Chronic pain

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Canadian Family PhysicianLe Médecin de famille canadien Vol 56: january • janVier 2010

Book Reviews

Chronic pain

AUTHORS Beverly J. Field, Robert A. Swarm

PUBLISHER Hogrefe & Huber Publishers, 1543 Bayview Ave, Suite 514, Toronto, ON M4G 3B5 TELEPHONE 416 482-6339

WEBSITE PUBLISHED 2008/97 pp/$37.50

OVERALL RATING Very good STRENGTHS Clinically relevant and in-depth, with practical advice

WEAKNESSES Complicated psychological assessment scales


psychologists, social workers, and family physicians


hronic Pain is volume 11 of the Advances in Psychotherapy—

Evidenced-Based Practice series, published with the support of the American Psychological Association.

It is an excellent compact guide written for clinical psychologists (who are referred to as clinicians in the book) in the United States.

It contains step-by-step advice, from receiving the referral from

physicians and initial assessment to intervention and follow-up. The diagnostic and reimbursement bill- ing codes of the American Current Procedural Terminology coding sys- tem are used.

The book tackles the most dif- ficult psychological aspects of chronic pain. The first couple of sections of the book are devoted to the definition, basic health sci- ences, pain theories, and models of chronic pain. These sections are difficult to read but serve as a solid foundation. The content becomes much more interesting in the latter sections, when clinical vignettes,

diagnostics, and treatments are discussed.

The book includes patients’

perspectives and covers a large array of psychological interven- tions, including cognitive behav- ioural therapy, education, and self-regulatory techniques (eg, meditation, guided imagery, hyp- n o s i s , b i o f e e d b a c k ) . I e s p e - cially liked the discussion on cognitive behavioural therapy, which advises health professionals on how to analyze patients’ con- cerns, paraphrase these concerns to help patients see most cogni- tive distortions, and help patients replace these with positive state- ments, eventually leading to spe- cific behaviour changes.

On the downside, the book is mostly written for psychotherapy sessions that last several hours each. It might be a bit daunting for family physicians to read the mul- tiple tables of psychological assess- ment scales. However, the book contains many clinical pearls we as family physicians could learn in order to broaden our understand- ing of chronic pain and psychother- apy itself.

—Jawad Khokhar MB BS CCFP FCFP Dr Khokhar is Program Chief of Family Medicine at Rouge Valley Health System in Ajax, Ont.

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