A critical review of the pain readiness to change model

Current approaches to treating chronic pain often incorporate a multidisciplinary approach and a focus on self-management. Although many of the patients who complete this type of treatment exhibit gains, there remain a significant proportion of patients who fail to engage in or complete this type of approach or who fail to adhere to treatment recommendations. In an attempt to address these issues, the construct of readiness (or motivation) to adopt a self-management approach to chronic pain has been described and has attracted research interest in recent years. Operationalization of the construct has led to the development of the Pain Stages of Change Questionnaire and other strategies for its assessment. Considerable discussion, debate, and ongoing research have expanded our understanding of motivation in the context of chronic pain treatment and have informed the articulation of potentially important ways in which self-management treatment approaches to chronic pain might be improved. The aim of this article is to review the work in this area and discuss implications for clinical practice and further research. Perspective: This article reviews the research to date in the area of pain readiness to change. It provides readers with an overview of the current conceptualization of readiness and discusses important implications for multidisciplinary treatment interventions with a focus on self-management (C) 2004 by the American Pain Society.