Harnessing Group Composition-Related Effects in Pain Management Programs: A Review and Recommendations

Abstract

Cognitive–behavioral therapy, an effective management strategy for chronic pain, is frequently conducted in groups. Although clinicians often report ‘knowing when a group will go well or badly’, investigations of the effect that group composition might have on outcomes is lacking. Conceptual models, explanatory theories and experiments have been developed in fields of psychotherapy, organizational, social and educational psychology, but there has been no attempt to take on this issue in our field. The current hypothesis-generating review synthesizes these substantial bodies of literature to identify common themes across fields and integrate them with current concepts of cognitive–behavioral therapy-based pain management. We present a putative conceptual model with testable hypotheses relating to features of each group as a whole, the individuals in that group and the group’s leader.

KEYWORDS:

• chronic pain
• cognitive–behavioral therapy
• group composition

Financial & competing interests disclosure

GL Moseley is supported by the National Health & Medical Research Council of Australia (ID 1061279). GL Moseley received royalties from the sales of the following books: ‘Explain Pain; Explain Pain Handbook: Protectometer’; ‘The Graded Motor Imagery Handbook’; ‘Painful Yarns. Metaphors and Stories to Help Understand the Biology of Pain’. GL Moseley also received speakers fees for professional development courses on pain and honoraria from Pfizer, Kaiser Permanente and Providence Healthcare. MK Nicholas receives royalties from sales of the book Manage Your Pain. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Additional information

Funding

GL Moseley is supported by the National Health & Medical Research Council of Australia (ID 1061279). GL Moseley received royalties from the sales of the following books: ‘Explain Pain; Explain Pain Handbook: Protectometer’; ‘The Graded Motor Imagery Handbook’; ‘Painful Yarns. Metaphors and Stories to Help Understand the Biology of Pain’. GL Moseley also received speakers fees for professional development courses on pain and honoraria from Pfizer, Kaiser Permanente and Providence Healthcare. MK Nicholas receives royalties from sales of the book Manage Your Pain. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.