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Reasons for Treatment Non-Response: A Controlled Study of Patients’ Views in Pain Rehabilitation

Published online by Cambridge University Press:  09 October 2017

A. D. Vittersø Open the ORCID record for A. D. Vittersø [Opens in a new window] ,
E. Keogh  and
J. Gauntlett-Gilbert
A. D. Vittersø
Affiliation:
Department of Psychology, University of Bath, Claverton Down, Bath BA2 7AY Bath Centre for Pain Services, Royal National Hospital for Rheumatic Diseases, Royal United Hospitals Bath, Upper Borough Walls, Bath BA1 1RL, UK
E. Keogh
Affiliation:
Department of Psychology, University of Bath, Claverton Down, Bath BA2 7AY, UK
J. Gauntlett-Gilbert*
Affiliation:
Bath Centre for Pain Services, Royal National Hospital for Rheumatic Diseases, Royal United Hospitals Bath, Upper Borough Walls, Bath BA1 1RL Faculty for Health and Applied Sciences, University of the West of England, Coldharbour Lane, Bristol BS16 1QY, UK
*
Correspondence to Dr Jeremy Gauntlett-Gilbert, Bath Centre for Pain Services, Royal National Hospital for Rheumatic Diseases, Upper Borough Walls, Bath BA1 1RL, UK. E-mail: Jeremy.gauntlett-gilbert@nhs.net
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Abstract

Background: Understanding successful and unsuccessful behavioural treatment for pain is essential. Aims: We carried out a retrospective survey of 130 people who had undergone pain rehabilitation based on acceptance and commitment therapy, aiming to identify factors associated with non-response. Method: The sample was selected using the reliable change index to define ‘responders’ and ‘non-responders’ to key outcome measures. We surveyed a range of treatment-related, systemic, practical and personal factors that may have affected their treatment, and then compared ‘non-responders’ with ‘responders’, controlling for factors that might not be causal or specific to non-response. Results: Logistic regression analysis showed two themes that distinguished the groups, ‘people outside programme’ and ‘emotional state’. Conclusions: These data have clinical implications, as such factors can be addressed directly or incorporated into an assessment of treatment ‘readiness’. This study introduced a novel methodology for the investigation of pain treatment response, which allowed a broad study of clinically relevant variables, but with greater rigour than conventional self-reports of ‘helpful factors’ in treatment.

Keywords

cognitive behavioural therapyacceptance and commitment therapytreatment processoutcomepain managementtreatment failure
Type
Brief Clinical Reports
Information
Behavioural and Cognitive Psychotherapy , Volume 46 , Issue 2 , March 2018 , pp. 238 - 243
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2017 

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