Conceptualizing and Treating Comorbid Chronic Pain and PTSD
Table 1
Summary of integrated care treatment components.
Treatment goal
Intervention
(i) Educate about the relationship between thoughts, emotions, and behaviors (ii) Increase awareness about the interaction between chronic pain, emotional functioning, and cognitive functioning (iii) Educate about the role of cognitions in emotional and behavioral functioning (iv) Educate about the interactions between chronic pain and PTSD (v) Educate about the role of fear-avoidance in the development and maintenance of chronic pain and PTSD
Psychoeducation
Reduce chronic pain and PTSD-related avoidance behaviors via systematic practice of increasingly challenging avoided stimuli
Construction of an in vivo hierarchy
Facilitate engagement in enjoyable activities to improve mood and challenge any inherent avoidances
Include behavioral activation activities on in vivo hierarchy
Correct attentional biases
Education; identification and cessation of safety behaviors
Normalize emotional experiences or responses and associated physiologic sensations
Normalization; education about fight or flight response; ongoing identification and systematic confrontation of avoidance or escape behaviors via real life exercises/activities
