title: Therapeutic elements in a self-management approach: experiences from group participation among people suffering from chronic pain.
abstract: OBJECTIVE
  Chronic pain is a complex, multifaceted subjective experience that involves the whole person. Self-management is the dynamic and continuous process of adapting one's situation to the cognitive, behavioral, and emotional responses necessary to maintain a satisfactory quality of life. Approaches based on cognitive behavioral therapy (CBT) are described as appropriate in assisting people suffering from chronic pain because they challenge maladaptive beliefs and behaviors in relation to pain. This study aimed to explore patients' experiences of therapeutic elements from group participation in a chronic pain management program.
  
  
  METHODS
  A qualitative research design with a phenomenological hermeneutic approach was used. Six months after participation in the 8-week course, 34 participants formulated and submitted written reports based on open-ended questions related to their group participation and self-help achievement. These reports were analyzed by elements of qualitative content analysis.
  
  
  RESULTS
  THE ANALYSIS RESULTED IN TWO SUBTHEMES: "The significance of active involvement in gaining new insight" and "The significance of community and group support." These were abstracted in the main theme: "Successful self-management is related to several significant contributions in the group."
  
  
  CONCLUSIONS
  An active role with writing, self-revelation, and exchanges of thoughts and feelings in the group seemed to be the key tools for success. In addition, group support and access to other group members' experiences were significant therapeutic elements. We suggest that successful self-management requires knowledge of essential therapeutic elements. In a CBT-based group approach, such elements may offer an important health care contribution.
authors.affiliation: Department of Health Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway.
authors.forename: Bodil
authors.initials: B
authors.lastname: Furnes
authors.affiliation: Department of Health Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway ; Department of Global Public Health and Primary Care, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
authors.forename: Gerd Karin
authors.initials: GK
authors.lastname: Natvig
authors.affiliation: Department of Health Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway.
authors.forename: Elin
authors.initials: E
authors.lastname: Dysvik
keywords: cognitive behavioral therapy; group therapy; pain management; self-directed therapy