooks, this workbook is designed to reassure people that their pain is understandable, to a certain extent, able to be managed if not controlled or reduced, and to help people to take steps to return to a normal life. What is slightly different about this book is the extensive use of self assessment across a wide range of areas to form a ‘Pain Scorecard’ – and thankfully, there is some empirical support for the assessment norms (just not norms developed for New Zealand!). There are actually 29 individual subscales comprising areas such as Pain Intensity, Sleep Interference, Fear of Re-Injury, Pain Behaviours, several Interference scales, and several relevant to ‘significant others’ in the person’s life.

For each subscale there is a separate questionnaire, many quite brief, that are asked throughout the book – and the scores are arranged in terms of areas of strength, concern and significant concern. Subscales can also be arranged by category, and the book provides specific solutions for ‘common areas of concern’.

While it’s possible to complete all the questionnaires before reading through the book, and therefore only dipping in and out of relevant chapters, it’s preferable to work through the book chapter by chapter, reviewing each area in the order indicated. This makes the workbook a little less daunting (it’s over 200 pages long), and the chapters do flow in a reasonably logical order.

Chapters include:
Part 1 - what is chronic pain, including definitions of chronic pain, the biopsychosocial model, readiness and intention for change, baseline pain ratings and goal-setting, and a brief review of diagnosis
Part 2 – Behavioural assessment of change, including fatigue, medication, thoughts and ideas, pain behaviours, activity interference and avoidance, emotional pain, family and social, sex and intimacy, and working with the health care team
Part 3 – Conclusion – setback planning, progress monitoring, acceptance
Part 4 – the Pain Scorecard and interpretation

The strengths of this book are the individual learning activities all the way through, ensuring that for the committed reader, the content is readily made relevant to the individual. It also uses quite clear language, there is room to breath (white space!) on each page, and it’s possible to complete all the exercises within the workbook.

I also liked the reference to stages of change, personal goals (the reasons for using this workbook), and the use of both behavioural and cognitive strategies. None of the strategies are particularly new or unique, but they are very relevant and low-cost. One example is the use of blue dots placed around the environment as a cue to notice and use a brief relaxation technique. Recording charts are also included for activities that can be used on a daily basis.

The aspects I felt were less helpful was the sheer volume of information, and some of the language is probably well beyond the people I work with. Like any workbook, it’s attempting to be ‘all things to all people’, so most people would probably appreciate having a therapist work through it with them – at the very least to get all the way through it! I would also have appreciated some diagrams, or visual aids that didn’t include words – personal preference, but probably applicable to a good number of people who would want to use this type of book.

Overall? A helpful workbook, but very in-depth, and probably would need someone very committed to complete it without support. Certainly a lot easier to read and follow than the Nicholas, Molloy, Tonkin & Beeston book I reviewed yesterday.
The Chronic Pain Care Workbook: A Self-treatment Approach to Pain Relief Using the Behavioral Assessment of Pain Questionnaire (A New Harbinger Self-Help Workbook)
by Michael J. Lewandowski
Paperback: 223 pages
Publisher: New Harbinger Publications; 1 edition (November 2006)
Language: English
ISBN-10: 1572244704
ISBN-13: 978-1572244702
It’s roughly NZ$30 and readily available.

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