Library
APS Bulletin • Volume 16, Number 1, Winter 2006
Resource Reviews
John D. Loeser, MD, Department Editor
Cognitive Therapy for Chronic Pain: A Step-By-Step Guide
Reviewed by Joan M. Romano, PhD
Beverly E. Thorn, PhD, New York, Guilford Publications, 2004. Soft cover, 278 pages, ISBN 1-57230-979-2, $35.
This book presents in clear, easy-to-understand language, a roadmap for the conduct of cognitive therapy in patients suffering from chronic pain. The intended audience is providers who may have some mental health background not necessarily in cognitive therapy who work with patients with chronic pain, and mental health providers who may be conversant with cognitive therapy methods but have not yet applied them to chronic pain patients. Both groups should find this a valuable addition to their library of treatment manuals for its clarity, ease of use, and grounding in both the theory and the empirical research foundation for this type of treatment and its application to pain. Thorn is a leading expert in the area, having conducted extensive research on cognitive and behavioral aspects of chronic pain, and one of the major strengths of this book is its validation in research and empirically supported practice.
The introductory sections provide a succinct but comprehensive overview of the rationale for cognitive approaches, as well as of the research literature and assessment methods relevant to understanding and applying cognitive therapy to chronic pain. Succeeding sections are aimed at providing a detailed therapist manual for conducting group cognitive therapy. This is one of the most attractive features of this book. The detailed outlines of how to conduct this therapy are clear, well-thought out, and accompanied by worksheets, handouts, and assignments, making the job of the therapist much simpler. Just having all the instruments for evaluation and treatment in one source is worth the price of the book. The sequencing of modules within the treatment follows a relatively standard cognitive therapy model with the exception of the addition of expressive writing and assertiveness training in the last modules. These seem slightly less integrated into the treatment as a whole, although the author ties them to making changes in catastrophizing. This rationale could have been better developed to integrate these modules more tightly into the rest of the treatment. Another limitation of the book, and perhaps given the goals of this volume it is understandable, is the lack of attention to the behavioral aspects of chronic pain treatment. Whereas much more has been written on that, and the focus on cognitive processes is really the point of this book, I would have liked to have seen more attention to the development of behavioral methods to test cognitions and how more traditional “behavioral” therapies can be integrated with cognitive therapy to enrich both methods of treatment.
Overall, this book provides a much-needed and user-friendly guide to conducting cognitive therapy in the context of chronic pain, and both experienced and neophyte cognitive therapists are likely to find themselves referring to it and using the materials provided on a repeated basis.
Dr. Romano is Associate Professor of Psychiatry and Behavioral Sciences at the University of Washington, Seattle.
Dr. Loeser is Professor of Neurological Surgery and Anesthesiology at the University of Washington in Seattle.
