Chronic pain: inpatient treatment with small group effects

Fifty-one patients who completed a multidisciplinary, inpatient, pain control program, in groups of three or four persons, were studied before and after treatment. Like most patients with chronic pain, many were hypochondriacal, depressed, and hysterical, in addition to being severely disabled. There was a significant decrease in scores for pain, disability, and hypochondriasis after treatment. At six-month follow-up, as compared with pretreatment assessments, pain was still significantly improved and more patients were employed or planning for employment. A patient's failure to improve depended in part on whether other members of his inpatient treatment group also failed to respond. Patients who responded to treatment despite being members of groups where others failed to respond, were less hypochondriacal than other responders. As social factors play an important role in the etiology of the chronic pain syndrome, treatment programs should be designed to capitalize on these social influences.