Behavioral management of chronic pain and excess disability: long-term follow-up of an outpatient program.
OBJECTIVE
To assess the overall efficiency of an outpatient behavioral rehabilitation program for excess disability and chronic pain and to describe the program staff, treatment components and outcomes in sufficient detail to facilitate comparison with similar programs.


METHODS
Eight-year follow-up study of patients referred and treated.


METHODS
Outpatient primary care and multispecialty group medical practice.


METHODS
354 of 421 unselected patients referred for the behavioral management of excess disability, who completed the treatment program and participated in follow-up.


METHODS
15-20 sessions of physical and occupational therapy, 5-10 sessions of biofeedback, and one or two family sessions all based upon behavioral techniques described by Fordyce and by Roberts.


METHODS
Questionnaires, including analog scales, administered before treatment and at 1, 6, 12, and 24 months posttreatment.


RESULTS
Patients (n = 67) who dropped out did not differ systematically from those who participated (n = 354). The treatment program resulted in a marked and enduring reduction of pain, and a statistically and clinically significant improvement in patients' ability to function at work and in the home. Patients overwhelmingly endorsed the program.


CONCLUSIONS
A brief, inexpensive, outpatient behavioral rehabilitation program for chronic pain and excess disability can achieve a clinically significant and lasting reduction of pain and improvement in function at work and at home.
Roberts
A H
AH
Division of Medical Psychology, Scripps Clinic and Research Foundation, La Jolla, California 92037.
Sternbach
R A
RA
Polich
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001521:Behavior Therapy; D001676:Biofeedback, Psychology; D002908:Chronic Disease; D006233:Persons with Disabilities / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy; D010045:Outpatients; D010146:Pain / Q000523:psychology / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D015397:Program Evaluation; D011795:Surveys and Questionnaires