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Verhaltenstherapeutische Konzepte in der Therapie chronischer Schmerzen

Behavioral concepts in the treatment of chronic pain

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Zusammenfassung

In den letzten Jahrzehnten haben sich innerhalb des konzeptionellen Rahmens der Verhaltenstherapie unterschiedliche Ansätze entwickelt, die sich in Theorie und Behandlungspraxis deutlich unterscheiden. Psychotherapeutische Interventionen bei chronischen Schmerzen sind idealerweise in ein multimodales Vorgehen eingebettet und basieren auf einer biopsychosozialen Sichtweise. Ausgehend vom „klassischen“ operanten Modell werden das Fear-avoidance-Modell und das Akzeptanzmodell beschrieben. Letztere haben sowohl die Theorie als auch die Praxis der letzten Jahre stark beeinflusst. Die verhaltenstherapeutische Sicht auf den chronischen Schmerz ist durch diese Erweiterungen differenzierter und komplexer, aber auch komplizierter geworden.

Abstract

In recent decades there has been much work on cognitive behavioral approaches to chronic pain. Now there is a considerable variety of concepts and interventions which share the same roots but differ in theoretical issues and application. Psychotherapeutic interventions are ideally embedded into an interdisciplinary setting and base on a bio-psycho-social perspective. Starting from a classical operant model we will describe the model of fear avoidance and the model of acceptance in the therapy of chronic pain. The latter have been influencing therapy and theory in recent years. The cognitive behavioral perspective on chronic pain has, therefore, not only become more differentiated and complex but also more complicated.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. U. Kaiser und P. Nilges geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. UniversitätsSchmerzCentrum, Universitätsklinik Carl Gustav Carus Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland

    U. Kaiser

  2. DRK Schmerzzentrum Mainz, Mainz, Deutschland

    P. Nilges

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Kaiser, U., Nilges, P. Verhaltenstherapeutische Konzepte in der Therapie chronischer Schmerzen. Schmerz 29, 179–185 (2015). https://doi.org/10.1007/s00482-014-1489-0

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