Targeted treatment of catastrophizing for the management of chronic pain

Pain catastrophizing refers to a negative mental set brought to bear during the experience of pain. Individuals who catastrophize often feel helpless about controlling their pain, ruminate about painful sensations, and expect bad outcomes. Not surprisingly, such individuals often fail to improve with treatment. This paper provides an assessment tool and outlines a cognitive-behavioral group treatment approach for chronic pain that is specifically designed to reduce catastrophizing. Principles from stress management, cognitive therapy for depression, assertiveness training, and communal coping models are incorporated within the treatment framework to address specific needs posed by catastrophizing. Suggestions are provided for organizing treatment sessions and for assigning homework based on treatment principles.