Sense of self, social functioning and response to multidisciplinary treatment for chronic pain

As an acute response to noxious stimuli, pain prompts vital behaviour aimed at avoiding or limiting further damage. In many cases, however, pain endures beyond the healing process, or occurs in the absence of tissue damage and other pathophysiological causes. Pain lasting longer than 12 weeks is defined as chronic pain (CP). Every year, over five million people in the UK develop CP but only two-thirds recover.
Despite the personal and societal impact of CP, surprisingly few studies have considered why so many patients do not respond to conventional psychological treatments. High initial pain intensity, depression, fear-avoidance beliefs and pain acceptance are all factors that have been associated with differential response to PMPs but the evidence is mixed and further research is urgently needed to improve treatment options.
The aim of the proposed research is to test a novel model of treatment response in CP. The model is derived from psychodynamic-interpersonal therapy, which has an evidence based for treating other pain conditions but has not been studied in relation to CP. According to this model, people will be less likely to respond to treatment if they have a poor sense of themselves and problems forming supportive relationships with others, which together undermine their ability to access social support and use self-management strategies.