Couple and family psychotherapeutic approaches to pain management

Introduction Pain does not occur in isolation but is expressed within an interpersonal context. Indeed, research has demonstrated that there is a consistent association between marital distress and physiological and immune processes that affect physical health and pain. Furthermore, marital dissatisfaction, behaviors during interaction, and spouse responses to pain behaviors are associated with a variety of pain adjustment variables. Healthy family members are often affected by chronic pain and can also contribute to patients' adjustment. A meta-analytic review of 70 studies of family-based interventions for chronic illness showed that 54% of interventions focused on relationship issues and most of these interventions focused on spousal relationships. Martire et al. concluded that family-based treatments for chronic illnesses are promising interventions for both patients and family members. Thus, when considering pain treatments, it is essential that clinicians consider involving family members as active members of the treatment team. The purpose of this chapter is to provide an overview of theory and research concerning family factors in chronic pain. A theoretical overview of how pain impacts and is impacted by the family is presented first. Then, various treatment methods that incorporate families are described and a case study is presented. We conclude by offering recommendations for further research and treatment innovation that might contribute to the quality of life of both patients and their families.