Evaluating a person-centred chronic pain service using indices of reliable and clinically significant change

Abstract

Background: Psychological interventions for chronic pain often require substantial individualisation, which can undermine links with the research evidence on which treatment is based. To ensure clients receive effective therapy, evaluation is needed. This paper demonstrates the use of individual level change indices, which may be more appropriate for assessing effectiveness of person-centred treatment than traditional group-level statistics.Aims: To evaluate the efficacy of a psychological chronic pain service at individual level and to recommend improvements for future service evaluation.Method: Indices of reliable and clinically significant change were used to assess outcomes on the HADS, CORE-10, and PSEQ.Results: 56 out of 83 clients had usable outcome data. On the most widely administered outcome measure, the CORE-10, n=15 met reliable change and n=22 met clinically significant change criteria. 18 showed no reliable change. Only one person deteriorated.Conclusions: The person-centred treatment provided by this service was effective and achieved outcomes similar to published data from a structured group programme. However, missing data reduces the reliability of these conclusions and led to reduced usefulness of the evaluation for service planning. Recommendations for future evaluation are made.