Newton-John Toby R, Geddes Jenny
Innervate Pain Management, 91 Chatham Street, Broadmeadow, Newcastle, NSW 2292, Australia.
Chronic Illn. 2008 Sep;4(3):199-208. doi: 10.1177/1742395308091868.
Group-based cognitive-behavioural therapy (CBT) for chronic, non-malignant pain is recognized as the treatment of choice for patients with intractable pain problems. The core components of CBT pain treatment have been standardized, and meta-analyses have shown that that this form of intervention is effective. However, the psychotherapy literature points to a range of influences on treatment outcome that arise out of the process of treatment, rather than directly from the active treatment components. These so-called non-specific treatment effects include the composition of the group, the leadership style of the group leader, and the ways in which group dynamics are dealt with. Although CBT pain management programmes are conducted in a group format, and are therefore subject to similar kinds of influences to other forms of group treatment, these issues have not been discussed in detail in any previous literature. The present paper proposes a number of non-specific treatment factors that are likely to be associated with positive outcomes from CBT pain management programmes, and discusses ways in which these factors may be deliberately manipulated in order to maximize treatment effectiveness.
基于团体的认知行为疗法（CBT）用于治疗慢性非恶性疼痛，被认为是治疗顽固性疼痛问题患者的首选方法。CBT疼痛治疗的核心组成部分已经标准化，荟萃分析表明这种干预形式是有效的。然而，心理治疗文献指出，一系列对治疗结果的影响源自治疗过程，而非直接来自积极的治疗成分。这些所谓的非特异性治疗效果包括团体构成、团体领导者的领导风格以及处理团体动力的方式。尽管CBT疼痛管理项目以团体形式开展，因此会受到与其他形式团体治疗类似的影响，但这些问题在以往的任何文献中都未得到详细讨论。本文提出了一些可能与CBT疼痛管理项目的积极结果相关的非特异性治疗因素，并讨论了如何有意操控这些因素以最大限度地提高治疗效果。
