Eric K. Willmarth – Behavioral Treatment of Chronic Pain: Evidence-Based Techniques to Move People from Hurt to Hope

Outline

Pain

• Acute vs. chronic pain
• Emotional aspect of pain
  • More problematic than physical aspect
  • Anxiety, fear, catastrophizing
• ACE (Adverse Childhood Experiences)
  • Study and link to pain
• Chronic pain onset: Physical & emotional
• Pain vs. suffering
• Impact of pain
  • Prevalence
  • Societal costs
• Chronic pain cycle
  • Psychological
  • Physical
• Factors that impact pain
  • Physical, thought, emotions, behaviors
  • Social interactions
• Suicidality and chronic pain

Opioids

• Scope of the problem
• The “painkiller” myth
  • Not effective pain relief
• Medication assisted treatment
  • Methadone
  • Buprenorphine (Suboxone)
  • Naltrexone injection (Vivitrol)
• Risks
  • Men, women, elderly

Assessment

• Pain experience factors
  • Psychological
  • Behavioral
  • Social
  • Physical
• 5 E’s of pain interview
• Self-report measures
• Impact of pain

Treatment

• Treatment options
  • Medication
  • Invasive
  • Non-invasive
• CDC guidelines
  • Behavioral treatment first
  • Importance of therapeutic relationship
• Mindfulness
  • Powerful evidence-based interventions
• Motivational interviewing
  • Proven techniques to move toward behavior change
• Goal-setting
  • SMART goals
  • Matching goals with client values
• CBT tools
  • Automatic negative thoughts
  • Thought distortions
  • ABC worksheet
  • Decatastrophizing
• Additional behavioral treatment tools
  • Breathing
  • Imagery
  • Pleasant activities
  • Progressive muscle relaxation
  • Anger management
  • Time-based pacing
  • Stress management
  • Sleep hygiene

Research limitations and risks of psychotherapeutic approaches