Behavioral Treatments for Pain Experienced by Older Adults

In the first part of this chapter, we delineate the characteristics of a behavioral approach to the treatment of pain and then describe four different theoretical perspectives on pain which have been derived from a behavioral model. These perspectives are respondent conditioning, operant conditioning, social learning theory, and cognitive behavior therapy. Examples of treatment methods derived from each perspective are presented, along with available research evidence pertinent to that method or perspective. In the second part of the chapter, we present the research evidence comparing different behavioral treatment modalities with the pain problems of older adult patients.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Subscribe and save

• Get 10 units per month
• Download Article/Chapter or eBook
• 1 Unit = 1 Article or 1 Chapter
• Cancel anytime

Buy Now

eBook EUR 117.69 Price includes VAT (France)

Softcover Book EUR 158.24 Price includes VAT (France)

Hardcover Book EUR 158.24 Price includes VAT (France)

Tax calculation will be finalised at checkout

Purchases are for personal use only

Preview

Similar content being viewed by others

Behavioral and Cognitive–Behavioral Approaches to Treating Patients with Chronic Pain: Thinking Outside the Pill Box

Medical Perspectives of Psychological Management of Pain in the Rehabilitation Patient

Psychological Interventions for the Treatment of Pain in the Rehabilitation Patient

References

• Achterberg, J., Kenner, C., & Lewis, G. (1988). Severe burn injury: A comparison of relaxation, imagery, and biofeedback for pain management. Journal of Mental Imagery, 12, 71–87. Google Scholar
• Appelbaum, K. A., Blanchard, E. B., Hickling, E. J., & Alfonso, M. (1988). Cognitive behavioral treatment of a veteran population with moderate to severe rheumatoid arthritis. Behavior Therapy, 19, 489–502. ArticleGoogle Scholar
• Arena, J. G., Blanchard, E. B., Andrasik, F., & Myers, P. E. (1983). Psychophysiological responding as a function of age: The importance of matching. Journal of Behavioral Assessment, 5, 131–141. ArticleGoogle Scholar
• Arena, J. G., Hannah, S. L., Bruno, G. M, & Meador, K. J. (1991). Electromyographic biofeedback training for tension headache in the elderly: A prospective study. Biofeedback and Self-Regulation, 16(4), 379–390. ArticlePubMedGoogle Scholar
• Arena, J. G., Hightower, N. E., & Chong, G. C. (1988). Relaxation therapy for tension headache in the elderly: A prospective study. Psychology and Aging, 3(1), 96–98. ArticlePubMedGoogle Scholar
• Berntzen, D., & Gotestam, G. (1987). Effects of on-demand versus fixed-interval schedules in the treatment of chronic pain with analgesic compounds. Journal of Consulting and Clinical Psychology, 55, 213–217. ArticlePubMedGoogle Scholar
• Blanchard, E., Andrasik, E., Evans, D., & Hillhouse, J. (1985). Biofeedback and relaxation treatments for headache in the elderly: A caution and a challenge. Biofeedback and Self-Regulation, 10, 69–73. ArticlePubMedGoogle Scholar
• Blanchard, E. B., Andrasik, E., Evans, D. D., Neff, D. E., Appelbaum, K. A., & Rodichok, L. D. (1985). Behavioral treatment of 250 chronic headache patients: A clinical replication series. Behavior Therapy, 16, 308–327. ArticleGoogle Scholar
• Boczkowski, J. (1984). Biofeedback training for the treatment of chronic pain in an elderly arthritic female. Clinical Gerontology, 2, 39–46. ArticleGoogle Scholar
• Cautela, J. (1986). Covert conditioning and the control of pain. Behavior Modification, 10, 205–217. ArticlePubMedGoogle Scholar
• Chapman, C. (1978). Pain: The perception of noxious events. In R. A. Sternbach (Ed.), The psychology of pain (pp. 169–202). New York: Raven Press. Google Scholar
• Craighead, L., Craighead, W. E., Kazdin, A., & Mahoney, M. (1994). Cognitive and behavioral interventions. Boston: Allyn & Bacon. Google Scholar
• Cziir, R., & Gallagher, D. (1983). Case report: Behavioral treatment of depression and somatic complaints in rheumatoid arthritis. Clinical Gerontology, 2, 63–66. ArticleGoogle Scholar
• De Berry, S. (1981–1982). An evaluation of progressive muscle relaxation on stress related symptoms in a geriatric population. International Journal of Aging and Human Development, 14, 255–269. ArticleGoogle Scholar
• Diamond, S., & Montrose, D. (1984). The value of biofeedback in the treatment of chronic headache: A four-year retrospective study. Headache, 24, 5–18. ArticlePubMedGoogle Scholar
• Dolce, J., & Dickerson, P. (1991). Pain management. In P. Wisocki (Ed.), Handbook of clinical behavior therapy with the elderly client (pp. 383–398). New York: Plenum Press. Google Scholar
• Dolce, J., & Raczynski, J. (1985). Neuromuscular activity and electromyography in painful backs: Psychological and biomechanical models in assessment and treatment. Psychological Bulletin, 97, 502–520. ArticlePubMedGoogle Scholar
• Doleys, D., Crocker, M., & Patton, D. (1982). Response of patients with chronic pain to exercise quotas. Physical Therapy, 62, 1111–1114. PubMedGoogle Scholar
• Downs, A., Rosenthal, T., & Lichstein, K. (1988). Modeling therapies reduce avoidance of bath time by institutionalized elderly. Behavior Therapy, 19, 359–368. ArticleGoogle Scholar
• D’Zurilla, T., & Goldfried, M. (1971). Problem solving and behavior modification. Journal of Abnormal Psychology, 78, 107–126. ArticlePubMedGoogle Scholar
• Engels, M. L., & Poser, E. (1987). Social skills training with older women. Clinical Gerontologist, 6, 70–73. Google Scholar
• Fordyce, W. (1973). An opérant conditioning method for managing chronic pain. Postgraduate Medicine, 53, 123–128. PubMedGoogle Scholar
• Fordyce, W. (1974) Treating chronic pain by contingency management. In J. Bonica (Ed.), Advances in neurology: Vol. 4. International symposium on pain (pp. 585–587). New York: Raven Press. Google Scholar
• Fordyce, W. (1976). Behavioral methods for chronic pain and illness. St. Louis: Mosby. Google Scholar
• Fordyce, W., Fowler, R., Lehmann, J., & Délateur, B. (1968). Some implications of learning in problems of chronic pain. Journal of Chronic Diseases, 21, 179–190. ArticlePubMedGoogle Scholar
• Fordyce, W., Fowler, R., Lehmann, J., Delateur, B., Sand, P., & Trieschmann, R. (1973). Operant conditioning in the treatment of chronic clinical pain. Archives of Physical Medicine Rehabilitation, 54, 399–408. PubMedGoogle Scholar
• Hamburger, L. (1982). Reduction of generalized aversive responding in a post-treatment cancer patient: Relaxation as an active coping skill. Journal of Behavior Therapy and Experimental Psychiatry, 12, 241–247. Google Scholar
• Holroyd, K. A., & Penzien, D. B. (1984). Client variables and the behavioral treatment of recurrent tension headache: A meta-analytic review. Paper presented at the 1984 meeting of the Association for the Advancement of Behavior Therapy, Philadelphia. Google Scholar
• Kabela, E., Blanchard, E. B., Appelbaum, K. A., & Nicholson, N. (1989). Self-regulatory treatment of headache in the elderly. Biofeedback and Self-Regulation, 14(3), 219–228. ArticlePubMedGoogle Scholar
• Kazdin, A. (1975). Covert modeling, imagery assessment, and assertive behavior. Journal of Consulting and Clinical Psychology, 43, 716–724. ArticlePubMedGoogle Scholar
• Keefe, F., & Beckham, J. (1994). Behavioral medicine. In L. Craighead, W. E. Craighead, A. Kazdin, & M. Mahoney (Eds.), Cognitive and behavioral interventions (pp. 197–213). Boston: Allyn & Bacon. Google Scholar
• Keefe, F., Caldwell, D., Williams, D., Gil, K., Mitchell, D., Robertson, C., Martinez, S., Nunley, J., Beckman, J., Crisson, J., & Helms, M. (1990). Pain coping skills training in the management of osteoarthritic knee pain: A comparative study. Behavior Therapy, 21, 49–62. ArticleGoogle Scholar
• Keefe, F., Caldwell, D., Queen, K., Gil, K., Martinez, S., Crisson, J., Ogden, W., & Nunley, J. (1987). Osteoarthritic knee pain: A behavioral analysis. Pain, 28, 309–321. ArticlePubMedGoogle Scholar
• Keefe, F, & Williams, D. A. (1990). A comparison of coping strategies in chronic pain patients of different age groups. Journal of Gerontology, 45(4), 161–165. ArticleGoogle Scholar
• King, A. C., & Arena, J. G. (1984). Behavioral treatment of chronic cluster headache in a geriatric patient. Biofeedback and Self-Regulation, 9, 201–208. ArticlePubMedGoogle Scholar
• Libb, J. W., & Clements, C. B. (1969). Token reinforcement in an exercise program for hospitalized geriatric patients. Perceptual and Motor Skills, 28, 957–958. ArticlePubMedGoogle Scholar
• Linoff, M., & West, C. (1982). Relaxation training systematically combined with music: Treatment of tension headaches in a geriatric patient. International Journal of Behavioral Geriatrics, 1, 11–16. Google Scholar
• Lopez, M. (1980). Social skills training with institutionalized elderly: Effect of pre-counseling structuring and over-learning on skill acquisitions and transfer. Journal of Counseling Psychology, 27, 286–293. ArticleGoogle Scholar
• Lorig, K., & Holman, H. (1989). Long term outcomes of an arthritis self-management study: Effects of reinforcement efforts. Social Science and Medicine, 29, 221–224. ArticlePubMedGoogle Scholar
• Lorig, K., Laurin, J., & Holman, H. (1984). Arthritis self-management: A study of the effectiveness of patient education for the elderly. The Gerontologist, 24, 455–457. ArticlePubMedGoogle Scholar
• Matteson, M. (1989). Effects of a cognitive-behavioral approach and positive reinforcement on exercise for older adults. Educational Gerontology, 15, 497–513. ArticleGoogle Scholar
• McCaul, K., & Malott, J. (1984). Distraction and coping with pain. Psychological Bulletin, 95, 516–533. ArticlePubMedGoogle Scholar
• Melzack, R., & Chapman, C. (1973). Psychological aspects of pain. Postgraduate Medicine, 53, 69–75. PubMedGoogle Scholar
• Melzack, R., & Wall, P. (1965). Pain mechanisms. A new theory. Science, 150, 971–979. ArticlePubMedGoogle Scholar
• Middaugh, S. J., Levin, R. B., Kee, W. G., Barchiesi, F D., & Roberts, J. M. (1988). Chronic pain: Its treatment in geriatric and younger patients. Archives of Physical Medicine and Rehabilitation, 69, 1021–1026. PubMedGoogle Scholar
• Middaugh, S. J., Woods, E., Kee, W. G., Harden, N., & Peters, J. R. (1991). Biofeedback-assisted relaxation training for the aging chronic pain patient. Biofeedback and Self-Regulation, 16(4), 361–377. ArticlePubMedGoogle Scholar
• Miller, C., & LeLieuvre, R. B. (1982). A method to reduce chronic pain in elderly nursing home residents. The Gerontologist, 22(3), 314–317. ArticlePubMedGoogle Scholar
• Mosley, T., Grothues, C., & Meeks, W. M. (1995). Treatment of tension headache in the elderly: A controlled evaluation of relaxation training and relaxation training combined with cognitive behavior therapy. Journal of Clinical Geropsychology, 1, 175–188. Google Scholar
• Nicholson, N. L., & Blanchard, E. B. (1993). A controlled evaluation of behavioral treatment of chronic headache in the elderly. Behavior Therapy, 24, 395–408. ArticleGoogle Scholar
• Pearson, B. (1987). Pain control: An experiment with imagery. Geriatric Nursing, 8, 28–30. ArticlePubMedGoogle Scholar
• Perkins, K., Rapp, S., Carlson, C., & Wallace, C. (1986). A behavioral intervention to increase exercise among nursing home residents. The Gerontologist, 26, 479–481. ArticlePubMedGoogle Scholar
• Puder, R. (1988). Age analysis of cognitive-behavioral group therapy for chronic pain outpatients. Psychology and Aging, 3, 204–207. ArticlePubMedGoogle Scholar
• Radojevic, V., Nicassio, P. M., & Weisman, M. H. (1992). Behavioral intervention with and without family support for rheumatoid arthritis. Behavior Therapy, 23, 13–30. ArticleGoogle Scholar
• Rickard, H. C., Scogin, F, & Keith, S. (1994). A one-year follow-up of relaxation training for elders with subjective anxiety. The Gerontologist, 34(1), 121–122. ArticlePubMedGoogle Scholar
• Rybstein-Blinchik, E. (1979). Effects of different cognitive strategies in the chronic pain experience. Journal of Behavioral Medicine, 2, 93–102. ArticlePubMedGoogle Scholar
• Smith, R., Follick, M., & Ahern, D. (1986). Cognitive distortion and disability in chronic low back pain. Cognitive Therapy and Research, 10, 201–210. ArticleGoogle Scholar
• Sturgis, E., Dolce, J., & Dickerson, P. (1987). Pain management in the elderly. In L. Carstensen & B. Edelstein (Eds.), Handbook of clinical gerontology (pp. 190–203). New York: Pergamon Press. Google Scholar
• Tan, S. (1982). Cognitive and cognitive-behavioral methods for pain control: A selective review. Pain, 12, 201–228. ArticlePubMedGoogle Scholar
• Thorn, B., & Williams, G. (1989). Goal specification alters perceived pain intensity and tolerance latency. Cognitive Therapy and Research, 13, 171–183. ArticleGoogle Scholar
• Turk, D., Meichenbaum, D., & Genest, M. (1983). Pain and behavioral medicine: A cognitive-behavioral perspective. New York: Guilford Press. Google Scholar
• Turk, D., & Rennert, K. (1981). Pain and the terminally ill cancer patient: A cognitive-social learning perspective. In H. Sobel (Ed.), Behavior therapy in terminal care: A humanistic approach (pp. 95–124). Cambridge, MA: Ballinger. Google Scholar
• Williams, G., & Thorn, B. (1989). An empirical assessment of pain beliefs. Pain, 36, 351–358. ArticlePubMedGoogle Scholar
• Wisocki, P. (1991). Behavioral gerontology. In P. Wisocki (Ed.), Handbook of clinical behavior therapy for the elderly client (pp. 3–51). New York: Plenum Press. Google Scholar
• Wisocki, P. (1993). The treatment of an elderly woman with orofacial tardive dyskinesia by relaxation and covert reinforcer sampling. In J. Cautela & A Kearney (Eds.), Covert conditioning casebook (pp. 108–116). Pacific Grove, CA: Brooks/Cole. Google Scholar
• Wolf, S., Nacht, M., & Kelly, J. (1982). EMG feedback training during dynamic movement for low back pain patients. Behavior Therapy, 13, 395–406. ArticleGoogle Scholar

Author information

Authors and Affiliations

1. Psychology Department, University of Massachusetts, Amherst, Massachusetts, 01003, USA Patricia A. Wisocki & Charles B. Powers

1. Patricia A. Wisocki

Editor information

Editors and Affiliations

1. Department of Psychology, Boston University, Boston, Massachusetts, 02215, USA David I. Mostofsky
2. The Herczeg Institute on Aging, Tel Aviv University, Ramat Aviv, Tel Aviv, 69978, Israel Jacob Lomranz

Rights and permissions

Copyright information

© 1997 Springer Science+Business Media New York

About this chapter

Cite this chapter

Wisocki, P.A., Powers, C.B. (1997). Behavioral Treatments for Pain Experienced by Older Adults. In: Mostofsky, D.I., Lomranz, J. (eds) Handbook of Pain and Aging. The Springer Series in Adult Development and Aging. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-0283-2_17

Download citation

• .RIS
• .ENW
• .BIB

• DOI : https://doi.org/10.1007/978-1-4899-0283-2_17
• Publisher Name : Springer, Boston, MA
• Print ISBN : 978-1-4899-0285-6
• Online ISBN : 978-1-4899-0283-2
• eBook Packages : Springer Book Archive

Share this chapter

Anyone you share the following link with will be able to read this content:

Get shareable link

Sorry, a shareable link is not currently available for this article.

Copy to clipboard

Provided by the Springer Nature SharedIt content-sharing initiative