National Center for Spinal Disorders, Hungary
Title: Pain and psychotherapy, in the light of evidence psychological treatment methods of chronic pain based on evidence
Csaszar Noemi Ph.D., ECP, is the Head of the Education Board of the Hungarian Association of Hypnosis (H.A.H), clinical psychologist, supervisor hypnotherapist, psychotherapist, Head of Psychotherapy Department and Psychosomatic Out-Patient Department at the National Center for Spinal Disorders in Budapest. She is the author of the special issue chapter: Csaszar N., Ganju A., Mirnics Zs., Varga P.P.: Psychosocial Issues In The Cancer Patient. Spine, 15:34 (22 Suppl):26-30, 2009. And the book chapter: Csaszar N.: Hypnotherapy treatment of chronic Pain. In: Vertes, G. (ed.): Hypnosis-Hypnotherapy. Budapest, Medicina Konyvkiado Rt., 2006, 31–62.
Several types of psychotherapies have been developed for patients suffering from chronic pain. In general it is problematic for all therapies to determine whether they are effective or not. The criteria for effectiveness could be the reduction of medication needed, the return of the patient to work, satisfaction evaluated positively by the patient, etc.
The organization called Initiative of Methods, Measurement and Pain Assessment in Clinical Trials (IMMPACT) suggested to develop an integrated method and a unified evaluation system for the results of different methods used for clinical pain assessment. This unified evaluation system includes the interference regarding pain, the severity of pain, emotional reactions and other evaluations regarding the treatment as a basic variable. In general we can say that psychological treatment is not for patients for whom effective and fast medical treatment is available without considerable side effects. Although patients can participate in a program of psychological treatment regardless to weather an organic pathology that needs medical intervention is present or not. The psychological approach can be used not only for the treatment of 'psychogenetic' pain but also in case when the patient loses partly his/her capacity to cope with the chronic disease that have strictly organic cause.
In our presentation we are going to show that in case of chronic pain there are effective psychological treatment methods that have been properly proven to be effective(in compliance with the 2013/14 EBM criteria). We are also going to talk about psycho-education, supportive therapy, behavior therapy, cognitive behavior therapy (CBT), acceptance and commitment therapy, dynamic oriented therapies, biofeedback and relaxation therapy, hypnotherapy, guided imagery, art therapy and family therapy.
With the above mentioned methods we can effectively treat a wide range of diseases related to pain and achieve moderate and considerable improvement. At the end we are going to unfold open issues such as: The limits of indication of psychological treatments, which are the most effective components of the treatment and what kind of effect do the different treatments have on pain.