Publications
APS Bulletin • Volume 16, Number 2, 2006
Resource Reviews
John D. Loeser, MD, Department Editor
Contextual Cognitive-Behavioral Therapy for Chronic Pain: Progress in Pain Research and Management, Volume 33
Reviewed by James E. Moore, PhD
Lance M. McCracken, Seattle, IASP Press, 2005. Hard cover, 148 pages, ISBN 0-931092-83-3. Nonmembers $67, IASP members $53
This excellent volume should be on the reading list of all psychologists, and probably all clinicians, involved in the management of patients with chronic pain. The author reviews the evolution of psychological approaches to chronic pain, starting with operant and then cognitive-behavioral approaches, and then blends these with newer therapies such as acceptance and commitment therapy, mindfulness-based therapies, and dialectical behavioral therapy. Contextual cognitive-behavioral therapy (CCBT) is an acceptance-based approach to chronic pain. CCBT emphasizes understanding the history and current context of behavior to help patients return to a functional and meaningful lifestyle.
Although many treatments are designed to cure or diminish pain, they are often unsuccessful. Similarly, patients often make it their life goal to avoid activities that increase pain, often at a cost of a meaningful and productive life. The goal of CCBT is not necessarily to reduce pain; its goal is to enable patients to accept pain that may have no resolution and to live a meaningful life consistent with the values of the patient. Clinicians will appreciate the several examples of CCBT group exercises the author gives to demonstrate how treatment principles might be clinically applied. Also helpful is the discussion of how some established cognitive-behavioral techniques, such as relaxation and exposure techniques, could be conceptualized to fit within a CCBT framework. In summary, this book will cause pain clinicians to rethink treatment approaches and will be an important contribution to the field of chronic pain treatment.
Dr. Moore is a member of the Section of Physical Medicine and Rehabilitation at Virginia Mason Medical Center, Seattle.
Dr. Loeser is Professor of Neurological Surgery and Anesthesiology at the University of Washington in Seattle.