Abstract
It was proposed that chronic pain patients could increase their capacity to achieve and to maintain pain therapy benefits by learning to apply assertive social interaction skills. Group assertion training (AT) sessions were added to a multidisciplinary pain therapy program for 35 chronic pain patients (20 females, 15 males). A control group (C) of 33 comparable patients (17 females, 16 males) participated in a parallel pain therapy program, in which AT sessions were replaced by sessions of supportive group psychotherapy. Therapeutic gains in physical and psychological functioning were assessed by therapist ratings made at the end of active treatment. Changes in attitude, coping styles, and depression were measured by pre and post therapy administration of paper and pencil assessment inventories. A set of self-report follow-up questionnaires was sent to the subjects 18 months after they had completed the pain therapy program. The only significant short-term effects were that AT group women received the highest ratings of rapport building abilities, and the highest ratings of overall psychological functioning, while men in the AT group received the lowest ratings on these two scales of functioning. In the follow-up AT women reported the highest levels of overall life satisfaction, of satisfaction with their functioning specifically in family activities, and of satisfaction with functioning in social activities outside the family. Conversely, AT males reported the lowest self ratings on these same three scales. The follow-up results also yielded several indications of degeneration of the condition of many C group females. The sex-linked differences found were interpreted as resulting from commonly existing sex-linked self-image differences which have been delineated by the work of Stake (e.g., 1979). It was concluded that the results of this study strongly suggest that brief formated AT therapy would be likely to provide general benefits to female chronic pain patients, but that male chronic pain patients are at risk of experiencing a disruption of their psychological functioning as a result of participating in such therapy.