Abstract
The relationship between patient and provider has long been the subject of study within the psychotherapy literature, with the available data suggesting a modest, but reliable, association between the strength of this relationship and treatment outcome. Conversely, there has been little work focused on the patient–provider relationship in chronic pain settings despite the complexities and difficulties that are often involved in this area. This review provides a brief, broad overview of the literature on the patient–provider relationship and identifies key aspects that are specifically relevant to chronic pain settings. In addition to reviewing the literature in this area, a series of recommendations for future clinical and academic work are offered.
Similar content being viewed by others
References
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
• Norcross JC, Lambert MJ. Psychotherapy relationships that work II. Psychother 2011;48:4–8. This is the introduction to a special issue on the patient–provider relationship in psychotherapy. The article provides an overview of the area and, in addition to the rest of the articles within the issue, specifies aspects of the relationship that are reliably related to outcomes.
Mumford E, Schlesinger HJ, Glass GV. The effect of psychological intervention on recovery from surgery and heart attacks: an analysis of the literature. Am J Public Health. 1982;72:141–51.
Jamison RN. Nonspecific treatment effects in pain medicine. Pain Clinical Updates. 2011;9:1–7.
Safran DG, Taira DA, Rogers WH, et al. Linking primary care performance to outcomes of care. J Family Practice. 1998;47:213–20.
Makoul G. Essential elements of communication in medical encounters: the Kalamazoo consensus statement. Acad Med. 2001;76:390–3.
Wasan AD, Wootton J, Jamison RN. Dealing with difficult patients in your pain practice. Region Anesth Pain Med. 2005;30:184–92.
Burns JW, Higdon LJ, Mullen JT, Lansky D, Wei JM. Relationships among patient hostility, anger expression, depression, and the working alliance in a work hardening program. Ann Beh Med. 1999;21:77–82.
Rogers CR. The necessary and sufficient conditions of therapeutic personality change. J Consult Psychol. 1957;21:95–103.
Horvath AO, Symonds BD. Relation between working alliance and outcome in psychotherapy: a meta-analysis. J Couns Psychol. 1991;38:149–39.
Martin DJ, Garske JP, Davis MK. Relation of the therapeutic alliance with outcome and other variables: a meta-analytic review. J Consulting Clin Psych. 2000;68:438–50.
Horvath AO, Del Re AC, Flückiger C, Symonds D. Alliance in individual psychotherapy. Psychother. 2011;48:9–16.
Cohen J. Psych Bull. 1992;112:155–9.
Burlingame GM, McClendon DT, Alonso J. Cohesion in group therapy. Psychother. 2011;48:34–42.
Elliott R, Bohart AC, Watson JC, Greenberg LS. Empathy. Psychother. 2011;48:43–9.
Farber B, Doolin EM. Positive regard. Psychother. 2011;48:58–64.
Kolden GG, Klein MH, Wang C-C, Austin SB. Congruence/genuineness. Psychother. 2011;48:65–71.
Grencavage LM, Norcross JC. Where are the commonalities among the therapeutic common factors? Prof Psychol Res Pr. 1990;21:372–8.
Myers S. Empathic listening: reports on the experience of being heard. J Humanist Psychol. 2000;40:148–73.
Lewis M, Morley S, van der Windt DAWM, et al. Measuring practitioner/therapist effects in randomised trials of low back pain and neck pain interventions in primary care settings. Eur J Pain. 2010;14:1033–9.
Williams ACDC, Potts HWW. Group membership and staff turnover affect outcomes in group CBT for persistent pain. Pain. 2010;148:481–6.
De Ruddere L, Goubert L, Prkachin KM, et al. When you dislike patients, pain is taken less seriously. Pain. 2011;152:2342–7.
Gulbrandsen P, Madsen HB, Benth JS, Laerum E. Health care providers communicate less well with patients with chronic low back pain: a study of encounters at a back pain clinic in Denmark. Pain. 2010;150:458–61.
Tryon GS, Winograd G. Goal consensus and collaboration. Psychother. 2011;48:50–7.
Frantsve LME, Kerns RD. Patient-provider interactions in the management of chronic pain: current findings within the context of shared medical decision making. Pain Med. 2007;8:25–35.
Hirsh AT, Atchison JW, Berger JJ, et al. Patient satisfaction with treatment for chronic pain: predictors and relationship to compliance. Clin J Pain. 2005;21:302–10.
Smith MY, Winkel G, Egert J, Diaz-Wionczek M, DuHamel KN. Patient-physician communication in the context of persistent pain: validation of a modified version of the Patients’ Perceived Involvement in Care Scale. J Pain Symptom Manag. 2006;32:71–81.
Thorne FM, Morley S. Prospective judgments of acceptable outcomes for pain, interference and activity: patient-determined outcome criteria. Pain. 2009;144:262–9.
Robinson ME, Brown JL, George SZ, et al. Multidimensional success criteria and expectations for treatment of chronic pain: the patient perspective. Pain Med. 2005;6:336–45.
Dobkin PL, Sita A, Sewitch MJ. Predictors of adherence to treatment in women with fibromyalgia. Clin J Pain;22:286–94.
Baker SC, Gallois C, Driedger SM, Santesso N. Communication accommodation and managing musculoskeletal disorders: doctors’ and patients’ perspectives. Health Commun. 2011;26:379–88.
Benner DE. Who can help me? A chronic pain patient’s view of multidisciplinary treatment. In: Schatman M, Campbell M, editors. Chronic pain management: guidelines for multidisciplinary program development. New York: Informa; 2007. p. 117–28.
Vowles KE, Robinson ME. Progressing towards acceptable treatment outcomes. Pain. 2009;144:228–9.
Norcross JC, Wampold BE. Evidence-based therapy relationships: research conclusions and clinical practices. Psychother. 2011;48:98–102.
Leila NM, Pirkko H, Eeva P, Eija K, Reino P. Training medical students to manage a chronic pain patient: both knowledge and communication skills are needed. Eur J Pain. 2006;10:167–70.
Baldwin SA, Wampold BE, Imel ZE. Untangling the alliance-outcome correlation: exploring the relative importance of therapist and patient variability in the alliance. J Cons Consulting Psych. 2007;75:842–52.
Miller WR, Rollnick S. Motivational interviewing: preparing people for change. New York: Guilford; 2002.
Vong SK, Cheing GL, Chan F, So EM, Chan CC. Motivational enhancement therapy in addition to physical therapy improves motivational factors and treatment outcomes in people with low back pain: a randomized controlled trial. Arch Phys Med Rehab. 2011;92:176–83.
Turk DC, Dworkin RH, Revicki D, et al. Identifying important outcome domains for chronic pain clinical trials: an IMMPACT survey of people with pain. Pain. 2008;137:276–85.
Beale M, Cella M, Williams ACDC. Comparing patients’ and clinician-researchers’ outcome choice for psychological treatment of chronic pain. Pain. 2011;152:2283–6.
•• Morley S. Efficacy and effectiveness of cognitive behaviour therapy for chronic pain: progress and some challenges. Pain 2011;152:S99–S106. This is a review and commentary on the progressive developments within cognitive and behavioral approaches to chronic pain. It also identifies areas in need of further work and challenges to be addressed.
Thompson M, McCracken LM. Acceptance and related processes in adjustment to chronic pain. Curr Pain Headache R. 2011;15:144–51.
Vowles KE, McCracken LM, O’Brien JZ. Acceptance and values-based action in chronic pain: a three-year follow-up analysis of treatment effectiveness and process. Beh Res Ther. 2011;49:748–55.
Hayes SC, Strosahl K, Wilson KG. Acceptance and commitment therapy: an experiential approach to behavior change. New York: Guilford; 1999.
Kohlenberg RJ, Tsai M. Functional analytic psychotherapy: creating intense and curative therapeutic relationships. New York: Springer; 2007.
Linehan M. Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford; 1993.
• Hayes SC, Villatte M, Levin M, Hildebrandt M. Open, aware, and active: contextual approaches as an emerging trend in the behavioral and cognitive therapies. Annu Rev Clin Psych 2011;7:141–68. This is a comprehensive review of the emerging contextual approaches that includes both a conceptual overview and empirical review.
Pierson H, Hayes S. Using acceptance and commitment therapy to empower the therapeutic relationship. In: Gilbert P, Leahy RL, editors. The therapeutic relationship in the cognitive behavioral psychotherapies. New York: Routledge/Taylor & Francis Group; 2007. p. 205–28.
Lambert MJ, Shimokawa K. Collecting client feedback. Psychother. 2011;48:72–9.
Disclosures
No potential conflicts of interest relevant to this article were reported.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Vowles, K.E., Thompson, M. The Patient-Provider Relationship in Chronic Pain. Curr Pain Headache Rep 16, 133–138 (2012). https://doi.org/10.1007/s11916-012-0244-4
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11916-012-0244-4