OBT, CBT, Group Therapy

Question 1

Operant-behavioral therapy (OBT) emphasizes the…

Answer 1

reinforcing role social and environmental factors have with the development and maintenance of pain

Question 2

OBT focus:

Answer 2

Improving functioning by modifying overt pain behaviors that provoke reinforcement from the environment (e.g., praise, aid, emotional support), and are associated with poorer outcomes and disability

Question 3

OBT goal:

Answer 3

identifying and reinforcing adaptive “well” behaviors (e.g., exercising and talking about non-pain topics) while reducing reinforcement for pain behaviors (e.g., excessive reclining and guarded movement)

Question 4

OBT techniques:

Answer 4

o Graded activation and exercise programs to increase activity level and fitness
o Tapering off habit-forming pain medications
o Social reinforcement by trained staff members, spouse, and family members—to enhance generalization and maintenance of treatment gains

Question 5

CBT theorists view pain as the result of a complex interaction of:

Answer 5

-Pathophysiology, cognition, affect, behavior

Question 6

CBT treatment involves three phases:

Answer 6

Educational, skills training, application

Question 7

CBT educational phase:

Answer 7

Patients are familiarized with a biopsychosocial model of pain

Question 8

CBT skills-training phase:

Answer 8

Training is provided in a variety of cognitive and behavioral pain coping skills; relaxation training, activity/ exercise pacing, activity scheduling, cognitive restructuring, assertiveness training, problem solving

Question 9

CBT application phase:

Answer 9

 Patients learn to apply their skills in progressively more challenging pain-related situations through the following methods:
• Relapse prevention
• Practice
• Homework assignments

Question 10

Group therapy: types of groups

Answer 10

o	Cognitive and behavior change
o	Patient education
o	Social support
o	Family/couples
o	ACT/mindfulness/DBT
o	Shared medical visits

Question 11

Issues in group therapy:

Answer 11

o	Patient screening
o	Group structure
o	Group content
o	Working with patient expectations
o	Working with anger and distress
o	Involving significant others
o	Integrating group therapy with other sorts of treatment