Comparing Psychological Approaches for the Management of Chronic Pain

This essay provides a comprehensive overview of chronic pain from a biopsychological perspective, emphasizing the role of psychological interventions in its management. It contrasts various treatment options, including medication and injections, with psychological approaches such as operant behavioral therapy, cognitive-behavioral therapy (CBT), and mindfulness-based stress reduction. The essay highlights the effectiveness of these psychological methods, supported by research findings, in improving patient outcomes and quality of life. It argues that psychological interventions are often more effective than traditional treatments, particularly when considering the limitations and potential side effects of medication. The discussion includes the importance of behavioral change, self-management, and cognitive restructuring in managing chronic pain, concluding with a strong recommendation for the use of psychological interventions as a primary approach, especially for patients who may not be suitable candidates for medical or pharmacological treatments. The essay also refers to studies that support the efficacy of tailored behavioral therapy and the relevance of acceptance and value-based actions in reducing suffering and disability associated with chronic pain.

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Name
Institution

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Introduction
From a biopsychological perspective, chronic pain is a complex, multifaceted experience
that emerges from the dynamic interplay of the thoughts, behaviors, physiological state,
emotions, as well as socio-cultural influences of a patient. Rather than viewing chronic pain as a
disease, the biopsychological perspective views chronic pain as an illness. As such, it recognizes
that chronic pain is a subjective experience and that its treatment methods are aimed at managing
rather than curing it. Psychological approaches that are used in managing the illness and which
will be discussed in this essay try to achieve behavioral change, enhance self-management, and
cognitive change. They include operant behavioral approach, cognitive-behavioral therapy, and
mindfulness-based stress reduction. The paper will first explain typical treatment options for the
illness before arguing why psychological approaches are more preferred.
Typical Treatment Options
Variety of options exist for treating chronic pain. Such an option is the medication that
comprises of both oral and topical therapies. Oral medications are those that are taken through
the mouth and which may include opioids, acetaminophen, and nonsteroidal anti-inflammatory
drugs. Nonetheless, other medications are applied on the skin either as a cream or an ointment
(Jamison, et al., 2014). Besides, other options may assists the patient manage the pain, and they
do not require medication. Such approaches are effective in relieving pain and reducing the
medications that are necessary for controlling the pain. Such an example is exercises which are
best performed under the guidance of a physical therapist. Alternative modalities such as
acupuncture are also available to assist reduce certain types of pain. Finally, there are treatment

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options that require injections into or around the spinal region. The method entails relatively
superficial injections to the muscles experiencing pain, commonly known as trigger point
injections. With this type of approach, several procedures may include epidural injections for the
type of pain involving the legs, arm, back, and neck. It may also include facet injections that are
injected into the joints that allow neck movement and back injections for pain mainly
experienced on the arms and legs as a result of Complex Regional Pain Syndrome (Keefe, et al.,
2013). Typical treatments are not effective compared to psychological interventions. This is
because high levels of pain still persist on the patient despite being given medications.
Nonetheless, methods such as medication may not apply to patients that do not qualify as
candidates for treatment.
Psychological Approaches
The first approach is the behavioral approach. This type of intervention tries to reward
healthy behaviors and at the same time ignore the unhealthy ones. Behavioral approach
positively reinforces healthy behaviors. Such behaviors include increasing physical activity,
reducing pain intensity, sick leave behavior, as well as symptoms associated with disability.
Other behavioral approaches include relaxation exercises that reduce the mind of painful stimuli.
The second type of psychological approach is cognitive behavior therapy (Gatchel, et al., 2014).
The approach seeks to psycho-educate the patients regarding their conditions as well as the
factors that are likely to cause the pain to increase, including the change maladaptive behavior
and thoughts. Nonetheless, this technique also champions problem-solving, the scheduling of
pleasant events, as well as cognitive reframing. The patients take an active role in the treatment
of chronic pain by setting achievable and realistic goals (Sturgeon, 2014). The third approach is
the mindfulness-based approach. An example of a mindfulness-based approach is the

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Acceptance and Commitment Therapy (ACT). ACT applies the mindfulness-based approach
which teaches the patients the prerequisite psychological skills that are needed to combat
thoughts and painful feelings.
Pike, Hearn & de C Williams, (2016) conducted a meta-analysis as well as a systematic
review to determine the effectiveness of psychological therapies for chronic pain. In this study,
the authors used previous systematic reviews. The method used to collect information was the
search strategy, whereby previous work was used for the study. The studies used were primarily
from Europe with two from the United States. There were 18 trials, all comprising of 2253
participants. Of the 18 studies, 15 of them assessed the use of health care as medication intake.
The purpose of the treatment was to improve the overall function, and from continuous data, it
was evident that there was a reduction in the use of health care. The research notes that
psychological interventions are more effective compared to active treatment. Nonetheless,
Bérubé, et al. (2017) researched to determine the impact of psychological interventions in the
prevention of chronic pain among adults. The method used in this study was randomized
controlled trials. The research involved adults aged above 18 years who had not experienced
non-cancer pain for the past three months. The comparators of this study included standard
treatment and other active treatment approaches. Effectively, the authors note that psychological
approaches of treating chronic pain were effective in the long-run compared to other treatment
methods.
Also, a study conducted by Smith & Torrance, (2011) to examine current evidence in
guiding the management of chronic disease notes that a tailored behavioral therapy of managing
musculoskeletal pain is a more superior approach. The method used for the study was a
randomized controlled trial. Considering these three studies, the authors agree that psychological

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interventions are more effective compared to other medications such as the use of opioids. Use of
this drug in managing nonmalignant pain, for instance, has resulted in increased concerns due to
fears of addiction and misuse. The three authors agree that acceptance, value-based actions,
collectively known as psychological interventions are relevant and effective in reducing
suffering and disability.
Other approaches to managing chronic pain such as taking medicine do not eliminate
chronic pain. The objective of taking medicine is to reduce pain to levels that allow an individual
to enhance their quality of life as well as functioning. However, the use of pain medication does
not work for all individuals with chronic pain. Besides, they only assist reduce pain by
approximately a third to a half. Such medications have side effects which may deteriorate the
health condition of the patient. According to existing literature, pain disorders such as headaches
are more responsive to certain psychological interventions that comprise of biofeedback, and this
approach of treatment is a more standard method of pain management (Eccleston, Morley &
Williams, 2013). Psychological interventions are more effective and are considered first-line
treatment methods to managing chronic pain especially if the patient is not suitable for medical
and pharmacological treatment such as through the use of chronic opioid therapy. According to
existing evidence base as well as the modern pain theory, rather than having treatment of last
resort, psychological interventions should be part of managing chronic pain.
Conclusion
Summing it up, there is enough evidence to show that compared to other approaches of
managing chronic pain, psychological intervention are more efficient in reducing symptoms of
chronic pain. This approach works by focusing on the emotional distress that is associated with

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chronic pain. Additionally, it also provides training along with education on how to use cognitive
as well as behavioral techniques that are capable of reducing perceptions of pain and the
associated disability. Psychological interventions are more effective compared to other
approaches because biological treatments are inadequate and as a result, high levels of pain
persist irrespective using advanced anesthetic, surgical, as well as anesthetic treatments.

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References
Bérubé, M., Gélinas, C., Choinière, M., Feeley, N., Martorella, G., Parent, S., & Streiner, D. L.
(2017). The effect of psychological interventions on the prevention of chronic pain in
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Gatchel, R. J., McGeary, D. D., McGeary, C. A., & Lippe, B. (2014). Interdisciplinary chronic
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Smith, B. H., & Torrance, N. (2011). Management of chronic pain in primary care. Current
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