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Couple Interventions for Chronic Pain

A Systematic Review

Smith, Shannon M. PhD*,†,‡; Li, Rui BMedSci§; Wolfe, Hannah BS; Swanger-Gagne, Michelle S. PhD; Bonham, Adrienne D. MD, MS; Kreher, Donna A. PhD†,‡; Poleshuck, Ellen L. PhD†,‡

doi: 10.1097/AJP.0000000000000752
Review Article
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Objective: Couple interventions for chronic pain have been shown to more effectively reduce pain intensity for individuals with chronic pain (ICPs) than individual behavioral interventions or usual care. This systematic review identified randomized controlled trials of couple interventions to highlight strategies that could be incorporated into psychotherapy with ICPs and their romantic partners.

Methods: The authors identified articles reporting randomized controlled trials of couple interventions for chronic pain. Three databases were searched (ie, PubMed, Embase, and PsycInfo), resulting in 18 studies and 22 articles.

Results: Couple interventions resulted in statistically significant improvements in pain intensity compared with other conditions in 8% to 40% of the studies depending on the comparator group (i.e., control, individual intervention, another couple intervention), and in statistically significant improvements on a pain-related outcome compared with other conditions in 31% to 50% of the studies depending on the comparator group (ie, control, individual intervention, another couple intervention). Educating couples about pain was the most common strategy (83%). Jointly administered relaxation or meditation skills were included in nearly half of the interventions (48%). Many interventions taught cognitive-behavioral skills jointly to couples (39%) or to the ICP with partner encouragement (30%). Teaching couples how to request and provide assistance (30%), and encouraging partners to avoid reinforcing pain behaviors (39%), occurred frequently. ICPs and their partners were often asked to set goals (30%).

Discussion: This review outlined strategies included in couple interventions for chronic pain that are derived from the cognitive-behavioral therapy, acceptance and commitment therapy, and operant behavioral traditions, but delivered relationally. Therapists working with ICPs and their partners may integrate these strategies into their practice to help couples who are managing chronic pain.

Department of *Anesthesiology and Perioperative Medicine

Obstetrics and Gynecology

Psychiatry

§Public Health Sciences, University of Rochester Medical Center, Rochester, NY

Northeastern University, Richmond, VA

The authors declare no conflict of interest.

Reprints: Shannon M. Smith, PhD, University of Rochester Medical Center, 601 Elmwood Ave, Box 604, Rochester, NY 14642 (e-mail: shannon1_smith@urmc.rochester.edu).

Received February 28, 2019

Received in revised form June 12, 2019

Accepted July 27, 2019

Online date: August 19, 2019

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