Managing chronic pain: A CBT approach

Scintillating title, but accurate! This workbook is a skinny one (just 83 pages), and it’s not from New Harbinger Publications! It’s actually from the esteemed Oxford University Press, and is one of quite a few self-help books that this publisher produces in the series ‘Treatments that work’. Written by John Otis, who is an Associate Professor of Psychology and Psychiatry at Boston University, this book has to be the leanest and simplest version of all the workbooks I’ve seen. It’s also the only one I’ve found so far that has an accompanying therapist manual, which is handy – however, for the cost-per-page, this has to be the most expensive one of the workbooks I’ve found too!

The chapters in this workbook include:
1. Education on chronic pain
2. Theories of pain and diaphragmatic breathing
3. Progressive muscle relaxation and visual imagery
4. Automatic thoughts and pain
5. Cognitive restructuring
6. Stress management
7. Time-based pacing
8. Pleasant activity scheduling
9. Anger management
10. Sleep hygiene
11. Relapse prevention

So you can see, it covers the majority of fundamental self management skills for chronic pain, and while it doesn’t overwhelm with vast amounts of information, it certainly contains the critical elements.

The therapist manual provides some additional supporting information and references to further readings, and also provides ways to vary or extend the skills and strategies provided in the workbook.

What I liked about this workbook is its brevity and clarity. It doesn’t provide a huge amount of information, and it doesn’t go into detail – it’s clearly meant to be used alongside input from a therapist. It has plenty of space for individualising aspects, including a number of very clear worksheets, and specific learning activities for between each clinic-based session. I also liked the layout which is very simple and clean, and although it doesn’t have diagrams, it does have good examples and bullet-point summaries.

I also liked the specific chapter on relapse prevention, something that can be problematic for many.

What I thought wasn’t quite so helpful is that this workbook is definitely one you would need to work through with a client. While there is less detail in it, so non-readers would probably cope better with it than the other workbooks I’ve reviewed, there is still a lot of reading and writing to do. It assumes the person is ‘ready’ to take action, rather than ambivalent, and it assumes also that the person can and will integrate the skills – and then go ahead with ‘normal life’. It doesn’t focus on long-term ‘life’ goals, and it doesn’t emphasise reconceptualising yourself (the client) as a person rather than a patient.

Overall, I think this book is a real asset for therapists seeking a summary book they could provide to clients to refresh their memories after having completed individual or group sessions. While it’s not detailed, it does emphasise the things that seem to be associated with improved function – especially the ‘homework’ aspect. It would be best paired with a functional approach, and like every other workbook I’ve seen so far, it doesn’t even touch momentarily on returning to work and whether these skills can be transferable to the workplace. It also focuses on control and containment rather than acceptance and mindfulness – so for some people it might not be the best approach.

Managing Chronic Pain: A Cognitive-Behavioral Therapy Approach Workbook (Treatments That Work) (Paperback)
by John Otis (Author)
Paperback: 96 pages
Publisher: Oxford University Press, USA; 1 Workbook edition (September 24, 2007)
Language: English
ISBN-10: 0195329171
ISBN-13: 978-0195329179

Managing Chronic Pain: A Cognitive-Behavioral Therapy Approach Therapist Guide (Treatments That Work) (Paperback)
by John D. Otis (Author)
Paperback: 128 pages
Publisher: Oxford University Press, USA; 1 edition (September 24, 2007)
Language: English
ISBN-10: 0195329163
ISBN-13: 978-0195329162

It’s about $80.00 for the therapists book, and about $40 for the workbook – not cheap, but discounts for multiple purchases may apply if you ask nicely!

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