New approaches towards chronic pain: Patient experiences of a solution-focused pain management programme
Open accessAbstract
Research has suggested that Solution-Focused Brief Therapy (SFBT) may be effective in facilitating meaningful change for those living with chronic pain. This study aimed to further this understanding through exploring the experiences of people living with chronic pain, who had attended an 8-week solution-focused pain management programme. The design of this study was conducted in consultation with a service-user advisory group, and employed a qualitative and interpretative design rooted in critical community psychology, participatory research frameworks and emancipatory disability research. Five participants opted-in to the study following an opportunity sampling method of persons who had attended a programme in the last 18 months. Interviews were transcribed verbatim and analysed using inductive thematic analysis. Five main themes were identified: ‘Accessing the pain management programme’, ‘A solution-focused group’, ‘The solution-focused clinician’, ‘Solutions and changes’ and ‘Challenges and improvements’. Clinical and research implications of the findings are discussed. Summary points: There has been an international proliferation of pain management programmes (PMPs) aimed at helping those with chronic pain to live well, despite an unremitting condition. Arguably, the most popular psychological approaches used within PMPs are informed by cognitive behavioural therapy (CBT). Despite a supportive evidence base for psychological approaches in pain management, there is a recognised need for further research into alternative approaches and their effectiveness. Emerging research and policy recommendations are beginning to value the expertise of those living with chronic conditions, particularly how these perspectives can be used to develop effective treatments and services. SFBT is an approach aimed at achieving a patient’s goals or ‘preferred future’ through identifying and utilising their expertise. SFBT may have significant efficacy in helping those with chronic conditions to live improved, meaningful lives.
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Written from the paper’s full text.
TL;DR
This qualitative study explored five patients’ experiences of an 8-week solution-focused pain management programme in a community setting. Participants described the programme as supporting meaningful psychological and behavioural change, particularly through individualised, strengths-based group processes, though transition after the group remained challenging.
Key findings
- Five main themes were identified: “Accessing the pain management programme,” “A solution-focused group,” “The solution-focused clinician,” “Solutions and changes,” and “Challenges and improvements.”
- Participants valued having their expertise invited and shared; they described increased support, meaning, purpose, and connectedness through group participation.
- The solution-focused clinician’s one-to-one communication within group exercises helped participants feel individually recognised, tailored to, and taken seriously despite living with an “invisible condition.”
- The greatest reported challenge was sustaining self-determined changes after the group ended, described as “a hell of a step” when support from others was difficult to access.
Methods
- Qualitative design using semi-structured interviews, informed by critical community psychology, participatory research, and emancipatory disability research; a service-user support group of 12 expert patients was consulted on design, recruitment, interview schedule, and procedure.
- Participants were two men and three women (N = 5; age range = 25–75 years; time with chronic pain range = 3–12 years), recruited by opportunity sampling from 30 people who had attended at least 87.5% of one of the three most recent 8-week pain management programmes.
- Interviews lasted 50–70 minutes, were transcribed verbatim, and analysed using inductive thematic analysis following Braun and Clarke’s six-stage process.
Limitations
- The paper states that opportunity sampling may affect representation and generalisation of findings, and that it is unknown whether the positive effects described can be attributed to solution-focused brief therapy or to pain management programmes more widely.
- The paper also states that because the study was opt-in only, no information is available on those who chose not to participate, and specific pain types and health conditions were not reported to protect anonymity.
- Evident from the text: the sample was very small (N = 5), and the study is qualitative and exploratory, so it cannot establish effectiveness or causality.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
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Cites
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Claims the paper makes
0 of 31 cited sources checked · 0 supported · 0 flagged
- Findingown data§ Results
Many participants had accepted that their pain was permanent prior to the programme.
“As many participants had accepted that their pain was permanent prior to the programme, an additional feature within participants’ accounts regarded how they were simply curious to attend a group aimed at helping people to improve living with a chronic condition when there is ‘no cure’:”
Quote in the paperNot a substantial claim - Findingown data§ Results
Participants' previous experiences of services seemed most predictive of their hopes and expectations about the pain management programme, rather than the information provided about the programme.
“Importantly, participants’ previous experiences of services seemed most predictive of their hopes and expectations, rather than the information which had been provided about the PMP.”
Quote in the paperNot a substantial claim - Findingown data§ Results
Participants were regularly encouraged to share their individual knowledge and expertise derived from living with chronic pain.
“In particular, participants described how they were regularly encouraged to share their individual knowledge and expertise derived from living with chronic pain.”
Quote in the paperSubstantial claim - Findingown data§ Results
Several aspects of the solution-focused approach were noted to have positive impacts upon the group experience of the pain management programme.
“In addition to common group factors that may promote engagement in PMPs (e.g. a sense of understanding from others living with pain), several aspects of the SF approach were noted to have positive impacts upon the group experience.”
Quote in the paperSubstantial claim - Findingown data§ Results
Sharing individual knowledge and expertise led to perceived increases in feelings of support within the group.
“Several participants described how this led to perceived increases in feelings of support within the group:”
Quote in the paperNot a substantial claim
- Findingown data§ Results
Participants were curious to attend a group aimed at helping people improve living with a chronic condition when there is 'no cure'.
“As many participants had accepted that their pain was permanent prior to the programme, an additional feature within participants’ accounts regarded how they were simply curious to attend a group aimed at helping people to improve living with a chronic condition when there is ‘no cure’:”
Quote in the paperNot a substantial claim - Findingown data§ Results
People who adopted a curious stance were more able to engage with the programme.
“It appeared that people who adopted a curious stance were more able to engage with the programme.”
Quote in the paperNot a substantial claim - Findingown data§ Abstract
Five main themes were identified from the analysis: 'Accessing the pain management programme', 'A solution-focused group', 'The solution-focused clinician', 'Solutions and changes' and 'Challenges and improvements'.
“Five main themes were identified: ‘Accessing the pain management programme’, ‘A solution-focused group’, ‘The solution-focused clinician’, ‘Solutions and changes’ and ‘Challenges and improvements’.”
- Also stated in: § Results · plain
“Five main themes were identified from the analysis.”
Quote in the paperSubstantial claim - Also stated in: § Results · plain
- Findingown data§ Results
Many participants described experiencing referral to the pain management programme as a 'last resort' only after all other treatments were found to be unsuccessful.
“Many participants also described experiencing referral to the PMP as a ‘last resort’ only after all other treatments were found to be unsuccessful.”
Quote in the paperNot a substantial claim - Findingown data§ Results
Participants' hopes and expectations about the pain management programme appeared to be less focused on reducing pain severity and more on gaining control and independence.
“These hopes and expectations appeared to be less focused upon reducing pain severity and more on gaining control and independence.”
Quote in the paperNot a substantial claim - Findingown data§ Results
Tailoring elements of the programme to participants' individual contexts made them feel taken seriously when living with an 'invisible condition' that was often invalidated.
“The tailoring of elements of the programme to participants’ individual contexts meant they felt taken seriously when they were living with an ‘invisible condition’ which was often invalidated:”
Quote in the paperSubstantial claim- Rests on an assumption: Participants' retrospective self-reports accurately reflect their experiences of the PMP.
- Findingown data§ Results
Participation in the programme provided group members with confidence or 'permission' to push themselves within their daily lives and to achieve the most they could within the limitations of their pain.
“In particular, group members felt participation in the programme had provided them with the confidence or ‘permission’ to push themselves within their daily lives, and to achieve the most they could within the limitations of their pain:”
Quote in the paperSubstantial claim- Rests on an assumption: Participants' retrospective self-reports accurately reflect their experiences of the PMP.
- Findingown data§ Results
For many participants, exercising independence and self-determination in practice facilitated an enhanced sense of self-understanding, particularly regarding which aspects of their chronic condition were within their control and acceptance of possible change.
“Importantly, for many participants, being able to exercise this independence and self-determination in practice appeared to facilitate an enhanced sense of self-understanding, particularly with regard to which aspects of their chronic condition were within their control and a sense of acceptance about what elements of change were possible:”
Quote in the paperSubstantial claim- Rests on an assumption: Participants' retrospective self-reports accurately reflect their experiences of the PMP.
- Findingown data§ Results
Participants were able to practically benefit from the competence of other group members.
“In addition to feeling a sense of support from the sharing of expertise, participants also described that they were able to practically benefit from the competence of others:”
Quote in the paperNot a substantial claim- Rests on an assumption: Participants' retrospective self-reports accurately reflect their experiences of the PMP.
- Findingown data§ Results
Participants described being encouraged to develop independence in a way that contrasted with other programmes.
“Participants described how they had been encouraged to develop independence in a way which contrasted with other programmes.”
Quote in the paperSubstantial claim- Rests on an assumption: Participants' retrospective self-reports accurately reflect their experiences of the PMP.
- Findingown data§ Results
Although the PMP used a group setting, the use of one-to-one communication enhanced participants' sense that the programme was tailored to their individual needs.
“Several participants stated although the PMP used a group setting, the use of one-to-one communication enhanced a sense of the programme feeling ‘tailored’ due to its sensitivity to their individual needs:”
Quote in the paperSubstantial claim- Rests on an assumption: Participants' retrospective self-reports accurately reflect their experiences of the PMP.
- Findingown data§ Results
The greatest challenge of the programme described by participants was making the transition from making self-determined changes with group support to continuing those changes after the group, when support was difficult to access.
“However, the greatest challenge of the programme described by participants was in making the transition from making self-determined changes with the support of the group, to continuing to uphold these positive changes after the group, where it was difficult to access the support of others.”
Quote in the paperSubstantial claim- Rests on an assumption: Participants' retrospective self-reports accurately reflect their experiences of the PMP.
- Findingown data§ Results
All participants described a sense of having their individual identities and needs recognised within the group.
“A sense of having their individual identities and needs recognised within the group was described by all participants.”
Quote in the paperSubstantial claim- Rests on an assumption: Participants' retrospective self-reports accurately reflect their experiences of the PMP.
- Findingown data§ Results
Being invited to share expertise provided participants with a sense of meaning, purpose and connectedness with others that had previously felt missing from their lives.
“Participants described that being invited to share such expertise provided a sense of meaning, purpose and connectedness with others, that had previously felt missing from their lives.”
Quote in the paperSubstantial claim- Rests on an assumption: Participants' retrospective self-reports accurately reflect their experiences of the PMP.
- Findingown data§ Results
The use of one-to-one communication within group exercises appeared to ensure that participants felt their personal goals and competence levels were recognised and valued.
“In particular, the use of one-to-one communication within group exercises appeared to ensure that participants felt their personal goals and competence levels were recognised and valued.”
Quote in the paperSubstantial claim- Rests on an assumption: Participants' retrospective self-reports accurately reflect their experiences of the PMP.
- Findingown data§ Results
The challenging accounts revolved predominantly around intra-group difficulties arguably inherent to the group process, such as negativity, dominance from other group members, or gender differences creating difficulties when discussing sensitive topics.
“These accounts revolved predominantly around intra-group difficulties arguably inherent to the group process, such as negativity, dominance from other group members, or gender differences creating difficulties when discussing sensitive topics – such as sexual issues.”
Quote in the paperNot a substantial claim- Rests on an assumption: Participants' retrospective self-reports accurately reflect their experiences of the PMP.
- Findingown data§ Results
Participating in PMP sessions as a group member with existing competence (rather than a participant to be taught) made group members feel listened to and important.
“Being able to participate in the PMP sessions as a group member with existing competence (rather than a participant to be taught) meant that group members felt listened to and important:”
Quote in the paperSubstantial claim- Rests on an assumption: Participants' retrospective self-reports accurately reflect their experiences of the PMP.
- Findingown data§ Results
An increase in self-management and/or self-determination was a significant mediating factor in enhancing self-belief.
“A significant mediating factor in enhancing self-belief was related to an increase in self-management and/or self-determination.”
Quote in the paperSubstantial claim- Rests on an assumption: Participants' retrospective self-reports accurately reflect their experiences of the PMP.
- Findingown data§ Results
Participants felt that the SF approach was effective in facilitating meaningful change in life with a chronic health condition.
“This theme reflects aspects of the SF approach participants felt were effective in facilitating meaningful change in life with a chronic health condition.”
Quote in the paperSubstantial claim- Rests on an assumption: Participants' retrospective self-reports accurately reflect their experiences of the PMP.
- Findingown data§ Discussion
Several participants described how, following other treatments, they have felt 'dumped' or 'like a number'.
“Several participants described how, following other treatments, they have felt ‘dumped’ or ‘like a number’”
Quote in the paperSubstantial claim- Rests on an assumption: Participants' retrospective self-reports accurately reflect their experiences of the PMP.
- Findingown data§ Results
Participants felt encouraged to use resources outside the programme due to an emphasis on action and behaviour in the future.
“It appeared that in addition to feeling interventions were personalised, participants also felt encouraged to use resources outside of the programme due to an emphasis upon action and behaviour in the future.”
Quote in the paperNot a substantial claim- Rests on an assumption: Participants' retrospective self-reports accurately reflect their experiences of the PMP.
- Findingnone given§ Conclusion
Participants felt that overall, their experiences of the PMP had been important in encouraging positive psychological and behavioural changes which allowed them to live better in the presence of chronic pain.
“Participants felt that overall, their experiences of the PMP had been important in encouraging positive psychological and behavioural changes which allowed them to live better in the presence of chronic pain.”
Quote in the paperSubstantial claim- Rests on an assumption: Participants' retrospective self-reports accurately reflect their experiences of the PMP.
- Findingnone given§ Discussion
The positive group environment was experienced as high in relatedness by participants.
“the positive group environment was experienced as high in relatedness by participants”
Quote in the paperSubstantial claim- Rests on an assumption: Participants' retrospective self-reports accurately reflect their experiences of the PMP.
- Findingown data§ Discussion
Many participants discussed being referred to a PMP only after an abundance of unsuccessful treatments which had promoted a sense of permanence and helplessness.
“many participants discussed being referred to a PMP only after an abundance of unsuccessful treatments which had promoted a sense of permanence and helplessness”
Quote in the paperSubstantial claim- Rests on an assumption: Participants' retrospective self-reports accurately reflect their experiences of the PMP.
- Premisecitation§ Introduction
Such frameworks share key similarities with many of the core features of SFBT and recommendations for working with patients living with chronic conditions.
“Such frameworks share key similarities with many of the core features of SFBT and recommendations for working with patients living with chronic conditions.22,23”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [22] 22. Department of Health (DOH). Our health, our care, our say: a new direction for community services. White paper. Cm 6737, January 2006. London: Department of Health. [Google Scholar]
Not checked in the free run.
- cites [23] 23. Department of Health. The expert patients programme. London: Department of Health, 2007. [Google Scholar]
Not checked in the free run.
- Premisecitation§ Introduction
Studies have found the solution-focused approach to be effective in facilitating outcomes that are meaningful to those with chronic pain.
“While direct research regarding SFBT and physical health is more limited, studies have found the SF approach to be effective in facilitating outcomes that are meaningful to those with chronic pain.”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [12] 12. Thorslund KW. Solution-focused group therapy for patients on long-term sick leave: a comparative outcome study. J Fam Psychother 2007; 18: 11–24. [Google Scholar] source
Not checked in the free run.
- cites [13] 13. Cockburn JT, Thomas FN, Cockburn OJ. Solution-focused brief therapy and psychosocial adjustment to orthopedic rehabilitation in a work hardening program. J Occup Rehabil 1997; 7: 97–106. [Google Scholar] source
Not checked in the free run.
- Interpretationreasoning§ Discussion
The valuing of an individual focus that allowed participants to find 'what works for me' may have contributed to patients gaining a greater sense of control or mastery over their pain.
“For instance, the valuing of an individual focus which allowed participants to find ‘what works for me’ may have contributed to patients gaining a greater sense of control or mastery over their pain.”
Quote in the paperSubstantial claim- Rests on an assumption: Participants' retrospective self-reports accurately reflect their experiences of the PMP.
- Interpretationreasoning§ Discussion
Possible mediators of positive change may be found in participants' accounts of feeling that their individual hopes, needs and competencies were always in focus.
“Possible mediators of positive change may be found in participants’ accounts of feeling that their individual hopes, needs and competencies were always in focus.”
Quote in the paperSubstantial claim- Rests on an assumption: Participants' retrospective self-reports accurately reflect their experiences of the PMP.
- Premisecitation§ Discussion
Quantitative analysis of the PMP involved in the present research suggests positive change can be maintained for up to 12 months upon both measures of statistical and clinical significance.
“However, quantitative analysis of the PMP involved in the present research suggests positive change can be maintained for up to 12 months upon both measures of statistical and clinical significance.9”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [9] 9. Simm R, Iddon J, Barker C. A community pain service solution-focused pain management programme: delivery and preliminary outcome data. Br J Pain 2014; 8: 49–56. [DOI] [PMC free article] [PubMed] [Google Scholar] source
Not checked in the free run.
- Interpretationreasoning§ Discussion
A strengths-based ethos in the SF PMP could facilitate meaningful change.
“this may indicate why a strengths-based ethos in the SF PMP could facilitate meaningful change.”
Quote in the paperSubstantial claim- Rests on an assumption: Participants' retrospective self-reports accurately reflect their experiences of the PMP.
- Interpretationreasoning§ Discussion
The responsibility and control participants took towards making changes in their lives through being empowered may be accounted for by SFBT being autonomy-centred and the group environment being high in relatedness.
“As SFBT is an autonomy-centred intervention where the patient must identify, initiate and sustain change during therapy, and the positive group environment was experienced as high in relatedness by participants, this may account for the responsibility and control participants took towards making changes in their lives through being empowered to do so.”
Quote in the paperSubstantial claim- Rests on an assumption: Participants' retrospective self-reports accurately reflect their experiences of the PMP.
- Premisecitation§ Discussion
Combining the pain management approach with disease management can be effective for patients living with arthritis.
“Indeed, studies have shown that combining the pain management approach with disease management can be effective for patients living with arthritis,31,32”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [31] 31. Dixon KE, Keefe FJ, Scipio CD, et al. Psychological interventions for arthritis pain management in adults: a meta-analysis. Health Psychol 2007; 26: 241–250. [DOI] [PubMed] [Google Scholar] source
Not checked in the free run.
- cites [32] 32. Knittle K, Maes S, de Gucht V. Psychological interventions for rheumatoid arthritis: examining the role of self-regulation with a systematic review and meta-analysis of randomized controlled trials. Arthritis Care Res 2010; 62: 1460–1472. [DOI] [PubMed] [Google Scholar] source
Not checked in the free run.
- Premisecitation§ Discussion
Self-efficacy may be intimately related to, or contained within, the concept of self-determination, which concerns autonomy, sense of competence and relatedness to others.
“Self-efficacy may also be intimately related to, or be contained within, the concept of self-determination,30 which is concerned with one’s autonomy, sense of competence and relatedness to others.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [30] 30. Ryan R, Deci E. Self-determination theory and the facilitation of intrinsic motivation, social development and well-being. Am Psychol 2000; 55: 68–78. [DOI] [PubMed] [Google Scholar] source
Not checked in the free run.
- Interpretationown data§ Conclusion
The findings from this research suggest that a community-based SF approach to PMP may be of value to those living with chronic pain.
“The findings from this research suggest that a community-based SF approach to PMP may be of value to those living with chronic pain.”
Quote in the paperSubstantial claim- Rests on an assumption: Participants' retrospective self-reports accurately reflect their experiences of the PMP.
- Interpretationreasoning§ Discussion
Participants may have experienced meaningful change due to increases in self-efficacy, which have previously been implicated in facilitating improvements in living with chronic pain.
“As generation and attainment of the client’s goals are consistently a central focus of the SF approach, it may be possible that participants experienced meaningful change due to increases in self-efficacy,27 which have previously been implicated in facilitating improvements in living with chronic pain.28”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [27] 27. Bandura A. Self-efficacy in changing societies. New York: Cambridge University Press, 1995. [Google Scholar] source
Not checked in the free run.
- cites [28] 28. Nicholas MK. The pain self-efficacy questionnaire: taking pain into account. Eur J Pain 2007; 11: 153–163. [DOI] [PubMed] [Google Scholar] source
Not checked in the free run.
- Rests on an assumption: Participants' retrospective self-reports accurately reflect their experiences of the PMP.
- May combine two claims. 17
- The quote only partly states this claim. 1
- Classified as probably not a substantial claim. 25
May combine two claims.
Findingown data§ ResultsFor some participants, referral to the pain management programme carried a sense of invalidation in their reality of pain, with one person questioning whether she had been 'chronic enough' to be referred earlier.
“For some participants, this experience appeared to carry a sense of invalidation in their reality of pain, with one person questioning whether she had been ‘chronic enough’ to be referred earlier before further unsuccessful treatment experiences:”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown data§ ResultsParticipants who adopted a curious stance seemed to have attended the group with an open mind and would 'try anything' to improve their experience of living with pain.
“These participants seemed to suggest that they had attended the group with an open mind and would ‘try anything’ to improve their experience of living with pain.”
Quote in the paperNot a substantial claimThe quote only partly states this claim.
Findingown data§ ResultsMany participants hoped to reduce their medication as a result of attending the pain management programme.
“For many participants, this could be represented by changes in medication:”
- Also stated in: § Results · hedged
“I hoped I could come off some medication, erm because as I said there before trying to deal with the pain [had been difficult] so if I could manage it er by different means […] I might be able to come off the medication. (Brenda, 338–344)”
Quote in the paperNot a substantial claim- Also stated in: § Results · hedged
Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).
Findingnone given§ ResultsNegative experiences of services could lead participants to feel hesitant about attending the pain management programme.
“While negative experiences of services could lead participants to feel hesitant about attending the PMP.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown data§ DiscussionParticipants valued having opportunities to share their expertise with staff and peers within the programme, and discussed benefits in learning from others and feeling valued and capable through sharing their perspectives.
“Additionally, participants valued having opportunities to share their expertise with staff and peers within the programme, and discussed the benefits both in learning from others and feeling valued and capable through sharing their perspectives.”
Quote in the paperSubstantial claim- Rests on an assumption: Participants' retrospective self-reports accurately reflect their experiences of the PMP.
May combine two claims.
Findingown data§ ResultsParticipants valued life outside the PMP and focused on functioning after the PMP finished, rather than viewing the group itself as a 'treatment'.
“Of essential importance to participants was the valuing of life outside of the PMP – rather than viewing the group itself as a ‘treatment’ – and the focus upon functioning after the PMP had finished.”
Quote in the paperSubstantial claim- Rests on an assumption: Participants' retrospective self-reports accurately reflect their experiences of the PMP.
May combine two claims.
Findingown data§ ResultsThe future-orientated focus and commitment to follow-up helped participants feel reassured and not 'dumped'.
“Participants described that the future-orientated focus and commitment to follow-up helped them to feel reassured and that ‘you don’t feel dumped’”
Quote in the paperSubstantial claim- Rests on an assumption: Participants' retrospective self-reports accurately reflect their experiences of the PMP.
May combine two claims.
Findingown data§ ResultsThe valuing of each individual within the group process modelled positive conversations to other group members, which then began to occur naturally.
“The valuing of each individual within the group process was also described to model positive conversations to other group members, which then began to occur naturally:”
Quote in the paperNot a substantial claim- Rests on an assumption: Participants' retrospective self-reports accurately reflect their experiences of the PMP.
May combine two claims.
Findingown data§ DiscussionParticipants valued the notion of 'aftercare' following the programme, whereby they could access future sessions to support them in times of challenge or difficulty, and felt that this encouraged them to maintain positive change.
“Participants also valued the notion of ‘aftercare’ following the programme, whereby they could access future sessions to support them in times of challenge or difficulty, and felt that this encouraged them to maintain positive change.”
Quote in the paperSubstantial claim- Rests on an assumption: Participants' retrospective self-reports accurately reflect their experiences of the PMP.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown data§ MethodThe study was approved by the local National Health Service (NHS) ethics committee.
“Following approval by the local National Health Service (NHS) ethics committee, participants were able to opt in to the research via email, telephone or letter.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown data§ MethodPrior to sampling, a patient-led support group was consulted regarding the study design, recruitment, interview schedule and procedure.
“Prior to the sampling of participants, a patient-led support group was consulted regarding the study design, recruitment, interview schedule and procedure.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation§ IntroductionChronic pain is among the most prevalent of chronic conditions.
“as chronic pain is among the most prevalent of chronic conditions,2”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [2] 2. Cornally N, McCarthy G. Chronic pain: the help-seeking behavior, attitudes, and beliefs of older adults living in the community. Pain Manag Nurs 2011; 12: 206–217. [DOI] [PubMed] [Google Scholar] source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone given§ MethodThe views of 12 expert patients were sourced during a 2-hour drop-in group.
“The views of 12 expert patients were sourced during a 2-hour drop-in group.”
Quote in the paperNot a substantial claimMay combine two claims.
Premisecitation§ IntroductionA recent systematic review suggests that CBT is effective in the management of chronic pain, with successful outcomes sustained upon mood and catastrophising at 6 months after treatment, although improvements upon pain are weaker and only significant immediately post treatment.
“A recent systematic review suggests that CBT is effective in the management of chronic pain, with successful outcomes sustained upon mood and catastrophising at 6 months after treatment, although improvements upon pain are weaker and only significant immediately post treatment.5”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [5] 5. Williams AC, Eccleston C, Morley S. Psychological therapies for the management of chronic pain (excluding headache) in adults. Cochrane Database Syst Rev 2012; 11: CD007407. [DOI] [PMC free article] [PubMed] [Google Scholar]
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation§ IntroductionThe largest effects of SFBT were demonstrated upon behavioural problems (d = .61).
“The largest effects of SFBT were demonstrated upon behavioural problems (d = .61).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [11] 11. Stams GJ, Dekovic M, Buist K, et al. Efficacy of solution-focused brief therapy: a meta-analysis. Dutch J Behav Ther 2006; 39: 81–95. [Google Scholar]
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone given§ MethodThe quality and coherence of the final themes were appraised by two independent research supervisors to strengthen the validity of the analytical process.
“The quality and coherence of the final themes were appraised by two independent research supervisors in an endeavour to strengthen the validity of the analytical process.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
Premisecitation§ IntroductionThe mechanism by which psychological therapies can reduce the negative effects of chronic pain is through increasing positive and meaningful behavioural change.
“a number of studies indicating that the mechanism by which psychological therapies can reduce the negative effects of chronic pain is through increasing positive and meaningful behavioural change.16,17”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [16] 16. Berman BM, Swyers JP. Establishing a research agenda for investigating alternative medical interventions for chronic pain. Prim Care 1997; 24: 743–758. [DOI] [PubMed] [Google Scholar] source
Not checked in the free run.
- cites [17] 17. Rainville J, Sobel J, Hartigan C, et al. Decreasing disability in chronic back pain through aggressive spine rehabilitation. J Rehabil Res Dev 1997; 34: 383–393. [PubMed] [Google Scholar]
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation§ IntroductionResearch has consistently demonstrated that chronic pain impact breaches multiple aspects of the self, including physical, neurological, psychological, social and spiritual concerns.
“Research utilising a variety of methodologies has consistently demonstrated that this impact breaches multiple aspects of the self, including – but not limited to – physical, neurological, psychological, social and spiritual concerns.1”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [1] 1. Smith BH, Hopton JL, Chambers WA. Chronic pain in primary care. Fam Pract 1999; 16: 475–482. [DOI] [PubMed] [Google Scholar] source
Not checked in the free run.
May combine two claims.
Premisecitation§ IntroductionA recent systematic review of SFBT found that 74% of studies reported significant positive behavioural and psychological outcomes and 23% reported positive trends.
“a recent systematic review of SFBT found that 74% of studies reported significant positive behavioural and psychological outcomes and 23% reported positive trends.10”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [10] 10. Gingerich WJ, Peterson LT. Effectiveness of solution-focused brief therapy: a systematic qualitative review of controlled outcome studies. Res Social Work Prac 2013; 27: 266–283. [Google Scholar] source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoning§ MethodAs the study was opt-in only, no information is available on those who chose not to participate.
“As the study was opt-in only, no information is available on those who chose not to participate (either outcome data or opt-out reason).”
Quote in the paperNot a substantial claimMay combine two claims.
Premisecitation§ IntroductionSF group therapy has been found to improve the rehabilitation of orthopaedic patients on sick leave in two studies: 60% SFBT group vs 13% control, and 68% SFBT vs 4% control.
“SF group therapy has been found to improve the rehabilitation of orthopaedic patients on sick leave in two studies (60% SFBT group vs 13% Control)12 and (68% SFBT vs 4% Control).13”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [12] 12. Thorslund KW. Solution-focused group therapy for patients on long-term sick leave: a comparative outcome study. J Fam Psychother 2007; 18: 11–24. [Google Scholar] source
Not checked in the free run.
- cites [13] 13. Cockburn JT, Thomas FN, Cockburn OJ. Solution-focused brief therapy and psychosocial adjustment to orthopedic rehabilitation in a work hardening program. J Occup Rehabil 1997; 7: 97–106. [Google Scholar] source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown data§ MethodThe minutes of the service-user consultation were used to alter the structure of the research project.
“The minutes of this consultation were used to alter the structure of the research project accordingly.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoning§ MethodComparisons with the extant literature were made after data had been collected and analysed in order to ensure that the analysis was inductive and to minimise influence on the development of themes.
“Comparisons with the extant literature were made after data had been collected and analysed in order to ensure that the analysis was inductive and to minimise influence on the development of themes.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductnone given§ MethodAt the time of the study, the lead researcher was a male doctoral clinical psychology trainee of White British working class origin, without experience of chronic pain.
“At the time of undertaking the study, the lead researcher was a male doctoral clinical psychology trainee of White British working class origin, without experience of chronic pain.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim. May combine two claims.
Premisecitation§ IntroductionThe concept of a 'preferred future' when living with pain has more recently been given focus by pain researchers, as have techniques such as focusing on successes during pain consultations.
“The concept of a ‘preferred future’ when living with pain has also more recently been given focus by pain researchers,18–20 as have techniques such as focusing on successes during pain consultations.21”
Quote in the paperSubstantial claim0 of 4 sources checked- cites [18] 18. Brandstadter J, Rothermund K. The life-course dynamics of goal pursuit and goal adjustment: a two process framework. Dev Rev 2002; 22: 117–150. [Google Scholar] source
Not checked in the free run.
- cites [19] 19. Brandstadter J, Rothermund K. Self-percepts of control in middle and later adulthood: buffering losses by rescaling goals. Psychol Aging 1994; 9: 265–273. [DOI] [PubMed] [Google Scholar] source
Not checked in the free run.
- cites [20] 20. Crombez G, Eccleston C, De Vlieger P, et al. Is it better to have controlled and lost than never to have controlled at all? An experimental investigation of control over pain. Pain 2008; 137: 631–639. [DOI] [PubMed] [Google Scholar] source
Not checked in the free run.
- cites [21] 21. Williamson A. Chronic psychosomatic pain alleviated by brief therapy. Contemp Hypn 2002; 19: 118–124. [Google Scholar] source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone given§ AbstractThe study design was conducted in consultation with a service-user advisory group.
“The design of this study was conducted in consultation with a service-user advisory group”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation§ IntroductionStudies which examined length of treatment all found that SFBT used fewer treatment sessions than comparative interventions.
“Studies which examined length of treatment all found that SFBT used fewer treatment sessions than comparative interventions, and the strongest evidence of effectiveness was found in the treatment of depression.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [10] 10. Gingerich WJ, Peterson LT. Effectiveness of solution-focused brief therapy: a systematic qualitative review of controlled outcome studies. Res Social Work Prac 2013; 27: 266–283. [Google Scholar] source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductnone given§ MethodThe lead researcher had no affiliations to the Community Pain Service and no personal or working relationships with any of the staff members or service users involved in the research.
“The lead researcher had no affiliations to the Community Pain Service at which the study was conducted and no personal or working relationships with any of the staff members or service users involved in the research.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoning§ MethodA rigorous inductive approach was ensured through regularly corroborating emerging themes with initial data, such as providing a digital audio link to each paragraph of the transcript.
“A rigorous inductive approach to qualitative research was ensured through regularly corroborating emerging themes with initial data, such as providing a digital audio link to each paragraph of the transcript, so that sections could be listened to again within their initial context to preserve intentionality and meaning.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim. May combine two claims.
Premisecitation§ IntroductionLiving with chronic pain is an active process of searching for solutions, and to react passively to pain is 'counter biological'.
“Eccleston and Crombez,14 for instance, describe that living with chronic pain is an active process of searching for solutions, and to react passively to pain is ‘counter biological’.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [14] 14. Eccleston C, Crombez G. Worry and chronic pain: a misdirected problem solving model. Pain 2007; 132: 233–236. [DOI] [PubMed] [Google Scholar] source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown data§ MethodAn additional recruitment sample was not deemed necessary due to the saturation of data themes.
“An additional recruitment sample of potential participants was not deemed necessary due to the saturation of data themes.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Premisecitation§ IntroductionA meta-analysis of 21 studies of SFBT outcome research comprising 1421 patients demonstrated only small to moderate positive effects on treatment outcomes (d = .37) and was not more effective than treatment as usual.
“meta-analysis of 21 studies of SFBT outcome research comprising a total of 1421 patients demonstrated only small to moderate positive effects on treatment outcomes (d = .37) and was not more effective than treatment as usual.11”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [11] 11. Stams GJ, Dekovic M, Buist K, et al. Efficacy of solution-focused brief therapy: a meta-analysis. Dutch J Behav Ther 2006; 39: 81–95. [Google Scholar]
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitation§ DiscussionThe involvement of those living with chronic pain to shape the research design and interview focus is considered a strength of the study, as the information gained is more likely to be relevant to service users.
“The involvement of those living with chronic pain (CP) to shape the research design and interview focus is considered as a strength of the study, as the information gained from the research is more likely to be of relevance to those using services.24”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [24] 24. Barnes C. What a difference a decade makes: reflections on doing ‘emancipatory’ disability research. Disabil Soc 2003; 18: 3–17. [Google Scholar] source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone given§ DiscussionIt is unknown whether the positive effects participants described can be attributed to SFBT or PMPs more widely.
“It is also unknown whether the positive effects participants described can be attributed to SFBT or PMPs more widely.”
Quote in the paperNot a substantial claimMay combine two claims.
Study design and conductreasoning§ DiscussionParticipants were recruited via opportunity sampling, which may affect the representation and generalisation of findings.
“However, as participants were recruited via opportunity sampling, this is a recognised feature that may affect the representation and generalisation of findings.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).
Interpretationown data§ DiscussionThis may indicate the importance of follow-up contacts as a routine component of PMPs.
“which may indicate the importance of follow-up contacts as a routine component of PMPs.”
Quote in the paperNot a substantial claim- Rests on an assumption: Participants' retrospective self-reports accurately reflect their experiences of the PMP.
May combine two claims.
Interpretationown data§ DiscussionThese experiences mirror the recommendations in policy guidance and demonstrate how they can be effective in practice.
“These experiences mirror the recommendations in policy guidance22,33,34 and demonstrate how they can be effective in practice.”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [22] 22. Department of Health (DOH). Our health, our care, our say: a new direction for community services. White paper. Cm 6737, January 2006. London: Department of Health. [Google Scholar]
Not checked in the free run.
- cites [33] 33. Department of Health. The expert patient: a new approach to chronic disease management for the 21st century. London: Department of Health, 2001. [Google Scholar]
Not checked in the free run.
- cites [34] 34. Department of Health. Equity and excellence: liberating the NHS. London: Department of Health, 2010. [Google Scholar] Articles from British Journal of Pain are provided here courtesy of SAGE Publications
Not checked in the free run.
- Rests on an assumption: Participants' retrospective self-reports accurately reflect their experiences of the PMP.
Classified as probably not a substantial claim.
Premisecitation§ DiscussionHigh self-efficacy is suggested to be a more robust determinant of disability than pain intensity or duration.
“As high self-efficacy is suggested to be a more robust determinant of disability than pain intensity or duration,29”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [29] 29. Denison E, Asenlof P, Lindberg P. Self-efficacy, fear avoidance, and pain intensity as predictors of disability in subacute and chronic musculoskeletal pain patients in primary health care. Pain 2004; 111: 245–252. [DOI] [PubMed] [Google Scholar] source
Not checked in the free run.
The paper relies on this without support.
There is a recognised need for further research into alternative psychological approaches to pain management and their effectiveness.
“Despite a supportive evidence base for psychological approaches in pain management, there is a recognised need for further research into alternative approaches and their effectiveness.”
The paper relies on this without support.
Emerging research and policy recommendations are beginning to value the expertise of those living with chronic conditions, particularly how these perspectives can be used to develop effective treatments and services.
“Emerging research and policy recommendations are beginning to value the expertise of those living with chronic conditions, particularly how these perspectives can be used to develop effective treatments and services.”
The paper relies on this without support.
The most popular psychological approaches used within pain management programmes are informed by cognitive behavioural therapy (CBT).
“Arguably, the most popular psychological approaches used within PMPs are informed by cognitive behavioural therapy (CBT).”
The paper relies on this without support.
Participants' retrospective self-reports accurately reflect their experiences of the PMP.
“Participants felt that overall, their experiences of the PMP had been important in encouraging positive psychological and behavioural changes which allowed them to live better in the presence of chronic pain.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The current approach to care requires patients to judge when an undesired event is problematic and what action to take in the face of that event.
“Specifically, the current approach to care requires patients to judge when an undesired event is problematic and what is the preferred action to take in the face of that event [30,31,32].”
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- Williams AC, 2012, Cochrane Database Syst Rev, 11, CD007407
- Stams GJ, 2006, Dutch J Behav Ther, 39, 81
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Cited by
Sorted by citations
Suso-Ribera, C., Castilla, D., Zaragozá, I., Mesas, Á., Server, A., Medel, J., & García-Palacios, A. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17186568 · Cited by 38 · see citing works
Hopper, M. J., Curtis, S., Hodge, S., & Simm, R. (2016) · British Journal of Pain · doi:10.1177/2049463716638368 · Cited by 28 · see citing works
Self-citationPractical approach to a patient with chronic pain of uncertain etiology in primary care
Salduker, S., Allers, E., Bechan, S., Hodgson, R. E., Meyer, F., Meyer, H., Smuts, J. A., Vuong, E., & Webb, D. (2019) · Journal of Pain Research · doi:10.2147/jpr.s205570 · Cited by 24 · see citing works
Iddon, J., Dickson, J. M., & Unwin, J. (2016) · International Journal of Applied Positive Psychology · doi:10.1007/s41042-016-0003-6 · Cited by 19 · see citing works
“7 Qualitative Studies Two studies (Dargan et al. 2014; Larsen et al. 2015) reported qualitative themes which reflected improvements relevant to positive psychological constructs (e.”
BackgroundSimm, R., Iddon, J., & Barker, C. (2014) · British Journal of Pain · doi:10.1177/2049463713507910 · Cited by 17 · see citing works
Self-citationSimm, R., & Barker, C. (2017) · British Journal of Pain · doi:10.1177/2049463717744358 · Cited by 16 · see citing works
Self-citationEgan, Á. M., Lennon, O. C., Power, C. K., & Fullen, B. M. (2016) · Pain Medicine · doi:10.1093/pm/pnw148 · Cited by 13 · see citing works
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“Complementary and alternative medicine therapies are attractive to patients in part because they offer support to patients whose challenges may include navigating physical, neurological, psychological, social, and spiritual concerns (43).”
BackgroundThe Role of Adaptive Goal Processes in Mental Wellbeing in Chronic Pain
Swindells, T., Iddon, J., & Dickson, J. M. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20021278 · Cited by 9 · see citing works
“SFBT for chronic pain invites clients to imagine and describe their personally meaningful hopes for the future, identify their own internal strengths and resources, and recognise small signs of success happening in an effort to improve self-efficacy, wellbeing, hope, and coping [42].”
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“Our research conclusion is roughly consistent with this conclusion [23].”
ResultRetractedTechnological Interventions for Pain Management
Suso-Ribera, C., Castilla, D., Martínez-Borba, V., Jaén, I., Botella, C., Baños, R. M., & García-Palacios, A. (2022) · Comprehensive Clinical Psychology · doi:10.1016/b978-0-12-818697-8.00009-1 · Cited by 6 · see citing works
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Solution-Focused Chronic Pain Self-Management Education: A Pilot Study 🇨🇳 🇹🇼 🇫🇷 🇮🇷
Valusek, J. E. (2021) · Journal of solution-focused brief therapy · doi:10.59874/001c.74978 · Cited by 3 · see citing works
Northcott, S., Baker, C., Thomas, S., Iddon, J., James, K., & Hilari, K. (2024) · Discover Psychology · doi:10.1007/s44202-024-00195-6 · Cited by 2 · see citing works
“There is evidence that people with aphasia derive benefit from group therapy, as it fosters social connections and friendship [57], personal growth and self-acceptance [58]; and that SFBT can work well delivered in a group format with other client groups [59, 60].”
Building and testing coherent models of treatment
Williams, A. C. D. C., & Batho, A. (2020) · Pain · doi:10.1097/j.pain.0000000000001987
“Other connect ions could be made with: cognitive exposure [16]; self-compassion [18]; solution-focus ed therapy [5]; and various elements of CBT and ACT [10,12].”
BackgroundResearch Progress on Solution Focused Approach in Surgical Nursing
高, 源. (2023) · Nursing Science · doi:10.12677/ns.2023.126151
Eshraghi, P., Drake, D., Iddon, J., & Dickson, J. M. (2026) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph23060708
“Despite medical advances, complete pain relief is often unattainable, with growing emphasis instead placed on effective management to support individuals living well alongside their pain [19].”
- Authors
- Dargan, P. J., Simm, R., & Murray, C.
- Affiliations
- Lancaster University (GB)
- Southport and Ormskirk Hospital NHS Trust (GB)
- ORCID
- Murray, Craig
- Venue
- British Journal of Pain
- Publisher
- SAGE Publications
- Published
- 2013-12-16
- Volume
- 8
- Issue
- 1
- Pages
- 34-42
- ISSN
- 2049-4637 (ISSN-L)
- 2049-4645
- PMC
- PMC4590174
- OpenAlex
- W2125058412
- Semantic Scholar
- e170eeda8517376838922054ad1e38276124952b
- Cited by
- 18
- References
- 33
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 2 · 2021: 3 · 2020: 3 · 2019: 2 · 2017: 1 · 2016: 3 · 2013: 1
- FWCI
- 0.98
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- British Journal of Pain (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Lancaster EPrints (Lancaster University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Social Sciences › Psychology › Clinical Psychology › Counseling, Therapy, and Family Dynamics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- chronic pain, solution-focused therapy, pain management program, patient experience, psychological intervention, preferred futures, service user involvement, clinician-patient relationship, community psychology, disability research
About these checks
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