Eric hurt his back two years ago when he was at work, and since that time he has experienced periods during which he could not work because of his low back pain. Workers' compensation has helped financially during those times, but his wife has been burdened by doing Eric's chores and caring for him when he is incapacitated. His physician is reluctant to continue his prescription of opiate analgesics but understands that Eric's back pain is a problem and would like to get him into a program that would help his pain. After reviewing the options, recommend a program for Eric.​

A. Eric receives reinforcement for his pain behaviors, including
1. Monetary compensation.
2. Supportive care from others.
3. Relief from work and family responsibilities.
B. A behavior modification program might help Eric exhibit fewer pain behaviors.
1. This type of program would probably teach Eric's family to ignore his chronic complaints about his pain and encourage him to resume his normal life's activities.
2. This program would probably systematically reinforce Eric's desirable, normal behaviors such as getting up without complaints of pain, getting dressed, interacting with his family, and so forth.
3. Such programs tend to be successful in helping patients to be more active and to request less medication.
C. A cognitive or cognitive behavioral therapy program might be a good alternative if Eric has the motivation to self-regulate his behavior.
1. Such programs place more responsibility on the patient and on the desire to change one's own behavior than behavior modification programs do.
2. A cognitive pain management program would include stages in which Eric would reconceptualize his pain and the role of psychology in the perception of pain, acquire new skills to cope with pain, and follow-through the reconceptualization and learning by practicing these skills.
3. Some research has indicated that Eric might make slower progress in a cognitive pain management program but that his gains would increase, making this type of program potentially more successful than a behavior modification program.