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Brief Treatment Approaches for Addressing Chronic Pain in Primary Care Settings
Published in Andrea Kohn Maikovich-Fong, Handbook of Psychosocial Interventions for Chronic Pain, 2019
The physical dimension of chronic pain covers a wide array of factors, including stress, physical deconditioning, and neurological pain processes (e.g., central sensitization of pain). The relationship between chronic pain and stress has been widely examined and supported. Chronic stress is a common (if not constant) chronic pain comorbidity likely affecting chronic pain through central mechanisms (e.g., activation of the hypothalamic–pituitary–adrenal axis) and distal mechanisms (e.g., increased muscle tension, changes in mood, distressed social interactions; Blackburn-Munro & Blackburn-Munro, 2001). As stress levels increase, pain and pain-related disability also tend to increase. Therefore, using proven brief methods of stress management are likely to contribute to effective chronic pain management outcomes. Relaxation skills are considered the “aspirin of behavioral medicine,” and numerous options/strategies for relaxation skills training are available, allowing the psychologist to tailor interventions to the needs and interests of the patient (Russo, Bird, & Masek, 1980). Brief relaxation strategies are conducive to the brevity of primary care appointments and include diaphragmatic breathing, short progressive muscle relaxation protocols, and guided imagery, all of which show good outcomes for pain (Nahin, Boineau, Khalsa, Stussman, & Weber, 2016).
Nutrition and Cardiovascular Disease
Published in James M. Rippe, Lifestyle Medicine, 2019
Implementation of the guidelines from these scientific bodies remains the key challenge which will require the recognition of multiple factors to interact with both individual and population-wide nutritional choices. A detailed and sophisticated understanding of not only the emerging science in nutrition and CVD but also behavioral medicine will be essential to accomplish the goal of helping individuals reduce their risk of heart disease through nutritional and other lifestyle practices.
Public health, behavioural medicine and eHealth technology
Published in Lisette van Gemert-Pijnen, Saskia M. Kelders, Hanneke Kip, Robbert Sanderman, eHealth Research, Theory and Development, 2018
Rik Crutzen, Rosalie van der Vaart, Andrea Evers, Christina Bode
In the field of behavioural medicine, eHealth technology can effectively be used for psychological support, to help people increase their self-management and to reduce the impact of their disease on their daily life (e.g. tertiary prevention). These eHealth interventions aim, for example, to teach people suffering from pain-related conditions how to cope with their pain (Hoffman, Papas, Chatkoff, & Kerns, 2007), or they target distress by treating moderate mood, anxiety or fatigue problems, for example, among people with diabetes, cancer or cardiovascular diseases (Paul, Carey, Sanson-Fisher, Houlcroft, & Turon, 2013). Generally, these eHealth interventions are secure websites (e.g. a person logs in from home, during several weeks or months) and include modules that combine psycho-educational texts, assignments and relaxation exercises, often supported with video and/or audio files. The content is typically based on treatment methods derived from Cognitive-Behavioural Therapy (CBT) and Acceptance and Commitment Therapy (ACT), in which people learn to alter their behaviour and/or their thoughts in order to decrease the associated negative feelings and problems and to live a meaningful life with the somatic disease (Butler, Chapman, Forman, & Beck, 2006).
Augmented behavioral medicine competencies in physical therapy students’ clinical reasoning with a targeted curriculum: a final-semester cohort-comparison study
Published in Physiotherapy Theory and Practice, 2022
Maria Elvén, Elizabeth Dean, Anne Söderlund
In Sweden, eight universities offer undergraduate programs in physical therapy. The duration of the program is three years, leading to a Bachelor’s of Science Degree in Physical Therapy (Häger-Ross and Sundelin, 2007). Clinical reasoning competencies are incorporated within the learning objectives of entry-level education programs (Swedish Council for Higher Education, 1993) and the means of achieving these objectives are established by each university, in turn resulting in some variations in their curricula. Universities with physical therapy programs have made efforts to incorporate theoretical and practical components pertaining to a biopsychosocial and behavioral approach into their curricula. One university in Sweden has recently reported its processes for integrating behavioral medicine content and competencies throughout its curriculum (Sandborgh et al., 2020). Behavioral medicine is defined as a multidisciplinary field dealing with the integration of biomedical and behavioral knowledge in relation to diagnosis, treatment, rehabilitation, care, health promotion and disease prevention (Dekker et al., 2020). Implementing a behavioral medicine approach in physical therapy implies that the bi-directional relationship between people’s daily living behaviors and diseases, disorders and health are the focus in client management and that associations between biomedical, psychosocial and behavioral factors underpin assessment, analysis, intervention, and evaluation (Åsenlöf, Denison, and Lindberg, 2005; Sandborgh et al., 2020).
Memorial to Daniel P. Brown, Ph.D., ABPH
Published in American Journal of Clinical Hypnosis, 2022
In the 1980s Dr. Brown was the Director of Training and then Chief Psychologist at The Cambridge Hospital. There, he helped develop and gain accreditation for an APA-approved clinical psychology internship and post-doctoral training program. His vision was to provide the best young talent in psychology the opportunity to work with a disenfranchised inner city chronic mental health population, which included intensive developmentally informed psychotherapy for patients with major mental illness and complex trauma disorders. His program included intensive multicultural and bilingual mental health training. At the Cambridge Hospital, he developed and directed the Behavioral Medicine Program, a joint venture between psychiatry and primary care medicine. His book Hypnosis and Behavioral Medicine represents the clinical approaches developed in that program. He developed a special interest in psychoneuroimmunology and the psychosocial treatment of immune disorders. As a result he developed a joint exchange between the Beijing College of Traditional Chinese Medicine and The Cambridge Hospital for dissemination of research findings on approaches to treating immune-related disorders in TCM and behavioral medicine.
Resilient youth with neurofibromatosis: Less perceived stress and greater life satisfaction after an 8-week virtual mind–body intervention
Published in Journal of Psychosocial Oncology, 2021
Ethan Lester, Ana-Maria Vranceanu
The active intervention RY-NF and control HE-NF were developed from their respective adult parent programs5 through qualitative focus groups, and they were matched by time and therapist attention. Both interventions were delivered by the senior author (A.M.V.) and utilized common factors and group therapy processes, with the active intervention using, mind– body, behavioral medicine, and cognitive-behavioral theory. Protocols (e.g., contacting emergency contact/parent) were in place in case participants presented with safety risks. All participants in both groups were briefed in the first session on virtual group rules, including participating in a quiet and private space and respecting others’ privacy. The intervention taught mind–body skills tailored for the cognitive and emotional needs of adolescents with NF, and included relaxation response, adaptive thinking, positive psychology, assertive communication, and problem-solving skills. The control condition provided educational information on stress in adolescents, nutrition, exercise, substances, and medical care. Data were collected at baseline (N = 51; RY-NF N = 27, HE-NF N = 24) post-treatment (N= 45; RY-NF N = 24, HE-NF N = 21) and 6 months (N = 39; RY-NF N = 21, HE-NF N = 18). Stress was assessed with the Perceived Stress Scale (PSS-10; 10 items)6 and life satisfaction with the Satisfaction with Life Scale (SWL; 5 items).7 Analyses were conducted with mixed-models repeated measures ANOVAs.