Pain Reprocessing Therapy (PRT)

PRT is a system of psychological techniques that retrains the brain to interpret and respond to signals from the body, subsequently breaking the cycle of chronic pain. Pain Reprocessing Therapy has five main components: 1) education about the brain origins and reversibility of pain, 2) gathering and reinforcing personalised evidence for the brain origins and reversibility of pain, 3) attending to and appraising pain sensations through a lens of safety, 4) addressing other emotional threats, and 5) gravitating to positive feelings and sensations. See the treatment outline for Pain Reprocessing Therapy here.

A randomised controlled study at the University of Colorado Boulder validated Pain Reprocessing Therapy as the most effective current treatment for chronic pain. In the study, there were 100 chronic back pain patients. Half of them received PRT twice a week for four weeks, and half of them received treatment as usual. In the PRT group, 98% of patients improved, and 66% of patients were pain-free or nearly pain-free at the end of treatment. These outcomes were largely maintained one year later. Read the study in JAMA Psychiatry here.

Acceptance and Commitment Therapy (ACT)

ACT is not to reduce the frequency or severity of unpleasant internal experiences. Rather, the goal is to reduce your struggle to control or eliminate these experiences while simultaneously increasing your involvement in meaningful life activities (i.e., those activities that are consistent with your values). Sessions can also include mindfulness exercises designed to foster nonjudgmental awareness of thoughts, feelings, sensations, and memories. Your therapist may also help you consider moments when your actions didn't fit your values, while helping you understand which behaviours would fit.

ACT has an extensive evidence base for a range of mental health difficulties and is recommended as a treatment for chronic pain in the UK by the National Institute for Health and Care Excellence here.

Compassion Focused Therapy (CFT)?

CFT draws on ideas from evolutionary, social and developmental psychology as well as neuroscience and Buddhism. It aims to help those who struggle particularly with self-critical thoughts and/or shame, which typically come from early experiences. CFT teaches a person to cultivate self-compassion skills, which can help regulate mood and lead to feelings of safety, self-acceptance, and comfort. CFT also instructs clients about the science behind the mind-body connection and how to practice mind and body awareness. For example, CFT helps us to understand and work with our ‘tricky’ brains. It builds our abilities to use our bodies to support our minds and develop the courage and wisdom to address our life difficulties and thrive.