Location of Repository

Benchmarking outcomes for psychological treatments of chronic pain

By Grania Fenton


In an attempt to bridge the widely acknowledged gap between research and clinical practice, this thesis examined the feasibility of benchmarking outcomes for published psychological treatments of chronic pain for application within routine clinical settings. Benchmarking outcomes is relatively common for psychological treatments in the mental health field, but in spite of the prevalence of chronic pain and its known impact on many areas of functioning, the chronic pain literature has previously only considered the generic application of benchmarks for developing services and considering standards for waiting times.\ud \ud Four studies of mixed methodological approaches were conducted. The first aimed to ascertain the extent of similarities between published psychological treatments of chronic pain and treatments delivered in routine clinical settings. This was to ensure that the application of benchmarks from the published literature to routine clinical settings would be meaningful. The second study examined whether the published literature was likely to facilitate the development of benchmarks, and the third sought clarification in terms of outcome domains within which useful benchmarks could be generated. The final study was a meta-analysis of data extracted from the published literature within specified outcome domains.\ud \ud The results suggested that it would be meaningful to apply benchmarks produced from the published literature to routine clinical settings, and that the literature would facilitate the development of benchmarks within several outcome domains. The meta-analysis led to the generation of four benchmarks. These were in the outcome domains of pain experience and physical functioning when compared with waiting list controls, and coping and cognitive appraisal and emotional functioning when compared with active controls. The impact of the design of each study and properties inherent within the literature on the benchmarks generated and their application within routine clinical settings was then considered, prior to suggestions for future research and clinical applications

Publisher: School of Medicine (Leeds)
Year: 2010
OAI identifier: oai:etheses.whiterose.ac.uk:1087

Suggested articles



  1. (2006). A core approach to practicebased evidence: a brief history of the origins and applications
  2. (1997). A metaanalysis of outcome studies comparing bona fide psychotherapies: empirically, "all must have prizes".
  3. (1992). A power primer.
  4. (2009). A review and critique of assessment instruments for patients with persistent pain.
  5. (2008). A systematic review of the effect of waiting for treatment for chronic pain.
  6. (2005). Acceptance-based treatment for persons with complex, longstanding chronic pain: a preliminary analysis of treatment outcome in comparison to a waiting phase.
  7. (1961). An inventory for measuring depression.
  8. (2008). Analyzing multiple endpoints in clinical trials of pain treatments: IMMPACT recommendations.
  9. (2008). Assessment of pain.
  10. (2007). Benchmarks for psychotherapy efficacy in adult major depression.
  11. (1986). Best-evidence synthesis: an alternative to meta-analytic and traditional reviews.
  12. (2003). Bridging evidence-based practice and practice based evidence: developing a rigorous and relevant knowledge for the psychological therapies.
  13. (2007). Clarification and elaboration on evidencebased practice in psychology.
  14. (1994). Classification of chronic pain:
  15. (1991). Clinical significance: a statistical approach to defining meaningful change in psychotherapy research.
  16. (2002). Combining effect size estimates in meta-analysis with repeated measures and independent-groups designs.
  17. (2002). Community clinic treatment of depressed youth: benchmarking usual care against CBT clinical trials.
  18. (1991). Coping with chronic pain: a critical review of the literature.
  19. (2005). Core outcome measures for chronic pain clinical trials:
  20. (2006). Developing patient-reported outcome measures for pain clinical trials: IMMPACT recommendations.
  21. (2009). Dissemination and effectiveness of multisystemic treatment in New Zealand: a benchmarking study.
  22. (2006). Effect-size measures and meta-analytic thinking in counseling psychology research. The Counseling Psychologist,
  23. (2008). Effects of psychological therapies in randomized trials and practice-based studies.
  24. (2008). Epidemiologic perspective on chronic pain treatment.
  25. (2008). Epidemiology of chronic pain with psychological comorbidity: prevalence, risk, course, and prognosis.
  26. (2008). Estimating the clinical effectiveness of cognitive behavioural therapy in the clinic: evaluation of a CBT informed pain management programme.
  27. (2006). Evaluating the relevance, generalization and applicability of research: Issues in external validation and translation methodology. Evaluation and the Health Professions,
  28. (2008). Evidence-based treatment and practice: new opportunities to bridge clinical research and practice, enhance the knowledge base, and improve patient care.
  29. (2009). from http://www.britishpainsociety.org/members_sigs_pmp.htm British Psychological Society (2007). Committee on Training in Clinical Psychology: Criteria for the accreditation of postgraduate training programmes in clinical psychology.
  30. (2009). from http://www.survey.bris.ac.uk
  31. (1996). Gazing into the Oracle: The Delphi Method and its Application to Social Policy and Public Health.
  32. (2006). Guidelines for meta-analyses of counseling psychology research.
  33. (1999). How Expectancies Shape Experiences.
  34. (2006). How to read a paper: the basics of evidence based medicine (3rd Edition ed.).
  35. (2008). Identifying important outcome domains for chronic pain clinical trials: an IMMPACT survey of people with pain.
  36. (2008). Implementing cognitive behavioral therapy for chronic fatigue syndrome in a mental health center: a benchmarking evaluation.
  37. (2008). Interpreting the clinical importance of treatment outcomes in chronic pain clinical trials: IMMPACT recommendations.
  38. (2006). Liverpool: Walton Centre for Neurology and Neurosurgery.
  39. (2004). Marital functioning, chronic pain, and psychological distress.
  40. (1996). Meta-analysis of experiments with matched groups of repeated measures designs.
  41. (2007). Meta-analysis of psychological interventions for chronic low back pain.
  42. (1996). NHS Psychotherapy Services in England: Review of Strategic Policy.
  43. (2005). Patient satisfaction with treatment for chronic pain: predictors and relationship to compliance.
  44. (2009). Preliminary evidence on the effectiveness of psychological treatments delivered at a university counseling center.
  45. (2009). Prospective judgements of acceptable outcomes for pain, interference and activity: patient-determined outcome criteria.
  46. (2006). Psychological 'resilience' and its correlates in chronic pain: findings from a national community sample.
  47. (2008). Psychological approaches in the treatment of chronic pain patients - when pills, scalpels, and needles are not enough.
  48. (2006). Psychological approaches to chronic pain management: part 1.
  49. (2002). Psychological factors in chronic pain: evolution and revolution.
  50. (2006). Psychological processes underlying the development of a chronic pain problem: a prospective study of the relationship between profiles of psychological variables in the fear-avoidance model and disability.
  51. (2009). Psychological therapies for the management of chronic pain (excluding headache) in adults. [Cochrane Review]. Retrieved 11th
  52. (2009). Publication bias in clinical trials due to statistical significance or direction of trial results [Methodology 95 Review]. Retrieved 20th
  53. (1979). Quasi-experimentation: Design and analysis issues for field settings.
  54. (2007). Recommended guidelines for Pain Management Programmes for adults. London: The British Pain Society.
  55. (2001). Relative Efficacy: the dodo bird was smarter than we have been led to believe. In
  56. (1994). Research synthesis as a scientific enterprise.
  57. (1985). Response expectancy as a determinant of experience and behavior.
  58. (2009). Reviews and Dissemination
  59. (2005). Rewiring efficacy studies of depression: an empirical test in transforming BDI-I to CORE-OM scores.
  60. (2002). Satisfaction with treatment for chronic pain in a specialty service: preliminary prospective results.
  61. (1994). Scientific communication and literature retrieval.
  62. (1997). Self-efficacy: the exercise of control.
  63. (2005). Sexual dysfunction and chronic pain: the role of psychological variables and impact on quality of life.
  64. (1997). Spinal radiographic findings and nonspecific low back pain: a systematic review of observational studies.
  65. (1985). Statistical methods for meta-analysis. San Diego:
  66. (1988). Statistical Power Analysis for the Behavioral Sciences (2nd ed.). New Jersey: Lawrence Erlbaum Associates.
  67. (2005). Suitability and utility of the CORE-OM and CORE-A for assessing severity of presenting problems in psychological therapy services based in primary and secondary care settings.
  68. (2006). Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment.
  69. (1988). Synthesizing standardized mean-change measures.
  70. (1999). Systematic review and meta-analysis of randomized controlled trials of cognitive behaviour therapy and behaviour therapy for chronic pain in adults, excluding headache.
  71. (1997). Systematic reviews: Synthesis of best evidence for clinical decisions.
  72. (1985). The clinical use of mindfulness meditation for the self-regulation of chronic pain.
  73. (2010). The Cochrane Collaboration (2010). Cochrane Reviews: What are Cochrane Reviews? Retrieved 20th
  74. (1995). The effectiveness of psychotherapy: the Consumer Reports study.
  75. (2000). The effects of psychological therapies under clinically representative conditions: a meta-analysis.
  76. (2005). The Handbook of Research Synthesis
  77. (1983). The hospital anxiety and depression scale.
  78. (2004). The power of statistical tests for moderators in metaanalysis.
  79. (1996). The Psychological Management of Chronic Pain: A Treatment Manual.
  80. (2007). The role of mindfulness in a contextual cognitive-behavioural analysis of chronic pain related suffering and disability.
  81. (1999). The role of psychological factors in chronic pain.
  82. (1983). The use of coping strategies in chronic low back pain.
  83. (1998). Transporting an empirically supported treatment for panic disorder to a service clinic setting: a benchmarking strategy.
  84. (2008). Trial design of psychological treatments in chronic pain: what can we tell patients? In
  85. (2008). Using clinical trials to benchmark effects produced in clinical practice.
  86. What constitutes high quality of care for adults with epilepsy?
  87. (2001). What is a Systematic Review? Retrieved 26th
  88. (1999). When there is no benchmark: designing a primary care-based chronic pain management programme from the scientific basis up.

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.