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Scandinavian Journal of Pain

Official Journal of the Scandinavian Association for the Study of Pain

Editor-in-Chief: Breivik, Harald

CiteScore 2017: 0.84

SCImago Journal Rank (SJR) 2017: 0.401
Source Normalized Impact per Paper (SNIP) 2017: 0.452

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Volume 7, Issue 1


Happy despite pain: Pilot study of a positive psychology intervention for patients with chronic pain

Ida K. Flink
  • Corresponding author
  • Center for Health and Medical Psychology (CHAMP), Institution of Law, Psychology, and Social Work, Örebro University, Örebro, Sweden
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Elke Smeets / Sofia Bergboma
  • Center for Health and Medical Psychology (CHAMP), Institution of Law, Psychology, and Social Work, Örebro University, Örebro, Sweden
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Madelon L. Peters
  • Corresponding author
  • Department of Clinical Psychology Science, Maastricht University, Maastricht, The Netherlands
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2015-04-01 | DOI: https://doi.org/10.1016/j.sjpain.2015.01.005


Background and purpose

Dealing with chronic pain is difficult and affects physiological as well as psychological well-being. Patients with chronic pain are often reporting concurrent emotional problems such as low mood and depressive symptoms. Considering this, treatments need to involve strategies for improving mood and promoting well-being in this group of patients. With the rise of the positive psychology movement, relatively simple intervention strategies to increase positive feelings, cognitions, and behaviours have become available. So far, the evidence for positive psychology techniques mainly comes from studies with healthy participants, and from studies with patients expressing emotional problems such as depression or anxiety as their main complaint. This study describes an initial attempt to explore the potential effects of a positive psychology intervention in a small sample of patients suffering from chronic pain.


A replicated single case design was employed with five participants. The participants started to fill out daily self-reports and weekly questionnaires two weeks before the intervention started, and continued throughout the intervention. In addition, they filled out a battery of questionnaires at pretest, posttest, and at a three months follow-up. The instruments for assessment were selected to cover areas and constructs which are important for pain problems in general (e.g. disability, life satisfaction, central psychological factors) as well as more specific constructs from positive psychology (e.g. compassion, savoring beliefs).


The results on pre and post assessments showed an effect on some of the measures. However, according to a more objective measure of reliable change (Reliable Change Index, RCI), the effects were quite modest. On the weekly measures, there was a trend towards improvements for three of the participants, whereas the other two basically did not show any improvement. The daily ratings were rather difficult to interpret because of their large variability, both between and within individuals. For the group of participants as a whole, the largest improvements were on measures of disability and catastrophizing.


The results of this preliminary study indicate that a positive psychology intervention may have beneficial effects for some chronic pain patients. Although it is not to be expected that a limited positive psychology intervention on its own is sufficient to treat pain-related disability in chronic patients, our findings suggest that for some it may be an advantageous complement to enhance the effects of other interventions.


The results of this pilot study about the potential effects of a positive psychology intervention for chronic pain patients may be encouraging, warranting a larger randomized controlled study. Future studies may also concentrate on integrating positive psychology techniques into existing treatments, such as composite CBT-programs for chronic pain patients. Our advice is that positive psychology interventions are not to be regarded as stand-alone treatments for this group of patients, but may potentially enhance the effect of other interventions. However, when and for which patients these techniques may be recommended is to be explored in future research.

This article offers supplementary material which is provided at the end of the article.

Keywords: Positive psychology; Single case design; Chronic pain


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About the article

Institution of Law, Psychology, and Social Work, 70182 Örebro, Sweden. Tel.: +46 19 303 740; fax: +46 19 303 484

Received: 2014-10-31

Revised: 2015-01-14

Accepted: 2015-01-19

Published Online: 2015-04-01

Published in Print: 2015-04-01

Conflict of interest: The authors have no conflicts of interest in relation to this study.

Citation Information: Scandinavian Journal of Pain, Volume 7, Issue 1, Pages 71–79, ISSN (Online) 1877-8879, ISSN (Print) 1877-8860, DOI: https://doi.org/10.1016/j.sjpain.2015.01.005.

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