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“This book is aptly named, for it truly does take the reader on a step-by-step journey through the therapeutic process....Eminently practical.”

—Health Psychology and Rehabilitation (on the first edition)


“An excellent resource for practitioners and trainees who work with chronic pain patients. The author's skill for applying theory and research to the clinic setting is masterful....This guidebook will help practitioners improve patient outcomes for years to come.”

—Journal of Pain and Palliative Care Pharmacotherapy (on the first edition)


“Detailed, systematic, and very well organized….This is a book worth keeping and using, and it is a book worth sharing. It would be helpful for those working in pain clinics, as well as for mental health professionals and traditional physical medicine doctors.”

—Bulletin of the Menninger Clinic (on the first edition)


“This up-to-date second edition not only provides an overview of the scientific evidence supporting CBT for chronic pain, but also is filled with practical tips for dealing with challenges that typically arise when working with patients. Thorn is an internationally recognized expert who has pioneered novel approaches to implementing CBT with chronic pain sufferers, including those with multiple comorbid conditions. She draws on her rich background of clinical experience and brings the material to life with numerous anecdotes and examples. A wide range of practitioners will find this book very accessible and will learn techniques they can integrate into their daily practice.”

—Francis J. Keefe, PhD, Department of Psychiatry and Behavioral Sciences and Director, Duke Pain Prevention and Treatment Research Program, Duke University School of Medicine


“Experts in pain management are unanimous in encouraging timely and equitable access to cognitive therapy to address the interrelated public health crises of undertreatment of pain and the opioid epidemic. Thorn’s contribution stands alone in providing a patient-centered guide that can be used in the broadest array of clinical practice settings. It is clear that this book will serve as the gold standard for the field of pain management for many years to come.”

—Robert D. Kerns, PhD, Departments of Psychiatry, Neurology, and Psychology, Yale University


“There has been a recent resurgence of interest in nonpharmacological interventions for pain, and this evidence-based book is packed with interventions that really work. Easy to read and understand, the manual includes helpful reproducible materials and real-world examples to offer guidance in the management of pain. The second edition features freestanding modules, incorporates new clinical techniques, and has up-to-date resources and reproducible tools. Thorn emphasizes goal setting and active collaboration to help clients gain control over an otherwise debilitating condition. I highly recommend this book as a 'must have' for seasoned professionals as well as clinicians and students new to the field.”

—Robert N. Jamison, PhD, Departments of Anesthesia and Psychiatry, Brigham and Women's Hospital, Harvard Medical School


“Grounded in theory and rigorous scientific research, this book is a classic. The second edition incorporates new techniques, including mindfulness meditation, as well as additional tools, such as downloadable client handouts and audio recordings. The treatment modules are now more self-contained, allowing practitioners to integrate and adapt the treatment for a variety of applications and settings. What hasn’t changed since the first edition is the book’s engaging and insightful style. It is obvious that Thorn both understands the science underlying the treatment and has compassionately and effectively delivered it to many clients. This book is the essential reference for providing group or individual CBT to people with chronic pain, and should be part of predoctoral and postdoctoral training for all professionals who plan to work with chronic pain in psychology, social work, nursing, occupational therapy, and other health care disciplines.”

—Dawn M. Ehde, PhD, Department of Rehabilitation Medicine, University of Washington


“This second edition is extensively revised and represents a seminal contribution to the field of pain treatment. The book is unique in that its methods are so rigorous as to be usable as a scientific protocol for a clinical trial, while at the same time so practical as to be easily implemented in the clinical setting. Thorn translates the science of pain treatment into practice.”

—Daniel Bruns, PsyD, FAPA, Health Psychology Associates, Greeley, Colorado


“With unprecedented challenges in chronic pain management, there is a growing need for evidence-based, non-pharmacological treatment options. Thorn has delivered a comprehensive, up-to-date guide that meets this need. The book not only covers foundational research and theory, but also presents a wealth of step-by-step practical tools for engaging patients in effective clinical treatment. This is the ultimate one-stop resource for all things relevant to cognitive therapy for chronic pain.”

—Jennifer L. Murphy, PhD, CBT for Chronic Pain Master Trainer, U.S. Department of Veterans Affairs

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Table of Contents

I. Rationale, Theory, Research, and Assessment

1. Why Consider Cognitions When Treating Chronic Pain?

2. Conceptual/Organizational Model and Treatment Rationale: Cognitive Therapy for Chronic Pain

3. The Research Foundation for Cognitive Treatment of Pain

4. Clinical Assessment of Pain from a Biopsychosocial Perspective

II. A Cognitive Treatment Program for Chronic Pain

Treatment Module 1. The Brain in Pain: Rationale for Cognitive Therapy

Treatment Module 2. The Stress–Judging–Pain Connection

Treatment Module 3. Identifying Automatic Thoughts

Treatment Module 4. Examining Our Thoughts and Creating New Ones

Treatment Module 5. Muscle Relaxation and Coping Self-Statements

Treatment Module 6. Deeper Beliefs

Treatment Module 7. Observing and Letting Go

Treatment Module 8. Writing about Strong Emotions: Another Way of Acknowledging and Letting Go

Treatment Module 9. Assertiveness: A Great Way to Communicate

Treatment Module 10. Putting It All Together

Appendices

Appendix A. Brief Pain Inventory—Short Form (BPI-SF)

Appendix B. P4 Suicidality Screener (P4)

Appendix C. Pain Catastrophizing Scale (PCS)

Appendix D. Tampa Scale for Kinesiophobia–11 (TSK-11)

Appendix E. Pain Self-Efficacy Questionnaire (PSEQ)

Appendix F. Patient Global Impression of Change Scale

Audio Downloads

1. Diaphragmatic (Belly) Breathing

2. Passive Muscle Relaxation

3. Mindfulness Relaxation

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About the Author

Beverly E. Thorn, PhD, ABPP, is Professor Emerita of Psychology at the University of Alabama, where she was on the faculty for 30 years, including serving as Director of the Clinical Psychology PhD program for 15 years. She is the recipient of the 2018 Wilbert E. Fordyce Clinical Investigator Award from the American Pain Society, and is a Fellow of the Society for Health Psychology (Division 38 of the American Psychological Association (APA)), the Society of Clinical Psychology (Division 12 of the APA), and the Society of Behavioral Medicine. Dr. Thorn is on the editorial boards of several scientific journals, including Health Psychology, Pain, Journal of Pain, and European Journal of Pain. Her research has focused on investigating the important components of CBT for chronic painful conditions. Since retiring in 2016, she has remained actively involved in dissemination and implementation of CBT for chronic pain with low-income, multiply disadvantaged populations. She also consults in health care settings to help train behavioral health providers to implement CBT for pain management.

• Author's website

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Audience

Clinical psychologists, counselors, social workers, and psychiatrists; also of interest to nurses, physicians, and allied health professionals.

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Previous editions published by Guilford:

First Edition, © 2004
ISBN: 9781572309791

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New to this edition:

• Incorporates over a decade of important advances in pain research and clinical practice.
• Treatment modules that allow clients to enter a group at any point after an introductory session.
• Expanded with motivational enhancement, relaxation, and mindfulness techniques.
• Many new handouts, assessment tools, and therapist scripts, as well as audio downloads.
• Orients and engages clients using state-of-the-art research on how the brain processes pain.