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Reasons for Treatment Non-Response: A Controlled Study of Patients' Views in Pain Rehabilitation
A D Vittersø1, E Keogh2, J Gauntlett-Gilbert3
1Department of Psychology,University of Bath,Claverton Down,Bath BA2 7AY.
Background:
Understanding successful and unsuccessful behavioural treatment for pain is essential.
Aims:
We carried out a retrospective survey of 130 people who had undergone pain rehabilitation based on acceptance and commitment therapy, aiming to identify factors associated with non-response.
Method:
The sample was selected using the reliable change index to define 'responders' and 'non-responders' to key outcome measures. We surveyed a range of treatment-related, systemic, practical and personal factors that may have affected their treatment, and then compared 'non-responders' with 'responders', controlling for factors that might not be causal or specific to non-response.
Results:
Logistic regression analysis showed two themes that distinguished the groups, 'people outside programme' and 'emotional state'.
Conclusions:
These data have clinical implications, as such factors can be addressed directly or incorporated into an assessment of treatment 'readiness'. This study introduced a novel methodology for the investigation of pain treatment response, which allowed a broad study of clinically relevant variables, but with greater rigour than conventional self-reports of 'helpful factors' in treatment.
