A deconstructive turn in chronic pain treatment: a redefined role for social work

Chronic pain treatment programs in North America are based predominantly on a behavioral science model of contingency management, whereby the focus of treatment is directed toward the psychological aspects of pain. Treatment objectives are designed to eliminate reinforcing environmental contingencies, thus changing pain behavior and reestablishing well behavior. The purpose of this article is to displace the contingency management model with deconstruction and thus present an alternative conceptualization based on the experiences of chronic pain sufferers. Social work's value base of self-determination and empowerment upholds these challenges to the predominant treatment model. Alternative social work interventions are explored.