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Pain Management: Cognitive Therapy for Chronic Pain and Fibromyalgia
Pain Management: Cognitive Therapy for Chronic Pain and Fibromyalgia

CEU Answer Booklet
Psychologist CEs, Counselor CEUs, Social Worker CEUs, MFT CEUs

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Audio Transcript Questions The answer to Question 1 is found in Track 1 of the Course Content. The Answer to Question 2 is found in Track 2 of the Course Content… and so on. Select correct answer from below. Place letter on the blank line before the corresponding question. Do not add any spaces.
Important Note! Numbers below are links to that Section. If you close your browser (i.e. Explorer, Firefox, Chrome, etc..) your answers will not be retained. So write them down for future work sessions.

Questions:
1. What are three kinds of pain frames?
2. What are three external and internal factors that affect a client's perceptions of pain?'
3. What are three concepts related to automatic thoughts?
4. What are three concepts related to core beliefs?
5. What are three characteristics of stress related to pain?
6. What are three concepts related to redefining self-worth in chronic pain clients?
7. What are three manifestations of anger commonly found in chronic pain clients?
8. What are three concepts related to helplessness?
9. What are three concepts related to self-victimization?
10. What are three sources of guilt for clients with chronic pain?
11. What are three concepts related to depression and fibro fog?
12. What are three manifestations of anxiety in chronic pain clients?
13. What are three techniques for helping clients lessen their chronic pain in day-to-day life?
14. What are three coping techniques?
Answers:
A. negative automatic thoughts; helplessness; and automatic thought evaluation.
B. negative life events; self-identification; and culturally influenced core beliefs.
C. sense of betrayal; projections; and resentment.
D. anger arising from limitations; outbursts; and inbursts
E. depression:  fact vs. fiction; fibro fog; and dispelling the fibro fog myth.
F. biological; social; and personality.
G. unmet obligations; burden guilt; and external influences
H.  threat; loss; and challenge.
I. poor self-image; grieving; and building the new identity.
J. humility vs. humiliation; catastrophizing; and assertingindependence. 
K. spontaneous stress and chronic stress; stress as an automatic thought trigger; and physical manifestations of stress.
L. generalized anxiety; social anxiety; and fear of mortality.
M. Self-Motivators; Emotional Essay; and Assert Yourself.
N. Brain Talk; Focus Anger; and Name Your Symptoms.

Course Content Manual Questions The Answer to Question 15 is found in Section 15 of the Course Content… and so on. Select correct answer from below. Place letter on the blank line before the corresponding question.
Important Note! Numbers below are links to that Section. If you close your browser (i.e. Explorer, Firefox, Chrome, etc..) your answers will not be retained. So write them down for future work sessions.

Questions:
15. According to Kurtais, what are the three components of cognitive-behavioral treatment? 
16. What does a clinician need to effectively utilize during group therapy in order to enhance treatment effectiveness and patient satisfaction in cognitive-behavioral treatment for chronic pain? 
17. What style of trained questioning used in cognitive interventions gently probes for patient meanings and stimulates alternative viewpoints or ideas? 
18. According to Buenaver et al., what is the rationale behind self-help cognitive-behavioral therapy?  
19. Under what two concepts is psychosocial pain research carried out? 
20. What mechanism of pain can lead to a re-activation of childhood feelings of helplessness which, in turn, leads to severe psychosocial crisis? 
21. What is one of the most researched variables of pain that influences pain intensity and physical / psychosocial disability?  
22. What is the assumption of cognitive models of pain? 
23. Why is it that certain patients when referred for psychological treatment (for a pain problem), may not attend the sessions or follow through with homework assignments or practice recommendations that are often a part of these psychological approaches?  
24. What are the four psychologic factors of Mr. H’s pain?   
25. According to Romano, what are the three specific goals of a psychological assessment? 
26. How do the gate control theory and the biopsychosocial model of pain relate to cognitive-behavioral therapy?
Answers:
A.  coping and coping strategies.
B.  (a) identify psychosocial factors that may affect pain perception and behavior as well as functional impairment, (b) identify specific treatment goals for each patient and (c) identify intervention strategies that may produce maximum patient improvement.
C. 1) An educational phase; to help patients to understand the effects of thoughts, beliefs, expectations and behaviors on their symptoms (biopsychosocial model). 2) A skills training phase; patients are emphasized on cognitive and behavioral strategies for coping pain. 3) An application phase; patients learn to apply cognitive and behavioral skills to real life situations. In this phase relapse prevention is aimed.
D. The effective utilization of the group process can enhance treatment effectiveness and patient satisfaction in cognitive-behavioral treatments for chronic pain.
E.  One reason for this apparent resistance may be the belief that seeing a psychologist for pain problems amounts to an admission that their pain is “in the head” and not real.
F.  "Socratic dialogue" or "guided recovery"
G.  The narcissism mechanism
H.  The assumption of cognitive models of pain is that cognitive activity and an individual’s emotional distress or behavioral difficulty is not a direct reaction to an untoward life event but rather a consequence of how that event is perceived.
I.  The gate control theory explicitly acknowledges the roles of cognitive-evaluative and affective motivational processes, in addition to sensory- discriminative or nociceptive input, in determining an individual’s perception of pain. The biopsychosocial model provides a more general framework for explaining the interrelationship among biologic, psychological, and social influences on individual’s experience of illness.
J.  Self-help is typically more cost efficient and can be made available to a greater number of patients than traditional individual therapy.
K.  (1) significant fear-avoidance, (2) does not pace his activities to adjust for his pain, (3) coping skills are passive and rely heavily on resting and taking analgesic medications, and (4) prior history of depression.
L.  (a) psychodynamic; and (b) behavioral medicine concepts


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