Pain Counseling or Pain Management Therapy focuses on the experience of physical discomfort. Following a medical evaluation and/or diagnosis, clients can discover either a source of validation for their recurring pain, or they can suffer the uncertainty of its cause.
People diagnosed with such conditions as Fibromyalgia, Rheumatoid arthritis, or Chronic-Fatigue Syndrome may have “validation” that their pain or discomfort is the result of an illness, but the management of their physical symptoms can be aided through therapeutic practice.
For those without a formal diagnosis to attach to their experience of frequent or chronic pain, visiting a therapist specializing in Pain Counseling can offer a client ways to connect their physical discomfort to deep-seated psychological challenges, traumatic experiences, and shed light on potential triggers causing pain to recur.
What to Expect
Cognitive Behavioral Therapy:
Cognitive behavioral therapy (CBT) for pain helps patients with pain to understand the relationship between one’s physiology (e.g., pain and muscle tension), thoughts, emotions, and behaviors. A main goal in treatment is cognitive restructuring to encourage helpful thought patterns, targeting a behavioral activation of healthy activities such as regular exercise and pacing. Lifestyle changes are also trained to improve sleep patterns and to develop better coping skills for pain and other stressors using various techniques (e.g., relaxation, diaphragmatic breathing, and even biofeedback).
Studies have demonstrated the usefulness of cognitive behavioral therapy in the management of chronic low back pain, producing significant decreases in physical and psychosocial disability.  A study published in the January 2012 issue of the Archives of Internal Medicine found CBT is significantly more effective than standard care in treatment of people with body-wide pain, like fibromyalgia. Evidence for the usefulness of CBT in the management of adult chronic pain is generally poorly understood, due partly to the proliferation of techniques of doubtful quality, and the poor quality of reporting in clinical trials. The crucial content of individual interventions has not been isolated and the important contextual elements, such as therapist training and development of treatment manuals, have not been determined. The widely varying nature of the resulting data makes useful systematic review and meta-analysis within the field very difficult.
In 2009 a systematic review of randomized controlled trials (RCTs) of psychological therapies for the management of adult chronic pain (excluding headache) found that “CBT and BT have weak effects in improving pain. CBT and BT have minimal effects on disability associated with chronic pain. CBT and BT are effective in altering mood outcomes, and there is some evidence that these changes are maintained at six months;”[needs update] and a review of RCTs of psychological therapies for the management of chronic and recurrent pain in children and adolescents, by the same authors, found “Psychological treatments are effective in pain control for children with headache and benefits appear to be maintained. Psychological treatments may also improve pain control for children with musculoskeletal and recurrent abdominal pain. There is some evidence available to estimate effects on disability or mood.”[needs update]
A 2007 review of 13 studies found evidence for the efficacy of hypnosis in the reduction of pain in some conditions, though the number of patients enrolled in the studies was small, bringing up issues of power to detect group differences, and most lacked credible controls for placebo and/or expectation. The authors concluded that “although the findings provide support for the general applicability of hypnosis in the treatment of chronic pain, considerably more research will be needed to fully determine the effects of hypnosis for different chronic-pain conditions.”:283
Hypnosis has reduced the pain of some noxious medical procedures in children and adolescents, and in clinical trials addressing other patient groups it has significantly reduced pain compared to no treatment or some other non-hypnotic interventions. However, no studies have compared hypnosis to a convincing placebo, so the pain reduction may be due to patient expectation (the “placebo effect”). The effects of self hypnosis on chronic pain are roughly comparable to those of progressive muscle relaxation.
A meta-analysis of studies that used techniques centered around the concept of mindfulness, concluded, “Findings suggest that MBIs decrease the intensity of pain for chronic pain patients.