Persistent Pain: Psychosocial Assessment and Intervention (Current Management of Pain, 2)

Chronic and persistent pain, which is a problem for the individual who suffers and the society that has to deal with it, has become increasingly appreciated. Over the last three decades, several books and journals have been specifically devoted to the topic of pain, especially chronic and persistent pain. It has been increasingly recognized that chronic and persistent pain, unlike acute pain, involves significant psychosocial factors and requires treatment strategies that deal with these issues. All measurements and factors that affect improvement seem to be in the psychosocial area rather than the medical/ biological/physical areas. Psychosocial conveys the importance of the environmental and interpersonal factors of the patient's functioning. The writing of this book has brought together some of the leading researchers and clinicians in the area of managing the patient with chronic pain. The authors express their opinions based on experience and review of the literature available to date. Each of the chapters focuses on an important element of the assessment and/or treatment intervention utilized for the individual with chronic pain. The concluding chapter summarizes the status of the assessment and treatment strategies for those patients. The pain center/clinic is in the stage of transition. It has come a long way since chronic pain was a nonexistent entity and patients with difficult pain problems did not receive well-deserved attention or were lost in the busy practices of vari­ ous specialty clinics. Thirty-five years ahead of the rest of us, John]. Bonica was the first physician who had a clear vision of a pain center's potential. Twenty years later, in response to loud public demands for relief of chronic pain, this idea was put into practice by a number of others on a somewhat larger scale. A team of specialists from various disciplines, trained in the management of chronic pain, now offer approaches ranging from simple outpatient care to inpatient hospital­ ization for comprehensive care including drug detoxification, behavior modi­ fication, and total rehabilitation of these patients. Hospitals have entered this arena with renewed enthusiasm. The pain center/clinic is now an established, ac­ cepted, and expanding method of providing care for chronic pain patients. The chapters in this book are based on examples of multidisciplinary projects that deal comprehensively with management of chronic pain. Aimed primarily at the pain center/clinic in the university hospital setting, this book ranges from his­ torical perspectives to current pain centers with their less orthodox methods of re­ lieving chronic pain to the future of algology as a specialty. Front Matter....Pages i-xi A Rationale and Format for Psychosocial Evaluation....Pages 1-22 Cognitive Deficits....Pages 23-41 Marital Maladjustment and the Family....Pages 43-59 Assessment of Behaviors....Pages 61-73 Vocational Assessment....Pages 75-91 Depression....Pages 93-101 Chronic Pain and the Injured Worker....Pages 103-115 Counseling the Patient with Chronic Pain—The Role of the Physician....Pages 117-132 Cognitive Therapy: An Overview of Theory and Practice....Pages 133-161 Relaxation, Biofeedback, and Hypnosis in the Management of Pain....Pages 163-188 Psychotherapy....Pages 189-194 Perspectives in Assessment and Treatment of the Chronic Pain Patient....Pages 195-197 Back Matter....Pages 199-208 Edited By Jawahar N. Ghia. Includes Bibliographies And Index.