Rudd, M. D., Williams, B., & Trotter, D. (2006). The Elaboration and Evolution of CBT: A Familiar Foundation and Creative Application With Chronic Pain. Cognitive and Behavioral Practice, 13, 188–190.
The case presented by Wicksell and colleagues (2005) raises a number of intriguing issues, particularly about the utility and application of cognitive and behavioral approaches in pain management. Rather than focus on the specific application of Acceptance and Commitment Therapy (ACT; Hayes, Strosahl, and Wilson, 1999) in this case, we have chosen to comment on how their work reminds us of the similarities across CBT approaches and to suggest some minor but important modifications. We also emphasize the importance of understanding both the common foundation in CBT and the need for continued evolution, elaboration, and creative application of these therapies in new and challenging environments.
As McCracken (2006; this issue) has so eloquently reminded us, the application of clinical psychology in pain
management is clearly tied to cognitive behavioral therapy, with an increased focus on the functional and
contextual aspects of the problem, such as with the case presented. Just as the application of ACT emphasizes the functional and contextual elements of a targeted problem, recent advances in cognitive theory have offered an approach that is much more flexible and easily applied in challenging clinical environments such as with chronic pain. Beck's (1999) recent modification of traditional cognitive theory, the theory of modes, is relevant to the discussion, particularly since it has received surprisingly...