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Analgesia and Pain Management01:25

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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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Frustration occurs when people are obstructed or prevented from achieving a desired goal or fulfilling a perceived need. For example, when someone's input is ignored in a discussion, it can lead to feelings of frustration. Conflict, however, arises from opposing interests, goals, or actions. Conflicts can take various forms based on the nature of these opposing desires or goals.
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Related Experiment Video

Updated: Sep 16, 2025

Investigating Pain-Related Avoidance Behavior using a Robotic Arm-Reaching Paradigm
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[Graded balance in pain therapy : Risk factor-based approaches based on the avoidance-endurance model].

M I Hasenbring1, C Titze2

  • 1Abt. Medizinische Psychologie und Medizinische Soziologie, Medizinische Fakultät, Ruhr-Universität Bochum, Universitätsstr. 105, Bochum, Deutschland. monika.hasenbring@rub.de.

Schmerz (Berlin, Germany)
|July 11, 2025
PubMed
Summary
This summary is machine-generated.

Graded balance interventions (GBI) offer an individualized approach to pain psychotherapy, showing superiority over standardized methods for subacute radicular pain. This cognitive behavioral therapy (CBT) technique helps patients manage pain by balancing activity and relaxation.

Keywords:
Chronic painCognitive behavioral therapyCoping with painGraded balance interventionsInteroception

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Area of Science:

  • Psychology
  • Pain Management
  • Therapeutic Interventions

Background:

  • Cognitive behavioral therapy (CBT) is a primary psychotherapy for pain, yet treatment response varies significantly.
  • Graded balance interventions (GBI) are CBT methods specifically for pain patients with dysfunctional pain processing, as per the avoidance-endurance model (AEM).
  • These patients exhibit fear-avoidant or suppressive pain responses.

Purpose of the Study:

  • To present the individualized Graded Balance Intervention (GBI) approach for subacute or chronic pain patients with AEM-based dysfunctional pain processing.
  • To outline the GBI procedure, enabling patients to alternate between relaxation and activity with pain relief.
  • To illustrate the GBI model with a case study and present preliminary empirical evidence.

Main Methods:

  • The study utilized selected empirical literature and clinical case reports.
  • A modular form of CBT, specifically GBI, was presented.
  • An individually targeted psychological procedure was developed, guided by self-reported pain processing screening, to complement medical treatments.

Main Results:

  • A randomized long-term study on individually targeted GBI in subacute radicular pain demonstrated its superiority over standardized procedures.
  • GBI led to greater reductions in pain intensity, impairment, and emotional distress.
  • These findings are based on extensive research into CBT efficacy for chronic pain.

Conclusions:

  • GBI facilitates personalized pain treatment by addressing distinct patterns of affective, cognitive, and behavioral pain processing.
  • Current findings suggest GBI's long-term effectiveness.
  • Further research is needed to confirm GBI's superiority over generalized CBT and elucidate its mechanisms of action.