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Pain management: CBT or a CBT perspective?


There is a bit of a misconception about CBT for chronic pain management. Some people think that it consists only of cognitive behavioural therapy as it is used for depression or other mental health problems. And this often means people think mainly of cognitive therapy as conducted by clinical psychologists – meaning that clinicians from other professions can lack confidence to be involved.

I thought today I’d outline the views of one of the ‘founding fathers’ of the cognitive behavioural perspective for chronic pain, Dennis Turk. In a paper by Turk and colleagues Kimberley Swanson from University of Washington School of Medicine, Department of Anesthesiology, Seattle, and Eldon Tunk, Emeritus Professor in the Department of Psychiatry and Behavioural Neurosciences, McMaster University, Ontario, the psychological models used to conceptualize chronic pain—psychodynamic, behavioural (respondent and operant), and cognitive-behavioural are described. They also briefly review treatments based on these models.

One of the main points of this editorial paper is, in their words, ‘to differentiate the cognitive-behavioural perspective from cognitive and behavioural techniques and suggest that the perspective on the role of patients’ beliefs, attitudes, and expectations in the maintenance and exacerbation of symptoms are more important than the specific techniques.’ (more…)