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Do Operant Treatments of Chronic Pain Adhere to Precepts of Behavioural Analysis?

Published online by Cambridge University Press:  16 June 2009

Drifa Hardardottir
Affiliation:
The University of Adelaide and The Pain Management Unit, Flinders Medical Centre
Jack E. James
Affiliation:
School of Social Sciences, The Flinders University of South Australia
Neville Owen
Affiliation:
The University of Adelaide

Abstract

Fordyce's (1976) analysis of pain behaviour provides a framework for evaluating the extent to which empirical studies of the operant treatment of chronic pain have adhered to appropriate behaviour–analytic principles. These are the identification of target behaviours and their reinforcing contingencies, the specification of individualised reinforcers to be used in treatment, and the generalisation and maintenance of treatment effects. Twenty-five studies that reported having used an operant approach in the management of chronic pain problems were reviewed. With one exception, none of the studies reported sufficient data to indicate the degree of adherence to behaviour–analytic principles. Until more such data are reported, it will continue to be difficult to determine clearly those factors that contribute to the efficacy of operant approaches to chronic pain management.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 1988

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References

Anderson, T. P., Cole, T. M., Gullickson, G., Hudgens, A. and Roberts, A. H. (1977). Behavior modification of chronic pain: a treatment program by a multidisciplinary team. Clinical Orthopaedics 129, 96100.CrossRefGoogle Scholar
Arakawa, K. (1981). Outpatient pain clinic. Journal of the Kansas Medical Society 82, 292294.Google ScholarPubMed
Block, A. R., Kremer, E. and Gaylor, M. (1980). Behavioral treatment of chronic pain: variables affecting treatment efficacy. Pain 8, 367375.CrossRefGoogle ScholarPubMed
Cairns, D. and Pasino, J. A. (1977). Comparison of verbal reinforcement and feedback in the operant treatment of disability due to chronic low back pain. Behavior Therapy 8, 621630.CrossRefGoogle Scholar
Cairns, D., Thomas, L., Mooney, V. and Pace, J. B. (1976). A comprehensive treatment approach to chronic low back pain. Pain 2, 301308.CrossRefGoogle ScholarPubMed
Chapman, S. L., Brena, S. F. and Bradford, L. A. (1981). Treatment outcome in a chronic pain rehabilitation program. Pain 11, 255268.CrossRefGoogle Scholar
Cinciripini, P. M. and Floreen, A. (1982). An evaluation of a behavioral program for chronic pain. Journal of Behavioral Medicine 5, 375389.CrossRefGoogle ScholarPubMed
De Benedittis, G. (1979). A new strategy for chronic pain control: the multi-modal approach: preliminary results (Part II). Journal of Neurosurgical Sciences 23, 191200.Google ScholarPubMed
Fordyce, W. E. (1974a). Pain viewed as learned behavior. In Advances in Neurology: Vol. 4 Pain, Bonica, J. (Ed.), (pp. 415422). New York: Raven Press.Google Scholar
Fordyce, W. E. (1974b). Treating chronic pain by contingency management. In Bonica, op. cit., pp. 583589.Google Scholar
Fordyce, W. E. (1976). Behavioral Methods for Chronic Pain and Illness. St Louis: Mosby.Google Scholar
Fordyce, W. E., Fowler, R. S. and DeLateur, B. (1968). Case histories and shorter communications: an application of behaviour modification technique to a problem of chronic pain. Behaviour Research and Therapy 6, 105107.CrossRefGoogle Scholar
Fordyce, W. E., Fowler, R. S., Lehmann, J. F., DeLateur, B. J., Sand, P. L. and Trieschmann, R. B. (1973). Operant conditioning in the treatment of chronic pain. Arch. Phys. Med. Rehabil. 54, 399408.Google ScholarPubMed
Fordyce, W. E., Roberts, A. H. and Sternbach, R. A. (1985). The behavioral management of chronic pain: a response to critics. Pain 22, 113125.CrossRefGoogle ScholarPubMed
Fowler, R. S. (1975). Operant therapy for headaches. Headache 15, 6368.CrossRefGoogle ScholarPubMed
Gotestam, G. K. and Mellgren, S. I. (1981). Psychological aspects of the treatment of chronic pain: theoretical considerations and a series of case studies. Tidskrift for den Norske Laegeforening 33, 17671771.Google Scholar
Greenhoot, J. H. and Sternbach, R. A. (1974). Conjoint treatment of chronic pain. In Bonica, op. cit., pp. 595603.Google Scholar
Hammonds, W., Brena, S. F. and Unikel, J. P. (1978). Compensation for work-related injuries and rehabilitation of patients with chronic pain. Southern Medical Journal 71, 664666.CrossRefGoogle ScholarPubMed
Hudgens, A. J. (1979). Family-oriented treatment of chronic pain. Journal of Marital and Family Therapy 5, 6778.CrossRefGoogle Scholar
Keefe, F. J. (1982). Behavioral assessment and treatment of chronic pain: current status and future directions. Journal of Consulting and Clinical Psychology 50, 896911.CrossRefGoogle ScholarPubMed
Khatami, M. and Rush, A. J. (1978). A pilot study of the treatment of outpatients with chronic pain: symptom control, stimulus control and social system intervention. Pain 5, 163172.CrossRefGoogle ScholarPubMed
Khatami, M., Woody, G. and O'Brien, C. (1979). Chronic pain and narcotic addiction: a multitherapeutic approach—a pilot study. Comprehensive Psychiatry 20, 5560.Google Scholar
Latimer, P. R. (1982). External contingency management for chronic pain: critical review of the evidence. American Journal of Psychiatry 139(10), 13081312.Google ScholarPubMed
Linton, S. J. (1982). A critical review of behavioural treatments for chronic benign pain other than headache. British Journal of Clinical Psychology 21, 321337.CrossRefGoogle ScholarPubMed
Linton, S. J. (1986). Behavioral remediation of chronic pain: a status report. Pain 24, 125141.CrossRefGoogle ScholarPubMed
Linton, S. J. and Gotestam, G. K. (1984). A controlled study of the effects of applied relaxation plus operant procedures in the regulation of chronic pain. British Journal of Clinical Psychology 23, 291299.CrossRefGoogle ScholarPubMed
Linton, S. J., Melin, L. and Gotestam, K. G. (1983). Behavioral Analysis of Chronic Pain and its Management. (Research Rep. No. 21). Norway: University of Trondheim, Department of Psychiatry.Google Scholar
Linton, S. J., Melin, L. and Stjernlof, K. (1985). The effects of applied relaxation and operant activity training on chronic pain. Behavioural Psychotherapy 13, 87100.Google Scholar
Nelson, R. O. and Hayes, S. C. (1981). Nature of behavioral assessment. In Behavioral Assessment: A Practical Handbook (2nd ed.), Hersen, M. and Bellack, A. S. (Eds.). New York: Pergamon Press, pp. 337.Google Scholar
Pearce, S. (1983). A review of cognitive-behavioral methods for the treatment of chronic pain. Journal of Psychosomatic Research 27, 431440.CrossRefGoogle Scholar
Rybstein-Blinchik, E. (1979). Effects of different cognitive strategies on chronic pain experience. Journal of Behavioral Medicine 2, 93101.CrossRefGoogle ScholarPubMed
Sanders, S. H. (1979). Behavioral assessment and treatment of clinical pain. In Progress in Behaviour Modification. Vol. 8. Hersen, M., Eisler, R. and Miller, P. (Eds.). New York: Academic Press, pp. 249291.Google Scholar
Sanders, S. H. (1983). Component analysis of a behavioral treatment program for chronic low-back pain. Behavior Therapy 14, 697705.CrossRefGoogle Scholar
Seres, J. L. and Newman, R. I. (1976). Results of treatment of chronic low-back pain at the Portland Pain Center. Journal of Neurosurgery 45, 3236.CrossRefGoogle ScholarPubMed
Swanson, D. W., Maruta, T. and Swenson, W. M. (1979). Results of behavior modification to the treatment of chronic pain. Psychosomatic Medicine 41, 5561.CrossRefGoogle Scholar
Swanson, D. W., Swensen, W. M., Maruta, T. and McPhee, M. C. (1976). Program for managing chronic pain. I. Program description and charcteristics of patients. Mayo Clinic Proceedings 51, 401408.Google Scholar
Timming, R. C., Cayner, J. J., Malec, J. F., Harvey, F. R., Schwettmann, R. S. and Chosey, J. (1980). Inpatient treatment program for chronic pain. Wisconsin Medical Journal 79, 2336.Google Scholar
Turk, D. C., Meichenbaum, D. and Genest, M. (1983). Pain and Behavioral Medicine: A Cognitive-Behavioral Perspective. New York: Guilford Press.Google Scholar
Tyre, T. E. and Anderson, D. L. (1981). Inpatient management of the chronic pain patient: a one-year follow-up study. The Journal of Family Practice 12, 819827.Google Scholar
Vrni, J. W., Bessman, C. A., Russo, D. C. and Cataldo, M. F. (1980). Behavioral management of chronic pain in children: case study. Archives of Physical Medicine and Rehabilitation 61, 375378.Google Scholar
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