From disaster to recovery: single session therapy for pain

From disaster to recovery: single session therapy for pain

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So far we have mainly dealt with how to integrate Single Session Therapy into professional practice. In this article, however, we will deepen through a study carried out on the catastrophication of pain: which problems can be treated effectively through a single therapy session, also giving people the opportunity to receive treatment quickly and with reduced costs.

Why are we looking at this particular study?

From investigations conducted in 2014 by Darnall et al. of the Stanford University School of Medicine in Palo Alto, chronic pain is a phenomenon that has a huge impact on the quality of life of more than 100 million people in the United States and more than 1 billion people worldwide.

The resulting economic burden is equally astounding. In the United States alone, annual costs of combined treatment and related disability exceed half a trillion dollars.

The need, therefore, to treat the factors that maintain and worsen the pain experience to reduce human suffering, as well as to reduce the costs of pain treatment and chronic debilitation are clearly a priority.

But let’s go into more detail!

 

What does this problem consist of?

Pain catastrophization is defined as a pattern of negative cognitive and emotional responses to actual or anticipated pain that maintains chronic pain and undermines medical treatments.

Chronic pain is also associated with a number of negative phenomena including: increased pain intensity, affective affliction, muscle and joint pain, muscle tension at rest, pain-related disability, poor response to various pain treatments including surgery and a increased use and abuse of opioids.

What did the pilot study focus on?

This study tested the feasibility of the Single Session intervention on the catastrophication of pain which generally involves multiple sessions of cognitive behavioral therapy. In this case, to provide effective treatment, a 2 hour single session class entitled “From Catastrophizing to Recovery” (FCR) was developed aimed at the exclusive treatment of Pain Catastrophizing (PC).

The aim of the study was to determine:

  1. the feasibility of the FCR;
  2. participants’ assessments for acceptance, understanding, satisfaction and the likelihood of using the information learned;
  3. the preliminary effectiveness of the FCR to reduce the PC.

 

What do the results highlight?

This prospective study involved 76 patients who received outpatient care at the Stanford Pain Management Center and who attended the class as free treatment. Of all participants who completed and returned The Pain Catastrophizing Scale (PCS), administered at class check-in (baseline) and 2 and 4 weeks after treatment, 57 with a mean age of 50 were included in the study. ,2 years.

The highly positive results of the post-class anonymous survey suggested that the FCR was well received by the participants and that most of them felt that the class offered valuable information that they could integrate into their lives.

Another interesting aspect concerned the reduction of CP at 2 and 4 weeks after treatment and the preliminary efficacy of the Single Session surgery.

Other results suggest that the positive effect of treatment may strengthen over time: available data from participants who completed both follow-up assessments suggest that CP continues to decline for 4 weeks after treatment.

Finally, the results obtained on participants diagnosed with anxiety or depression suggest that short treatment is also effective for those who present with these symptoms. However, this last data, given the small sample size, underlines the need to better characterize the role of anxiety and depressive disorders in adherence and longitudinal results.

 

Conclusions

To conclude, the results highlighted above are particularly promising as they allow us to state that the possibility of effectively reducing the CP through a Single Session intervention can greatly expand access to efficient and low-cost treatments.

Recall that PC treatment involves multiple visits to a psychologist, imposing a considerable burden on patients in terms of time, travel and costs. These burdens can be an obstacle to treatment, leaving many patients without treatment.

Lastly, previous studies have shown that the initial reduction in CP is associated with a better response to subsequent pain treatment modalities. Consequently, this highlights the specific value of early administration of FCR treatment in the pain management process. However, future studies may examine whether the brief intervention is able to optimize the response to multidisciplinary pain treatment or other specific modalities (eg physical therapy).

 

Angelica Giannetti

Psychologist, Psychotherapist

Italian Center team

for Single Session Therapy

Bibliography

Darnall, B. D., Sturgeon, J. A., Kao, M. C., Hah, J. M. & Mackey, S. C. (2014). From Catastrophizing to Recovery: a pilot study of a single-session treatment for pain catastrophizing. Journal of Pain Research, 7, 219-226. doi: 10.2147 / JPR.S62329

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