THE EFFECTS OF MULTIDISCIPLINARY PAIN MANAGEMENT TREATMENT ON LOCUS OF CONTROL AND PAIN BELIEFS IN CHRONIC NON-TERMINAL PAIN

Objective: To determine whether chronic pain patients' beliefs and and attributions about pain control are amenable to change in a short-term inpatient multidisciplinary pain management program. Design: Non-randomized consecutive sample with prospective, before-after treatment. Setting: Pain-management, tertiary care center in a major U.S. city. Patients: All adult patients (n = 50) who were treated in an inpatient multidisciplinary pain management center were contrasted with those of a control group of 46 adult patients who were treated in an outpatient pain center. Outcome Measures: Pain Locus of Control Scale, the Pain Beliefs and Perceptions Inventory, subjective pain intensity, and medication usage were measured before and after treatment. Results: Statistically significant posttreatment changes were found for the treatment group, but not the control group. Patients who completed the inpatient pain management program reported significant decreases in subjective pain intensity despite discontinuation of narcotic analgesics. Patients in the treatment group showed an increased sense of personal control over their pain and substantial decreases in attributions of pain control to powerful others and chance. Patients in the treatment group also showed a significant reduction in their endorsement of the belief that their pain was a mysterious phenomenon. Conclusion: Chronic non-terminal pain patients' beliefs about pain and attributions of pain control are amenable to change in a short-term inpatient multidisciplinary pain management program. These results suggest that an intensive multidisciplinary program involving psychotherapy might be more effective in treating chronic pain patients similar to those in this study than outpatient treatment without psychotherapy.