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Abstract

Statement of the Problem: A range of psychosocial factors impact on chronic pain, function and poor adjustment has negative consequences for e.g. mental health, activities of daily living and quality of life. Around a third of people attending specialist clinics need clinical intervention for adjustment difficulties. Hammond & Hirst-Winthrop proposed an integrative model of adjustment to chronic conditions (IMACC) based on a grounded theory study into type 2 diabetes. The model is directly clinically applicable as an assessment and intervention tool for people struggling to adjust. This paper reports on preparations for clinical testing in chronic pain. Methodology & Theoretical Orientation: In order to evidence applicability to chronic pain, a theoretical review aimed to link key theories and standard interventions to the IMACC. This was followed by identification of a testing design and development of assessment, treatment and test study protocols. Findings: All components of the IMACC could be linked to one or more key theories in chronic pain. Furthermore, the IMACC showed compatibility with a range of multidisciplinary interventions in standard practice. A multiple baseline single case experimental study design was identified as an appropriate first level testing of the IMACC and behavioural outcome measures were identified. Conclusion & Significance: The theoretical evidence points towards application of the IMACC to chronic pain, which warrants clinical testing of the model. The chosen study design aims to demonstrate clinical effectiveness of the IMACC before progressing to comparative studies. Recent Publications: 1. Hammond L D and Hirst-Winthrop S (2016) Proposal of an integrative model of adjustment to chronic conditions: An understanding of the process of psychosocial adjustment to living with type 2 diabetes. Journal of Health Psychology doi: 10.1177/ 1359105316664131. 2. Dekker J and de Groot V (2018) Psychological adjustment to chronic disease and rehabilitation – an exploration. Disability and Rehabilitation 40:116-120. 3. Tan G, Teo I, Anderson K, & Jensen M (2011) Adaptive versus maladaptive coping and beliefs and their relation to chronic pain adjustment. Clinical Journal of Pain 27:769-74. 4. Morley S (2008) Psychology of Pain. British Journal of Anaesthesia 10:25-31. 5. Moss-Morris R (2013) Adjusting to chronic illness: time for a unified theory. British Journal of Health Psychology 18:681-6.

Biography

Lis D Hammond is a Counselling Psychologist specializing in psychosocial adjustment to chronic conditions. She gained years of clinical experience in brain injury rehabilitation and pain management before going into academia with the aim of focusing on adjustment research. She is currently appointed as Representative of the British Psychological Society on the NHS England Clinical Reference Board for Specialized Pain.

E-mail: Lis.Hammond@tees.ac.uk