Exploring the process of change using single case design
Research type
Research Study
Full title
What changes for whom? Exploring the process of change in a pain management programme using single case design
IRAS ID
124279
Contact name
Amanda Williams
Contact email
Research summary
Pain is defined as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.” (International Association of the Study of Pain, 1987). Many people have pain that is not relieved by medical or physical treatments. It affects up to one in five European adults (Breivik et. al., 2006) and interferes with emotional, social, and occupational life. The search for a diagnosis and for pain relief is often long, discouraging, and damaging psychologically and physically. Ways of coping that are clinically encouraged and adaptable in acute pain episodes can become unhelpful and maladaptive in persistent pain. While there is solid evidence that rehabilitative cognitive and behavioural treatment (CBT) for persistent pain is effective in improving activity levels and mood and to a lesser extent reducing pain, those results use averages across people. They therefore cannot tell us about the process of change, which is important to understand in order to maximise benefits to patients. The pain management programmes at the Pain Management Centre of the National Hospital, Queen Square, use the same CBT methods and show good results. The experienced team of psychologists, physiotherapists, doctors and nursing staff run several programmes for different types of pain. We propose to sample 12 patients from their first contact with the pain management service through treatment to follow-up using repeated measurement to identify processes of change. We will measure changes in disability, mood, self efficacy, therapeutic alliance, programme adherence and catastrophic thinking and analyse it using single case methods.
REC name
London - Fulham Research Ethics Committee
REC reference
13/LO/0940
Date of REC Opinion
11 Jun 2013
REC opinion
Favourable Opinion