Ronald Melzack Award Lecture: Putting the brain to work in cognitive behavioral therapy for chronic pain.
Ronald Melzack Award Lecture: Putting the brain to work in cognitive behavioral therapy for chronic pain.
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DOI：
10.1097/j.pain.0000000000001839
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发表时间：
2020-09
期刊：
影响因子：
7.4
通讯作者：
Thorn BE
中科院分区：
文献类型：
--
作者：
Thorn BE
医疗保健从业者可能不熟悉认知行为疗法（CBT）等生物心理社会疗法，并且可能认为心理社会治疗仅适合患有精神疾病的人。此外，从业者可能不知道基于生物心理社会模型的治疗具有生物学基础。对待疼痛患者，就好像所有疼痛都与必须定位和修复的持续组织损伤有关（生物医学模型），这会导致错误的印象，即伤害=伤害，并且“真正的”疼痛可以通过生物医学标记检测到，并可以通过正确的生物医学干预来纠正。我们的许多患者不知道大脑对于疼痛感知和疼痛自我管理至关重要。在这篇综述中，我描述了最近的研究，使用简化的门控原理图作为低收入、多重弱势患者的生物心理社会疼痛教育和 CBT 的治疗原理。我使用疼痛的认知模型（简化为“思考→感觉→行动”），提供了心理社会保健提供者如何培训患者技能的示例，让他们能够独立地使用他们的想法来激励和实施疼痛自我管理行为。进入对治疗机制（调解、节制）的简要审查，我将得出以下论点：有效的心理社会干预比有时承认的有更多的共性，并且这些治疗可以用作跨学科治疗的一部分，以帮助患者自我管理疼痛。
Healthcare practitioners may not be familiar with biopsychosocial therapies such as cognitive-behavioral therapy (CBT), and may view psychosocial treatments as only appropriate for those with mental illness. Further, practitioners may not know that treatments based on a biopsychosocial model have a biological basis. Treating patients with pain as if all pain is related to ongoing tissue damage that must be located and repaired (a biomedical model) has led to the false impression that hurt = harm and that “real” pain is detectable with a biomedical marker and correctable with the right biomedical intervention. Many of our patients do not know that the brain is critically important to the perception of pain and in pain self-management. In this review, I describe recent research using a simplified gate-control schematic as a treatment rationale for biopsychosocial pain education and CBT with low-income, multiply disadvantaged patients. Using the cognitive model of pain (simplified as “Think → Feel → Act”), I provide examples of how psychosocial health care providers train patients in skills they can independently use to work with their thoughts to motivate and implement pain self-management behaviors. Moving into a brief examination of treatment mechanism (mediation, moderation), I will conclude with the argument that effective psychosocial interventions share more commonalities than sometimes acknowledged, and that these treatments can be used as part of interdisciplinary treatment to help patients self-manage their pain.
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影响因子：
2.6
作者：
Craner, Julia R.;Lake, Eric S.;George, Logan L.
通讯作者：
George, Logan L.
影响因子：
1
作者：
Bajracharya, Suraj;Singh, Mahipal;Shrestha, Bikram Prasad
通讯作者：
Shrestha, Bikram Prasad
影响因子：
2.7
作者：
Bruns, Daniel;Mueller, Kathryn;Warren, Pamela A.
通讯作者：
Warren, Pamela A.
DOI：
10.1001/jama.2016.2323
发表时间：
2016-03-22
期刊：
JAMA
影响因子：
--
作者：
Cherkin DC;Sherman KJ;Balderson BH;Cook AJ;Anderson ML;Hawkes RJ;Hansen KE;Turner JA
通讯作者：
Turner JA
影响因子：
0.2
作者：
Bhattarai, Srijana;Chhetri, Himal Paudel;Thapa, Pabin
通讯作者：
Thapa, Pabin