Are We Speaking the Same Language? Finding Theoretical Coherence and Precision in "Mindfulness-Based Mechanisms" in Chronic Pain

TY - JOUR

T1 - Are We Speaking the Same Language?

T2 - Finding Theoretical Coherence and Precision in "Mindfulness-Based Mechanisms" in Chronic Pain

AU - Harrison, Anthony M

AU - Scott, Whitney

AU - Johns, Louise C

AU - Morris, Eric M J

AU - McCracken, Lance M

N1 - © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: [email protected].

PY - 2017/11/1

Y1 - 2017/11/1

N2 - OBJECTIVE : Over the past 50 years, the field of chronic pain has witnessed an evolution of psychological approaches with some notable success. Some of this evolution has included "mindfulness-based interventions" (MBIs), now regarded as having encouraging partial support for their effectiveness. However, several theoretical challenges remain that may inhibit the progress of MBIs. These challenges include a lack of clarity surrounding the mindfulness construct itself, the proliferation of purported underlying mechanisms arising from different theories, and limited evidence for the mechanisms through which MBIs work. The current conceptual review provides a critique of existing theoretical models of mindfulness that have been applied to understanding and treating chronic pain. DESIGN : A conceptual narrative review was conducted. SETTING : Treatment programs for people with chronic pain. PATIENTS : Individuals with any type of chronic pain.INTERVENTIONS:  MBIs for chronic pain. OUTCOME MEASURES : Mindfulness-based mechanisms explored in relation to several domains of functioning. RESULTS AND CONCLUSIONS : Based on this assessment, a summary of available evidence for a particular contextual behavioral theory of "mindfulness"-psychological flexibility-is outlined. Findings show the need for further integration of existing mindfulness constructs to better guide development and evaluation of mindfulness-based treatment methods in the future.

AB - OBJECTIVE : Over the past 50 years, the field of chronic pain has witnessed an evolution of psychological approaches with some notable success. Some of this evolution has included "mindfulness-based interventions" (MBIs), now regarded as having encouraging partial support for their effectiveness. However, several theoretical challenges remain that may inhibit the progress of MBIs. These challenges include a lack of clarity surrounding the mindfulness construct itself, the proliferation of purported underlying mechanisms arising from different theories, and limited evidence for the mechanisms through which MBIs work. The current conceptual review provides a critique of existing theoretical models of mindfulness that have been applied to understanding and treating chronic pain. DESIGN : A conceptual narrative review was conducted. SETTING : Treatment programs for people with chronic pain. PATIENTS : Individuals with any type of chronic pain.INTERVENTIONS:  MBIs for chronic pain. OUTCOME MEASURES : Mindfulness-based mechanisms explored in relation to several domains of functioning. RESULTS AND CONCLUSIONS : Based on this assessment, a summary of available evidence for a particular contextual behavioral theory of "mindfulness"-psychological flexibility-is outlined. Findings show the need for further integration of existing mindfulness constructs to better guide development and evaluation of mindfulness-based treatment methods in the future.

U2 - 10.1093/pm/pnw310

DO - 10.1093/pm/pnw310

M3 - Review article

C2 - 28082525

SN - 1526-2375

VL - 18

SP - 2138

EP - 2151

JO - Pain Medicine

JF - Pain Medicine

IS - 11

ER -