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Psychological approaches in the treatment of chronic pain patients--when pills, scalpels, and needles are not enough.

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Psychological approaches in the treatment of chronic pain patients--when pills, scalpels, and needles are not enough.

Can J Psychiatry. 2008 Apr;53(4):213-23

Authors: Turk DC, Swanson KS, Tunks ER

BACKGROUND: Chronic pain is a prevalent and costly problem that eludes adequate treatment. Persistent pain affects all domains of people's lives and in the absence of cure, success will greatly depend on adaptation to symptoms and self-management. METHOD: We reviewed the psychological models that have been used to conceptualize chronic pain-psychodynamic, behavioural (respondent and operant), and cognitive-behavioural. Treatments based on these models, including insight, external reinforcement, motivational interviewing, relaxation, meditation, biofeedback, guided imagery, and hypnosis are described. RESULTS: The cognitive-behavioural perspective has the greatest amount of research supports the effectiveness of this approach with chronic pain patients. Importantly, we differentiate the cognitive-behavioural perspective from cognitive and behavioural techniques and suggest that the perspective on the role of patients' beliefs, attitudes, and expectations in the maintenance and exacerbation of symptoms are more important than the specific techniques. The techniques are all geared to fostering self-control and self-management that will encourage a patient to replace their feelings of passivity, dependence, and hopelessness with activity, independence, and resourcefulness. CONCLUSIONS: Psychosocial and behavioural factors play a significant role in the experience, maintenance, and exacerbation of pain. Self-management is an important complement to biomedical approaches. Cognitive-behavioural therapy alone or within the context of an interdisciplinary pain rehabilitation program has the greatest empirical evidence for success. As none of the most commonly prescribed treatment regimens are sufficient to eliminate pain, a more realistic approach will likely combine pharmacological, physical, and psychological components tailored to each patient's needs.

PMID: 18478824 [PubMed - in process]

A meditation on doing time - Boston Globe

Lifestyle News via Google - 6 hours 56 min ago

Boston Globe

A meditation on doing time
Boston Globe, United States - 49 minutes ago
A Concord-based cultural anthropologist and psychotherapist, Phillips has long worked with the incarcerated in Massachusetts, using a meditation program ...

Zen toolbox offers path to peace for prisoners - Seattle Post Intelligencer

Lifestyle News via Google - Fri, 2008-05-16 22:45

Zen toolbox offers path to peace for prisoners
Seattle Post Intelligencer - 1 hour ago
He uses a Zen toolbox -- teaching meditation, mindfulness and nonviolent communication. The approach is making such a difference that top state ...

Mahatma Gandhi and mind power - Inquirer.net

Lifestyle News via Google - Fri, 2008-05-16 13:24

Mahatma Gandhi and mind power
Inquirer.net, Philippines - 10 hours ago
Gandhi taught his people that by a positive system of anything they believed in, reaffirmed by constant prayer and meditation, their freedom could be ...

Serenity in the high desert: the Buddhist Meditation Center sinks ... - Los Angeles Times

Lifestyle News via Google - Fri, 2008-05-16 12:52

Serenity in the high desert: the Buddhist Meditation Center sinks ...
Los Angeles Times, CA - 11 hours ago
The monk who takes care of the shrine hopes to raise $12 million to build a 6000-square-foot meditation hall. By Louis Sahagun, Los Angeles Times Staff ...

Filmmaker touts TM for students - Arizona Republic

Lifestyle News via Google - Fri, 2008-05-16 02:26

Filmmaker touts TM for students
Arizona Republic, AZ - 21 hours ago
Meditation for students? It's too weird. People think it's a religion, it's mumbo-jumbo, it's a cult. It's none of those things. ...

Walking meditation: steps that nourish body, soul - OurayNews.com

Lifestyle News via Google - Fri, 2008-05-16 01:17

Walking meditation: steps that nourish body, soul
OurayNews.com, CO - 22 hours ago
Vietnamese-born Buddhist monk Nhat Hanh has practiced and taught walking meditation for several decades in France and throughout the world. ...

Lay food and health worker involvement in community nutrition and dietetics in England: roles, responsibilities and relationship with professionals.

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Lay food and health worker involvement in community nutrition and dietetics in England: roles, responsibilities and relationship with professionals.

J Hum Nutr Diet. 2008 Jun;21(3):210-24

Authors: Kennedy LA, Milton B, Bundred P

BACKGROUND: Community-based food initiatives have developed in recent years with the aim of engaging previously 'hard to reach' groups. Lay workers engaged in community nutrition activities are promoted as a cost-effective mechanism for reaching underserved groups. The main objective of the study was to explore perceptions and definitions of lay food and health worker (LFHW) helping roles within the context of National Health Service (NHS) community nutrition and dietetic services in order to define the conceptual and practical elements of this new role and examine the interface with professional roles. METHODS: Interpretive qualitative inquiry; semi-structured interviews with LFHW and NHS professionals employed by community-based programmes, serving 'hard-to-reach' neighbourhoods, across England. A total sampling framework was used to capture all existing and 'fully operational' lay food initiatives in England at the commencement of fieldwork (January 2002). FINDINGS: In total, 29 professionals and 53 LFHWs were interviewed across 15 of the 18 projects identified. Although all 15 projects shared a universal goal, to promote healthy eating, this was achieved through a limited range of approaches, characterized by a narrow, individualistic focus. Lay roles spanned three broad areas: nutrition education; health promotion; and administration and personal development. Narratives from both professionals and LFHWs indicated that the primary role for LFHWs was to encourage dietary change by translating complex messages into credible and culturally appropriate advice. CONCLUSIONS: This research confirms the emerging discipline involving lay helping within the NHS and community dietetics. The primary role of LFHWs in the 15 projects involved was to support existing NHS services to promote healthy eating amongst 'hard to reach' communities. The activities undertaken by LFHWs are strongly influenced by professionals and the NHS. Inherent to this is a fairly narrow interpretation of health, resulting in a limited range of practice.

PMID: 18477177 [PubMed - in process]

Big-house meditation - The Oregonian - OregonLive.com

Lifestyle News via Google - Thu, 2008-05-15 23:24

Big-house meditation
The Oregonian - OregonLive.com, OR - May 15, 2008
The documentary "Dhamma Brothers" falls squarely in the second category, as it demonstrates the impact of a radical form of meditation upon the inmates at a ...

Singing its praises - Canada.com

Lifestyle News via Google - Thu, 2008-05-15 23:22

Singing its praises
Canada.com, Canada - May 15, 2008
Friesen, who also practises meditation, says singing has the same effect on him as a Buddhist meditation. Nicholson agrees. She once heard someone on the ...

GUEST MEDITATION - Greene County Record

Lifestyle News via Google - Thu, 2008-05-15 15:32

GUEST MEDITATION
Greene County Record, VA - May 15, 2008
By Rev. Wendell Lamb, Guest Correspondent There is a danger of serving the Lord for self-serving motives and then withdrawing from the battle. ...

Public Health: Lifestyle change key to diabetes prevention - Marianas Variety

Lifestyle News via Google - Thu, 2008-05-15 07:21

Public Health: Lifestyle change key to diabetes prevention
Marianas Variety, Micronesia - 16 hours ago
By Junhan B. Todeno PUBLIC Health Secretary Joseph Kevin Villagomez says his department’s diabetes program is underfunded, but will continue its public ...

STREET PEOPLE: Toni Pope - San Diego Union Tribune

Lifestyle News via Google - Thu, 2008-05-15 07:05

San Diego Union Tribune

STREET PEOPLE: Toni Pope
San Diego Union Tribune, United States - 17 hours ago
The very first time I used my voice was in meditation. My mother bought me a children's meditation book when I was 9 and I sang: Om. It was the first time I ...

Jail break - Boston Globe

Lifestyle News via Google - Thu, 2008-05-15 00:19

Jail break
Boston Globe, United States - 23 hours ago
Yoga for juvenile offenders is relatively rare, but yoga and similar stress-relieving practices such as meditation have been used in prisons for years. ...

Barriers to changing dietary behavior.

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Barriers to changing dietary behavior.

J Assoc Physicians India. 2008 Jan;56:27-32

Authors: Kapur K, Kapur A, Ramachandran S, Mohan V, Aravind SR, Badgandi M, Srishyla MV

Dietary change requires giving up long established patterns of eating behavior and acquiring new habits. 'Non-compliance' to diet advice may be a result of inability to provide diet self-management training and getting the right messages across to change eating behavior. Using a pre-tested questionnaire based interview, we carried out a study amongst 350 adults (> 20 years) with type 2 diabetes from two metro cities in South India, who had previously received diet advice with the objective to understand perceptions, attitudes and practices, as well as study factors that enhance or reduce compliance to diet advice. Ninety six patients (28%) followed diet for the full duration of diabetes (Group1), 131 (38%) followed diet for a partial duration varying between more than a quarter to three quarters of the total diabetes duration (Group 2) and 115 (34%) did not follow diet advice (Group 3) - followed for a duration less than a quarter of their diabetes duration. Study results show that many factors both patient and health care provider related influence outcomes of dietary advice. Factors that have a positive impact on compliance are - older age, shorter duration, nuclear family, good family support, less busy work life, higher health consciousness, advice given by dietician, more frequent visits to dietician, advice that includes elements to promote overall health not merely control of blood sugar, diet counseling that is easy to understand and use and includes healthy food options, cooking methods, practical guidance to deal with lifestyle issues. We conclude that patient barriers related to life circumstance are mostly non-modifiable, most modifiable barriers are related to behavioural aspect and the inability of the health care provider to provide individualized diet advice and self management training. Efforts must be made to improve counseling skills.

PMID: 18472496 [PubMed - in process]

Enjoying the Silence - The Portland Mercury

Lifestyle News via Google - Wed, 2008-05-14 18:27

Enjoying the Silence
The Portland Mercury, OR - 5 hours ago
The Dhamma Brothers is a documentary about what happened when an intensive 10-day silent meditation program was introduced to Donaldson's inmates in 2002. ...

Silence of the graveyard! - Economic Times

Lifestyle News via Google - Wed, 2008-05-14 13:56

Silence of the graveyard!
Economic Times, India - 10 hours ago
All for the benefit of ten minutes of meditation! Let us see how the meditation proceeds. The moment they start meditating they start to doze! ...

Wellness destination offers mystical twist - Metro Canada - Ottawa

Lifestyle News via Google - Wed, 2008-05-14 11:41

Wellness destination offers mystical twist
Metro Canada - Ottawa, Canada - 12 hours ago
She recommends yoga, meditation and massage. Coincidentally, I’m booked for a massage immediately following the session. There is no actual spa here, ...

10 myths and misconceptions about meditation - Sedona.biz

Lifestyle News via Google - Wed, 2008-05-14 09:01

Sedona.biz

10 myths and misconceptions about meditation
Sedona.biz, AZ - May 14, 2008
by Sarah McLean The purpose of meditation is to enliven the space and silence between the thoughts, not to stop the thoughts from coming altogether. ...

'Meditation is no more a choice, it's a must' - Nepalnews.com

Lifestyle News via Google - Wed, 2008-05-14 06:11

Nepalnews.com

'Meditation is no more a choice, it's a must'
Nepalnews.com, Nepal - May 14, 2008
A renowned guru of Meditation, Swami Anand Arun, has said meditation is no more a choice for people in modern times, but it has become a must. ...
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