Psychology and Health

101614

Psychology and Health

Student name

Student ID

Spring 2020

Describe and Explain the Psychological Intervention that appears to be most effective in Treating or Managing Symptoms of Chronic Pain. Why is this approach more effective than others?

Chronic pain is an illness that is characterized by continuous pain that normally goes beyond 12 weeks of pain or pain that persistently lasts beyond the expected period for healing. Chronic pain may be caused by idiopathic, disease-related, or post-injury conditions. The prevalence for chronic pain range differently concerning community surveys; for example (musculoskeletal pain: 4-40%; headache: 8-83%; back pain: 14-24%; abdominal pain: 4-53%), this condition is generally higher in girls and increases with age (Hylands, Duarte, & Raphael, 2017). Further, research was done by Cohen, Vase, & Hooten (2021), revealed that over 100 million Americans are suffering from chronic disease, which is cause comes with symptoms of depression, anxiety, and chronic stress. This condition affects the body’s healing ability, prompting further pain, thereby effective the body and mind. One of the typical treatment options for chronic pain is psychological intervention. From this perspective, CBT appears to be the appropriate, effective psychotherapeutic intervention in treating the pain. Another is the use of drug therapy which has been found to relieve the pain with most patients opting for over-the counter treatment. Therefore, this report will discuss the medical treatment of chronic disease and then address the CBT approach for managing chronic pain. For instance, Sheikh, Brandt, Vinh & Elon (2021) argued that anti-inflammatory drugs NSAIDs are the typical treatment for chronic pain.

The most common treatment for chronic pain is nonsteroidal anti-inflammatory drugs that are more effective than the placebo for osteoarthritis pain. According to Wasef et al. (2020), just a few classes of drugs have been approved to be treating chronic pain. Currently, the typical treatment used in managing the condition has been provided for the treatment of chronic pain; however, anti-inflammatory is the most common drug for chronic pain as it is connected with other illnesses. For example, paracetamol relieves patients of osteoarthritis; however, it’s less effective than NSAIDs. Further, if paracetamol is taken in low dosage, the effects can be so adverse than placebo; an overdose can cause the risk of liver toxicity (hepatotoxicity). Therefore, anti-inflammatory is more effective than paracetamol and have been used since the 1970s (Roper et al., 2021). The drug tent to act actively within the body within the nervous body, and it can cause negative effects within the digestive system, which can result in serious bleeding. Therefore, to reduce these dosage risks, NSAIDs have been improved to reduce the adverse effects within the lower dosage and the lower dosage to a desirable dosage, thus increasing the anti-inflammatory characteristics; the COX-2 inhibitors. Moreover, another typical treatment for chronic pain is Opioids, which concerns the potential abuse with cancer patients. Therefore, the treatment might not be more effective in treating chronic pain due to the risks involved in using the typical treatment for managing chronic, including the lower, higher dosage and the risk health implications involved. This uncertainty calls for psychological interventions like CBT to treat chronic diseases.

Cognitive-behavioral therapy is a psychological intervention for treating chronic pain that many studies have supported. The therapy is measured based on the parameters of pain, symptoms, disability, and functionality of nerves, plus the physical patient confidence regarding the pain before and after the therapy was administered. According to Sil et al. (2021), the administration of CBT in chronic pain patients consists of three basic therapeutic approaches, including patient’s education based on the related expected goals of chronic pain therapy intervention, assisting the patient’s self-regulation in response to stress with behavioral management approaches, and managing the maladaptive thinking process in line with cognitive coping techniques. These three CBT therapeutic components aim to independently help self-regulation and efficiency improve pain management (Van et al., 2021). The administration of CBT to chronic pain patients is based on the theory of cognitive thinking; negative thought patterns that contribute to the higher level of stress, depression, and anxiety can be managed by teaching the patient how to challenge negative thoughts. Åkerblom et al. (2021) suggests that teachings majorly aim to form new ways of thinking and promote decreased levels of pain, anxiety, and depression. Achieving this will meet the goal of cognitive-behavioral therapy, which is to change the way a patient thinks about the pain so that the body and mind can respond better to pain. Therefore, through the application of Cognitive theory, a chronic patient is advised to look for a cognitive therapist to get administered with the skill to learn how to replace the negative thoughts patterns with more positive, realistic and harmless thoughts that might increase the level of pain.

The effectiveness of cognitive-behavioral therapy highly relies on previous studies aiming to prove its application and effectiveness depending on the response of the selected chronic pain patients. According to Kuner, and Kuner, (2021) the derivation of chronic pain from neural pains makes it complex to understand the effects of chronic pain, pain management, and cognitive behavioral therapy. In another study, Åkerblom et al. (2021) found that cognitive-behavioral therapy is effective because of how it alters an individual’s perception about pain. Gerdle et al. (2021) highlighted that selected groups used intervention and a control group, linking the effectiveness of cognitive behavioral therapy to being more active as a therapy strategy. Additionally, Kremer et al. (2021) conducted research to relate chronic pain and depression which showed the distinctive effects that depression alleviated in chronic pain. Finally, Van et al. (2021) agree with the assertion that cognitive behavioral therapy is effective in the control of chronic pain as it helps individuals to adjust gradually using physical activity and other improvements. Therefore, a majority of previous studies point towards the effectiveness of cognitive-behavioral therapy for chronic pain.

By contrast, Kupari et al. (2021) found the cognitive-behavioral therapy to be ineffective in addressing chronic pain. In another study, Wasef et al. (2020) summarized the findings of a study to mention that cognitive-behavioral therapy was only significant in affecting mood and not addressing chronic pain. Grace et al. (2021) provide insight from a qualitative study of chronic patients, including those who had gone through surgery, finding a need to supplement cognitive-behavioral therapy with other pain regulation medical interventions. In a different study, Huck et al. (2021) observed that cognitive-behavioral therapy was not a superior strategy for addressing pain and mood outcomes. While this is still under contention, Pardos-Gascón et al. (2021) added that cognitive-behavioral therapy has negligible benefits for disability posttreatment. Heapy et al. (2021) found that the older group with weak body functions showed no change after the intervention after 3-6 months. Although most chronic patients benefit from CBT, not everyone will respond positively; thus, it can go either way. In the end, a lot of these studies present some element of weakness in cognitive-behavioral therapy as it relates to the management of chronic pain.

The results obtained from the comparison of various studies indicate the general effectiveness of cognitive-behavioral therapy for people with chronic pain. While some weaknesses are pointed out, it is worth noting that they only relate to single aspects of the approach. cognitive-behavioral therapy is the current prevailing psychological approach for people with chronic pain. According to Phelps et al. (2021), looking at physical functionality, pain intensity, stress pressure, level of tiredness, and disability sheds light on the need to continue using cognitive-behavioral therapy. The studies concluded the cognitive-behavioral techniques mixed with other therapy methods increase the physical functionality of the patient. Besides, Åkerblom et al. (2021) found CBT intervention to effectively alleviate stress in younger people after 3-6 months of intervention. The effectiveness of the CBT can be answered by answering how effective the intervention works. According to the research conducted by Pardos-Gascón et al. (2021), CBT is the most effective treatment intervention for those trying to cope with depression and anxiety. According to Kremer et al. (2021) the research confirmed that CBT alone is 50-75% effective for overcoming depression and anxiety after 5-15 modules. Therefore, CBT is the most effective psychotherapy to treat pain because it rapidly helps patients identify and cope with specific challenges; it has allowed fewer sessions than other types of therapy and it is conducted in a more structured manner.

To sum up, this report has comprehensively discussed chronic pain and Cognitive-behavioral therapy as its best psychological intervention. The cognitive-behavioral therapy intervention for chronic pain delivered in the method of non-modern CBT, Phone-based CBT, learning how to cope with the therapy skills, and CBT- based physical intervention. According to the discussion, cognitive behavioral-based self-control is the most effective approach and can be applied in the management of chronic pain. Based on this report, CBT provides greater benefits for improving physical function, especially when combined with other forms of modalities in treating chronic pain.

References

Åkerblom, S., Perrin, S., Fischer, M. R., & McCracken, L. M. (2021). Predictors and mediators of outcome in cognitive behavioral therapy for chronic pain: the contributions of psychological flexibility. Journal of behavioral medicine, 44(1), 111-122. https://doi.org/10.1007/s10865-020-00168-9

Åkerblom, S., Cervin, M., Perrin, S., Rivano Fischer, M., Gerdle, B., & McCracken, L. M. (2021). A network analysis of clinical variables in chronic pain: a study from the Swedish quality registry for pain rehabilitation (SQRP). Pain Medicine. https://doi.org/10.1093/pm/pnaa473

Cohen, S. P., Vase, L., & Hooten, W. M. (2021). Chronic pain: an update on burden, best practices, and new advances. The Lancet, 397(10289), 2082-2097. https://doi.org/10.1016/s0140-6736(21)00393-7

Grace, P. M., Tawfik, V. L., Svensson, C. I., Burton, M. D., Loggia, M. L., & Hutchinson, M. R. (2021). The neuroimmunology of chronic pain: from rodents to humans. Journal of Neuroscience, 41(5), 855-865. https://doi.org/10.1523/jneurosci.1650-20.2020

Gerdle, B., Fischer, M. R., Cervin, M., & Ringqvist, Å. (2021). Spreading of pain in patients with chronic pain is related to pain duration and clinical presentation and weakly associated with outcomes of interdisciplinary pain rehabilitation: a cohort study from the Swedish Quality Registry for Pain Rehabilitation (SQRP). Journal of Pain Research, 14, 173. https://doi.org/10.2147/jpr.s288638

Hylands-White, N., Duarte, R. V., & Raphael, J. H. (2017). An overview of treatment approaches for chronic pain management. Rheumatology international, 37(1), 29-42. https://doi.org/10.1007/s00296-016-3481-8

Heapy, A. A., Tankha, H., Higgins, D. M., Driscoll, M., LaChappelle, K. M., Goulet, J. L., … & Krein, S. L. (2021). Incorporating walking into cognitive behavioral therapy for chronic pain: safety and effectiveness of a personalized walking intervention. Journal of Behavioral Medicine, 44(2), 260-269. https://doi.org/10.1007/s10865-020-00193-8

Huck, N. A., Siliezar-Doyle, J., Haight, E. S., Ishida, R., Forman, T. E., Wu, S., … & Tawfik, V. L. (2021). Temporal contribution of myeloid-lineage TLR4 to the transition to chronic pain: A focus on sex differences. Journal of Neuroscience, 41(19), 4349-4365. https://doi.org/10.1523/jneurosci.1940-20.2021

Kremer, M., Becker, L. J., Barrot, M., & Yalcin, I. (2021). How to study anxiety and depression in rodent models of chronic pain?. European Journal of Neuroscience, 53(1), 236-270. https://doi.org/10.1111/ejn.14686

Kupari, J., Usoskin, D., Parisien, M., Lou, D., Hu, Y., Fatt, M., … & Ernfors, P. (2021). Single cell transcriptomics of primate sensory neurons identifies cell types associated with chronic pain. Nature communications, 12(1), 1-15. https://doi.org/10.1038/s41467-021-21725-z

Kuner, R., & Kuner, T. (2021). Cellular circuits in the brain and their modulation in acute and chronic pain. Physiological Reviews, 101(1), 213-258. https://doi.org/10.1152/physrev.00040.2019

Pardos-Gascón, E. M., Narambuena, L., Leal-Costa, C., Ramos-Morcillo, A. J., Ruzafa-Martínez, M., & van-der Hofstadt Román, C. J. (2021). Psychological Therapy in Chronic Pain: Differential Efficacy between Mindfulness-Based Cognitive Therapy and Cognitive Behavioral Therapy. Journal of Clinical Medicine, 10(16), 3544. https://doi.org/10.3390/jcm10163544

Phelps, C. E., Navratilova, E., & Porreca, F. (2021). Cognition in the chronic pain experience: preclinical insights. Trends in Cognitive Sciences. https://doi.org/10.1016/j.tics.2021.01.001

Sheikh, F., Brandt, N., Vinh, D., & Elon, R. D. (2021). Management of Chronic Pain in Nursing Homes: Navigating Challenges to Improve Person-Centered Care. Journal of the American Medical Directors Association, 22(6), 1199-1205. https://doi.org/10.1016/j.jamda.2020.12.029

Sil, S., Woodward, K. E., Johnson, Y. L., Dampier, C., & Cohen, L. L. (2021). Parental psychosocial distress in pediatric sickle cell disease and chronic pain. Journal of Pediatric Psychology, 46(5), 557-569. https://doi.org/10.1093/jpepsy/jsaa130

Van Agteren, J., Iasiello, M., Lo, L., Bartholomaeus, J., Kopsaftis, Z., Carey, M., & Kyrios, M. (2021). A systematic review and meta-analysis of psychological interventions to improve mental wellbeing. Nature Human Behaviour, 1-22. https://doi.org/10.1038/s41562-021-01093-w

Wasef, S., Mir, S., Ryan, C., Waseem, R., Bellingham, G., Kashgari, A., … & Chung, F. (2021). Treatment for patients with sleep apnea on opioids for chronic pain: results of the OpSafe trial. Journal of Clinical Sleep Medicine, 17(4), 819-824. https://doi.org/10.5664/jcsm.9064