EVALUATION OF A COGNITIVE-BEHAVIORAL PROGRAM FOR REHABILITATING PATIENTS WITH CHRONIC PAIN

The aim of this prospective longitudinal study was to evaluate an inpa tient cognitive behavioural pain management programme for patients wit h chronic pain. A physical and psychological assessment of patients wa s carried out before and after treatment, and at one and six months fo llow up. A total of 212 patients with disabling chronic pain of mean d uration 10.5 years, for whom no further medical or psychiatric treatme nt was appropriate or available, were admitted, their mean age was 50 years and 65% were women. The four week programme was delivered by a m ultidisciplinary team of two psychologists, a physiotherapist, nurse, occupational therapist and anaesthetist. The main components of therap y included: education, teaching behavioural and cognitive skills, a st retch and exercise programme, medication reduction, goal setting and p acing, and relaxation training. Outcome measures assessed quality of l ife, physical performance (for example walking speed), pain intensity and distress, depression severity and confidence. Assessment immediate ly after treatment revealed significant improvements on all measures. Improvements were well maintained at six month follow up. Cognitive be havioural treatment can be of value in improving the day-to-day functi oning and quality of life of patients with chronic pain for whom conve ntional medical treatments have apparently failed.