Chronic Pain(Test Only)

By
Beverly J. Field, PhD
Robert A Swarm, MD
Dr. Michele D. Levine

Course Outline

There are effective psychological interventions for patients with chronic pain that can serve as an independent treatment or in conjunction with medical and physiological treatments. This volume in the series Advances in Psychotherapy- Evidence-Based Practice provides psychologists, physicians, and other health care providers with practical and evidence-based guidance on the psychological diagnosis and treatment of chronic pain in a reader-friendly format. In addition, it includes information about medical treatments, multidisciplinary management, and complementary and alternative therapies.


About Authors

Beverly J. Field, PhD, is Assistant Professor in the Departments of Anesthesiology and Psychiatry, Washington University School of Medicine, St. Louis, Missouri. She is cofounder and director of the STEPP program, a cognitive-behavioral program for patients with chronic pain. In addition to her clinical and teaching responsibilities, she lectures regularly on psychological therapies in multidisciplinary pain management.

Robert A Swarm, MD, is Associate Professor and Chief, Division of Pain Management in the Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri. He is also the Director of Pain Management Fellowship Training Program at Washington University, and Director of the Barnes-Jewish Hospital, Washington University Pain Management Center. His clinical work is exclusively focused on the multidisciplinary management of acute, chronic, and cancer pain.



Student Course Evaluation Form

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Learning Objectives

After completing this course you’ll be able to:

  1. State the purpose of the book.
  2. State the response to the question, “Is breast cancer a death sentence?”
  3. Define lumpectomy.
  4. State the type of doctor you will be sent for the purpose of diagnosis.
  5. Describe how to find a good cancer specialist.
  6. State a major source of data when evaluating physicians.
  7. List three factors to consider when evaluating a physician.
  8. Define an acinus.
  9. Define cancer.
  10. Describe a malignant tumor.
  11. Define in situ cancer and how it is detected.
  12. Define fibroadenoma.
  13. Discuss the old saying, “If it hurts, it’s not cancer.”
  14. Discuss the age to begin breast self-exams, frequency and timing.
  15. Describe digital mammography.
  16. Discuss why women under thirty-five should not have routine screening mammograms.
  17. Describe how sound waves react to liquid-filled cysts versus a solid mass.
  18. Compare a fine-needle aspiration and core biopsy.
  19. Define an incisional biopsy and an excisional biopsy.
  20. Describe the role of the pathologist.
  21. Describe a permanent section.
  22. Define multifocal and multicentric.
  23. State the length of time treatment should begin after diagnosis.
  24. List three characteristics of a personal advocate
  25. Define mutation and carrier.
  26. Describe the “founder’s effect.”
  27. Compare lumpectomy and mastectomy.
  28. List blood thinners that may interfere with clotting
  29. Discuss the informed consent.
  30. Describe monitoring devices used during surgery.
  31. Describe why lymph nodes are often removed.
  32. Describe sentinel nodes and describe how they are located.
  33. Define the Halstead procedure.
  34. Describe the skin-sparing mastectomy.
  35. List ways to prevent infection after surgery.
  36. Describe treatment for phlebitis.
  37. State when arm exercises should be started.
  38. Describe cancer in pregnancy.
  39. Define electromagnetic radiation and list side effects.
  40. Define metastasis and state the first line of defense.
  41. Describe the role of the radiation oncologist.
  42. Define simulation.
  43. Describe phase one and two of radiation.
  44. List several long-term side effects of radiation.
  45. List the three primary factors that are used to determine prognosis.
  46. Discuss lymph node involvement in the recurrence of cancer.
  47. Define oncogenes.
  48. Discuss the purpose of systemic therapy and its purpose in reducing the risk of recurrence.
  49. Compare chemotherapy and hormone therapy in premenopausal and postmenopausal women.
  50. List qualifications you should look for in a physician to administer systemic .
  51. State the most common route to administer chemotherapy.
  52. List several ways to administer chemotherapy.
  53. Define cytotoxic.
  54. List two very important strategies in using chemotherapy.
  55. Describe the five types of drugs for adjuvant therapy.
  56. Describe the method of reducing hair loss by use of a tourniquet and ice pack.
  57. Discuss the use of Procrit and Neupogen.
  58. List several other side effects while taking chemotherapy.
  59. List side effects of Prednisone, Adriamycin, Cytoxan, and Taxol.
  60. Describe the Group 0 through Group 6 chart related to nodal involvement.
  61. Define triple negative breast cancer.
  62. List several reasons women do not want breast reconstruction.
  63. Describe the trends in reconstruction after a mastectomy.
  64. Define a myocutaneous flap, pedicle flap and free flap.
  65. Describe several types of flaps.
  66. List the major complications of flap reconstruction.
  67. Define regional recurrence and distance recurrence.
  68. Describe how to decide which doctor will be in charge.
  69. List blood tests that are frequently done in follow-up visits.
  70. State the frequency of mammograms and chest x-rays after a mastectomy.
  71. Discuss how a patient should prepare for a bone scan.
  72. List several things you should take with you to the first appointment with a consulting physician.
  73. State where breast cancer cells often establish themselves and produce tumor recurrence.
  74. Define prognosis and remission
  75. Define palliative.
  76. Discuss the role of heredity and the development of breast cancer.
  77. List three methods of reducing fat in the American diet.
  78. State the number one cancer killer of women in the United States.
  79. Describe the relationship of hormones and breast cancer.
  80. State the procedures that should be done prior to taking hormone replacement therapy.
  81. Describe a suppressor gene.
  82. Define epigenetics.
  83. Define apoptosis.
  84. Describe cryosurgery and radiofrequency ablation.
  85. State briefly the four stages of drug testing.
  86. List groups and organizations who offer practical and emotional support.
  87. Discuss the possible role of environmental exposure to cancer producing agents regarding research.
  88. List the most important issues facing our society.
  89. State how we know about breast cancer in the United States, including SEER programs.
  90. Discuss the Mammography Quality Standards Reauthorization Act of 2003.

Table of Contents

  1. Description of the Disorder
    • 1.1 Definitions
    • 1.2 Terminology
    • 1.2.1 Classification of Pain
    • 1.3 Epidemiology
    • 1.3.1 Prevalence of Chronic Pain
    • 1.3.2 Economic Impact of Pain
    • 1.4 Course and Prognosis
    • 1.5 Differential Diagnosis
    • 1.6 Comorbidities
    • 1.6.1 Sleep Disorders
    • 1.6.2 Depression
    • 1.6.3 Anxiety
    • 1.6.4 Substance Abuse
    • 1.7 Diagnostic Procedures and Documentation
  2. Theories and Models of the Disorder
    • 2.1 Dualistic Models
    • 2.2 Gate-Control Theory
    • 2.3 Biopsychosocial Model
    • 2.3.1 Operant Conditioning Model
    • 2.3.2 Cognitive-Behavioral Model
    • 2.3.3 Multidisciplinary Management
  3. Diagnosis and Treatment Indications
    • 3.1 Referral Questions and Medical Record Review
    • 3.2 Guidelines of Assessing Medical History
    • 3.2.1 History of Pain Complaint
    • 3.2.2 Pain Intensity, Location, Aggravating and Relieving Factors
    • 3.2.3 Medical History
    • 3.3 Guidelines for Assessing Cognitions
    • 3.3.1 Beliefs and Expectations
    • 3.3.2 Cognition
    • 3.4 Guidelines for Assessing Psychiatric Disorders
    • 3.4.1 Behavioral Observations and Mental Status
    • 3.4.2 Depression
    • 3.4.3 Anxiety Disorders
    • 3.4.4 Substance Abuse
    • 3.5 Guidelines of Assessing Daily Activity Patterns
    • 3.5.1 Work and Everyday Activities
    • 3.5.2 Relationships- Family and Friends
    • 3.6 Additional Areas for Assessment
    • 3.6.1 Anger
    • 3.6.2 Social History
    • 3.6.3 Educational and Employment History
    • 3.6.4 Presurgical Screening
    • 3.7 Diagnosis and Treatment Recommendations
    • 3.7.1 Diagnosis
    • 3.7.2 Treatment Plan
    • 3.7.3 Referrals to Additional Providers and Communication with Referring Physicians
  4. Treatment
    • 4.1 Introduction
    • 4.2 Methods of Treatment
    • 4.2.1 Medical Treatments
    • 4.3 Psychological Interventions
    • 4.3.1 Cognitive-Behavioral Therapy
    • 4.3.2 Education
    • 4.3.3 Identifying and Restructuring Negative Cognitions
    • 4.3.4 Changing Behaviors
    • 4.3.5 Self-Regulatory Techniques
    • 4.4 Efficacy and Prognosis
    • 4.5 Mechanisms of Action
    • 4.6 Variations and Combinations of Methods
    • 4.6.1 Physical Therapy
    • 4.6.2 Complementary and Alternative Medicine (CAM)
    • 4.7 Problems in Carrying Out the Treatments
    • 4.8 Multicultural Issues
    • 4.9 Conclusion
  5. Case Vignette
  6. Further Reading
  7. References
  8. Appendix: Tools and Resources

Customer Comments

Chronic Pain is a small gem. [The authors] provide sage insights based on their clinical experience and available research into the complexities of patients with chronic pain… in a succinct and user-friendly package.” – Dennis C. Turk, PhD, Professor, Department of Anesthesiology, University of Washington

“[This book] contains an invaluable overview of assessment and treatment strategies for persons with chronic pain. [It] is highly recommended for healthcare providers and students alike.” – Robert N. Jamison, PhD, Director of Clinical Psychology and Associate Professor, Harvard Medical School

“A brief, highly readable volume that, nonetheless, is packed with important clinical information and savvy insights on the assessment and treatment of patients.” – Raymond C. Tait, PhD, Professor, Department of Neurology and Psychiatry, Saint Louis University School of Medicine

“Chronic Pain presents up-to-date information to the provider who has been overlooked in the treatment of pain.” – Bill H. McCarberg, MD, Chronic Pain Management Program, Kaiser Permanente and Assistant Clinical Professor, School of Medicine, University of California, San Diego



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