CBT for Chronic Pain Worksheet

What is a CBT For Chronic Pain Worksheet?

Pain is something that is experienced broadly and can manifest in a range of different ways that can harm an individual. When you think of pain, you probably think of things like injury or incidents that cause physical harm. However, pain can also be caused by our cognitions, including our thoughts, feelings, moods, and behaviors.

Chronic pain refers to pain that is withstanding, lasting for a minimum of 3 months. Though the severity of the pain can differ according to many influencing factors, research has demonstrated that psychosocial factors have a significant role in experiences of pain. Research has observed that emotional distress and issues with behaviors stem from maladaptive cognition, which influences chronic pain (Lim et al., 2018)—in acknowledging the role of cognition in pain management, cognitive behavioral therapy (CBT) developed evidence-based treatment and coping strategies to manage chronic pain.

CBT is a realm of psychological treatment that seeks to enhance mental health and reduce experiences of anxiety, stress, and depression. As a chronic pain management therapy, CBT techniques typically aim to reduce chronic pain through strategies that alter maladaptive behaviors, negative thoughts and feelings, and physical sensations that usually make the pain worse.

We at Carepatron have developed the CBT for Chronic Pain Worksheet to assist health practitioners involved in CBT. The worksheet involves clients providing daily information about the following:

• Their level of pain, rated on a scale from 1 to 5 (1 = no pain at all, 5 = unbearable pain)
• The event that may have triggered or worsened pain
• A description of their thoughts and feelings
• A description of their behavior in response to pain
• A rational, objective assessment of the situation

In completing the worksheet, clients are asked to reflect on their experiences and adapt their thinking for chronic pain management. It may also be used as a thought diary or to empower clients in pain management strategies.

Signs and symptoms of chronic pain

Although the cause of chronic pain can often be challenging to locate, it usually manifests following an injury or incident that causes acute pain, such as arthritis or muscle sprains. When this is prolonged for over three months, it is then diagnosed as chronic pain.

Given that chronic pain can manifest in different ways, such as chronic musculoskeletal pain or headaches, individuals typically experience a vicious cycle of pain followed by poor mood and irritability. These are often accompanied by unhelpful thoughts, depression, anxiety, fear of avoidance of certain activities, and sleep problems, which worsen experiences, creating a cycle of chronic pain.

How to use the CBT For Chronic Pain Worksheet

As a cognitive behavioral therapy approach to alleviating chronic pain, this worksheet can encourage new skills for chronic pain management, such as mindfulness meditation, abdominal breathing, or other techniques. To show you how the CBT for Chronic Pain Worksheet operates, we have broken down the process into the following steps:

Step 1: Access the worksheet

Begin by accessing an electronic copy of our free CBT for Chronic Pain Worksheet here, or download a printable copy using the link below:

Download our free CBT for Chronic Pain Worksheet PDF here.

Step 2: Client consultation

During a client consultation about chronic pain, you may find it beneficial to introduce the worksheet into your client's therapy regimen. Given the flexibility of the worksheet, it can be applied to various CBT skills and techniques aimed at managing chronic pain.

Step 3: Implement the worksheet

The worksheet can be easily implemented as part of your client's therapy regimen. This may involve having clients use the worksheet to document their thought processes, experiences with pain, or progress with CBT techniques.

Depending on your client's preferences, the worksheet can be provided as an electronic copy using your practice management software or printed as a physical copy. Since the worksheet follows a 7-day format, clients should aim to complete daily entries and can make copies of the initial resource each week.

Step 4: Monitor progressions

It may be beneficial for clients to bring completed worksheets to future client sessions to discuss their experiences. This may involve evaluating the therapy plan, introducing new CBT skills, and assessing the effectiveness of the treatments in managing pain.

Clients may also use entries to reflect on their journey and progress. This can be incredibly empowering, reminding clients of their new skills, which can help enhance mental health and help them overcome future challenges.

When would you use this worksheet?

Our free CBT for Chronic Pain Worksheet template is an invaluable resource designed for therapy or counseling sessions, offering a holistic approach to chronic pain management. The flexibility of this worksheet allows for its broad application to enhance the therapeutic processes, allowing it to be easily applied for the following:

Education about chronic pain

The CBT for Chronic Pain Worksheet can be used as a resource to educate clients about chronic pain, including how their mental health and cognition may be influencing their ability to manage chronic pain. Using this worksheet and our example, therapists can illustrate how cognitive factors like thought processes, stress, anxiety, and depression can influence pain management. Furthermore, completing the worksheet as a daily exercise can help clients reflect on their behaviors and establish coping strategies that alleviate pain.

Encouraging self-reflection

Alongside being a resource for pain management, the CBT for Chronic Pain Worksheet can support clients' reflections. Given that the worksheets serve as a thought diary and monitor progress, therapists can use this tool to encourage clients to reflect on how their emotions, moods, thoughts, and behaviors contribute to their chronic pain. As clients continue their journey, they may identify specific behaviors that heighten or alleviate symptoms, using these as discussion points for sessions to develop and enhance their coping skills.

Locating causality

The worksheet is invaluable for supporting therapists and clients in exploring factors influencing their pain. This tool lets therapists complete personalized factor appraisals for chronic pain and locate causality. This is essential for the problem-solving required to develop treatment plans and CBT techniques.

Reviewing CBT techniques

An essential therapeutic process component is ongoing monitoring and reviewing of therapeutic techniques. Given that the worksheet serves as a source of clinical documentation for client records, it can be used to review which techniques work for pain management and further inform treatment plans.

Benefits of the CBT For Chronic Pain Worksheet

Our free CBT for Chronic Worksheet template provides an array of benefits that not only elevate your therapeutic practice but also enhance outcomes for clients experiencing chronic pain, particularly those dealing with the vicious chronic pain cycle.

Elevates mental health

As an evidence-based treatment, CBT in itself can help reduce chronic pain and related symptoms, which can enhance mental health. Given that the worksheet takes a CBT approach to treatment, it can be a beneficial resource to reduce stress and low mood and elevate mental health overall. In particular, the worksheet seeks to break down the cycle of chronic pain, identifying the client's negative thoughts or emotions to begin problem-solving for more positive cognition.

Enhances therapeutic alliance

By implementing the worksheet into a client's treatment plan, clients and health practitioners can establish an effective communication channel. By bringing completed worksheets to future sessions, clients and practitioners can focus their sessions on developing exercises that address the client's specific needs. This can enhance the therapeutic alliance, as clients are heard and encouraged to take control of their journey.

Self-reflection and empowerment

Given that this worksheet is designed for client completion, it can encourage self-reflection and self-determination. This can empower clients to take the lead in their journey, promoting positive outcomes and elevating overall wellbeing.

Structured framework

The worksheet structures necessary reflection points, encouraging clients to identify and navigate patterns or challenges that may influence their chronic pain experiences. By systematically breaking down this reflection, clients and therapists gain a further idea of the factors underlying symptoms, from which they can develop other methods to overcome them.

References

Lim, J.-A., Choi, S.-H., Lee, W. J., Jang, J. H., Moon, J. Y., Kim, Y. C., & Kang, D.-H. (2018). Cognitive-behavioral therapy for patients with chronic pain. Medicine (Baltimore), 97(23), e10867. doi: 10.1097/MD.0000000000010867

John Hopkins Medicine (n.d.). Chronic Pain. John Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/chronic-pain