- Cognitive Behavioral Therapy (CBT) uses talking to manage problems including chronic pain, but its benefits are limited and not long-term and it focuses on only one person at a time.
- Shared reading that involves reading aloud, various literature such as short stories, novels and poetry in a group, can also be used to manage chronic pain .
- Shared reading provides an opportunity to recall and discuss diverse life experiences, extending over an entire life-span and not restricted to the time-period affected by pain.
Shared reading (SR) can be a useful therapy for chronic pain sufferers.
The study has been conducted by researchers from the University of Liverpool, The Reader and the Royal Liverpool University Hospitals Trust, and funded by the British Academy.
The study compared Shared Reading (SR) to Cognitive Behavioural Therapy (CBT) as an intervention for chronic pain sufferers.
Shared reading is a literature-based intervention developed by The Reader. It is used in many conditions similar to chronic pain, in conditions that can be chronic and incurable in nature, such as dementia, people restrained in prisons and severe mental illness with recurring episodes.
It involves small groups of 2-12 people coming together weekly to read literature such as short stories, novels and poetry, together aloud. The reading material ranges across genres and period, and is chosen for its intrinsic interest, not pre-selected with a particular 'condition' in mind.
Adequate pauses are taken while reading that allows participants to reflect:
- on what is being read
- on the thoughts or memories the book or poem has stirred
- on how the reading matter relates to their own lives
Cognitive Behavioral Therapy is commonly used to treat anxiety, depression and other mental health problems. It involves talking therapy that helps to change the way one thinks and behaves and thus manage problems. But the benefits of CBT are limited and short-term.
Though CBT allowed participants to share and exchange personal histories of living with chronic pain, they only focused exclusively on their pain without any thematic deviation.
But shared reading provided an opportunity to recall and discuss diverse life experiences including work, childhood, family members, relationships. This was related to the entire life-span and not restricted to the period affected by pain alone.
Thus shared reading has the potential therapeutic effect to help to recover a whole person, not just an ill one.
For the study, participants with severe chronic pain were recruited by the pain clinic at Broadgreen NHS Hospital Trust after their informed consent.
For the participants, a 5-week CBT group and a 22-week SR group was conducted in parallel, with CBT group-members joining the SR group after the completion of CBT.
The results showed that though CBT helped participants to manage emotions by means of systematic techniques, Shared Reading (SR) turned passive experience of suffering emotion into articulate contemplation of painful concerns.
Dr Josie Billington, Deputy Researcher, Centre for Research into Reading, said "Our study indicated that shared reading could potentially be an alternative to CBT in bringing into conscious awareness areas of emotional pain otherwise passively suffered by chronic pain patients."
"The encouragement of greater confrontation and tolerance of emotional difficulty that Sharing Reading provides makes it valuable as a longer-term follow-up or adjunct to CBT's concentration on short-term management of emotion." Billington added.
Pain that lasts for more than six months is categorized as chronic pain. In addition to the physical tissue damage, it causes unpleasant emotional experience.
In pain perception, usually the sensation is usually picked up by specialized cells in the body, and impulses are sent through the nervous system pathways to the brain.
In chronic pain, there is the involvement of other nerves in this 'pain' pathway that fire off messages to the brain, even in the absence of physical stimulus or damage.
Some common methods of managing chronic pain include nerve blockers (drugs) are one way and Cognitive Behavioral Therapy (CBT).
The study is led by Dr Josie Billington from the University's Centre for Research into Reading, Literature and Society (CRILS) is published in the BMJ Journal for Medical Humanities.
- Josie Billington et al. A Comparative Study of Cognitive Behavioural Therapy and Shared Reading for Chronic Pain. BMJ Journal for Medical Humanities; (2017) doi.org/10.1136/medhum-2016-011047