Article Text

  1. A. L. Golob,
  2. P. J. Robinson*
  1. University of Washington School of Medicine, Seattle, WA
  2. *Yakima Valley Farm Worker's Clinic, Toppenish, WA


Purpose Chronic pain can have a profoundly negative impact on a patient's life. Unlike acute pain, chronic pain is often unclear in physiological origin and may not respond well to medical treatment. For many patients, the treatment of chronic pain with strong painkillers is unacceptable because these drugs can impair daily functioning and carry a risk of causing chemical dependence. Farm workers are at high risk for sustaining injuries and developing chronic pain due to the physical nature of their work. The purpose of this project was to develop an educational tool that could be used by clinic providers to prevent and treat chronic pain using a behavioral approach.

Methods With the help of the clinic's psychologist, an educational tool, “The Bull's Eye,” was created. The tool is based on the “Acceptance and Commitment Therapy1 ” model, in which pain patients accept that they have pain, not avoid pain sensations, and commit to behaving in accordance with their life values. The tool was taught to the providers and used with patients in four chronic pain classes held at the clinic.

Summary Clinic providers welcomed the educational tool as another resource in the treatment and prevention of chronic pain. Patients who used the tool reported that it was useful in helping them identify their values and make plans to live in accordance with them. The clinic's providers will continue to use the tool with new patients as well as follow up on the progress made by current patients.

Conclusions Pharmacological treatment of chronic pain is often neither effective nor desirable. Studies indicate that behavioral therapy can be efficacious in increasing the level of functioning and quality of life in chronic pain patients.2 The Bull's Eye is a simple educational tool that could be used in the clinical setting to help chronic pain patients learn to accept their pain and thereby increase their level of functioning and quality of life. Further investigation is needed to assess the utility of the Bull's Eye tool. 1. Hayes SC, Strosahl KD, ilson, KG. Acceptance and commitment therapy: an experiential approach to behavior change. New York: Guilford; 1999. 2. McCracken LM. Learning to live with the pain: acceptance of pain predicts adjustment in persons with chronic pain. Pain 1998;74:21-7.

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