instructions: Read the case-study on John, a man with chronic low back pain who is interested
in participating in a psychological treatment to learn adaptive coping skills for managing his
pain. Answer the subsequent questions about what treatment you would recommend.

Case Study:

John is a 55-year-old, divorced African American male who was referred to a pain
management clinic for assistance in managing chronic low back pain. John reported that his
lower back pain has become progressively worse since he was involved in a motor vehicle
accident approximately 10 years ago. A radiographic study indicated the presence of
spinal stenosis and disk herniation.
John reported that his pain was located primarily in the low back and radiated down the
back of both thighs. He described the pain as constant, deep, and shooting. His average level of
pain was 8 on a scale of 0 (no pain) to 10 (worst pain imaginable). John has significantly reduced
his overall physical activity because of pain. The resulting weight gain and deconditioning has
further aggravated his pain.
John is employed full-time, but works remotely at home, which involves mostly sitting at
his desk to use his computer. Since his divorce, he lives alone and reports few social contacts. He
rarely discusses his pain with others or seeks social support. John describes himself as anxious,
having a negative outlook on his future, and experiences poor sleep as a result of his chronic
pain.
John reported that a physician advised him to delay any back surgery until his pain
became unbearable because surgery in his case would be complicated, and success could not be
guaranteed. He does not wish to take opioid analgesic medications because of fear of addiction.
His pain is exacerbated by standing, twisting, and prolonged walking and is decreased by hot
showers and over-the-counter pain medication. He reported that chiropractic therapy, massage,
and acupuncture had provided only temporary relief from pain, and thus, he is interested in
trying a different treatment approach that may have longer-lasting effects. Specifically, John
would like to participate in a psychological or behavioral treatment that helps teach him adaptive
coping skills for managing his back pain by reducing risk or promoting resilience factors.

Answer the Following:

1. Based on John’s background and symptoms, what treatment approach would you
recommend?

2. What specific symptoms do you think this treatment will reduce or improve?

3. What coping skills will John learn from this treatment?

4. What advice would you offer to John if he’s not seeing quick improvements in his

symptoms and starts to question whether he should continue the treatment?