***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: BACKGROUND Data have consistently shown that patient coping with chronic pain can be affected by various factors associated with the primary relationship , and hence efforts to include the patient 's partner in the treatment process have merit . This study evaluated the benefit of adding an adjunctive , couples-based , cognitive behavioural treatment ( CBT ) for chronic pain to a st and ard cognitive behavioural pain management programme . METHODS Forty-five couples were r and omly assigned to either an adjunctive couples intervention  ( n = 19 ) or the pain programme only ( n = 26 ) . All patient participants completed a 3-week multi-disciplinary pain management programme , to which their partners were invited to attend one full day . In addition , partners in the adjunctive condition received four , one hour treatment sessions focusing on pain education , patient-partner communication , operant behavioural principles and relapse prevention strategies . Partner sessions for the adjunctive intervention were provided over the telephone . RESULTS By the completion of the pain programme the adjunctive couples intervention demonstrated significant improvements in marital satisfaction for the spouses over and above attendance at the pain management programme alone ( p = 0.003 ) . However , spouse involvement did not facilitate any additional response to treatment for pain patients on marital satisfaction , pain , disability or any indices of distress . All treatment gains were maintained at 1 month follow-up . CONCLUSIONS These data demonstrate that a brief CBT intervention can significantly improve marital satisfaction for spouses of chronic pain patients , but the treatment does not translate to improvements in function on any outcomes , including marital satisfaction , for patients of chronic pain . WHAT DOES THIS STUDY ADD ? : A brief , telephone-based intervention for couples living with chronic pain is an acceptable format for intervention . This intervention can significantly improve marital satisfaction for partners of chronic pain patients . Patients who are already participating in a multidisciplinary pain programme will not obtain further benefit This study examined the supplemental value of a cognitive coping skills training when added to an operant-behavioral treatment for chronic low-back pain patients . The complete treatment package ( OPCO ) was compared with an operant program + group discussion ( OPDI ) and a waiting-list control ( WLC ) . After the WL period , the WLC patients received a less protocol ized operant program usually provided in Dutch rehabilitation centers ( OPUS ) . Regression analyses showed that , compared with WLC , both OPCO and OPDI led to less negative affect , higher activity tolerance , less pain behavior , and higher pain coping and pain control . At posttreatment , OPCO led to better pain coping and pain control than OPDI . Calculation of improvement rates revealed that OPCO and OPDI had significantly more improved patients than OPUS on all the dependent variables . The discussion includes findings regarding treatment credibility , compliance , and contamination bias Family-oriented approaches and consequent conjoint marital sessions have been widely accepted as ingredients of comprehensive treatment and rehabilitation of chronic pain patients . However , no controlled trials have been conducted to confirm the effectiveness of couple therapy in these patients . We examined 63 chronic low back pain ( CLBP ) patients identified in primary health care centres . They were r and omly allocated to a couple therapy group ( n = 33 ) and to a control group without couple therapy ( n = 30 ) . The therapy consisted of five monthly sessions and was attended by two family therapists . All patients attended an initial examination and a 12-month follow-up examination . Effects on self-reported pain , disability , and some clinical measures , as well as on the use of medical services were evaluated . The study groups did not differ significantly in any of the outcome measures . Hence , we conclude that couple therapy has no significant effect on disability in CLBP patients This study evaluated a novel intervention for older osteoarthritis ( OA ) patients and their spousal caregivers that consisted of st and ard patient education supplemented by information related to effectively managing arthritis as a couple . Twenty-four female OA patients and their husb and s were r and omly assigned to either an educational intervention that was targeted at both patient and spouse or to a patient education intervention that was targeted at only the patient . Findings revealed that both interventions were evaluated favorably but the couple intervention was better attended than the patient intervention . In addition , patients in the couple intervention experienced greater increased efficacy in managing arthritis pain and other symptoms . The findings of this pilot study point to the utility of a dyadic intervention approach to management of OA in late life The effects of outpatient group behavioral therapy including aerobic exercise ( BE ) , behavioral therapy only ( B ) , and aerobic exercise only ( E ) on pain and physical and psychosocial disability were evaluated and compared in a group of mildly disabled chronic low-back-pain patients . Ninety-six Ss were r and omly assigned to the 3 treatments and a waiting-list control ( WL ) condition and assessed on a variety of patient self-report , spouse-rated , and direct observational measures at pretreatment , posttreatment , and 6- and 12-month follow-ups . Patients in the BE condition , but not the B or E conditions , improved significantly more pretreatment to posttreatment than did WL patients on the patient self-report and observer-rated measures . At both follow-ups , all 3 treatment groups remained significantly improved from pretreatment , with no significant differences among treatments OBJECTIVE To evaluate the effects of a spouse-assisted pain-coping skills training intervention on pain , psychological disability , physical disability , pain-coping , and pain behavior in patients with osteoarthritis ( OA ) of the knees . METHODS Eighty-eight OA patients with persistent knee pain were r and omly assigned to 1 of 3 conditions : 1 ) spouse-assisted pain-coping skills training , ( spouse-assisted CST ) , 2 ) a conventional CST intervention with no spouse involvement ( CST ) , or 3 ) an arthritis education-spousal support ( AE-SS ) control condition . All treatment was carried out in 10 weekly , 2-hour group sessions . RESULTS Data analysis revealed that at the completion of treatment , patients in the spouse-assisted CST condition had significantly lower levels of pain , psychological disability , and pain behavior , and higher scores on measures of coping attempts , marital adjustment , and self-efficacy than patients in the AE-SS control condition . Compared to patients in the AE-SS control condition , patients who received CST without spouse involvement had significantly higher post-treatment levels of self-efficacy and marital adjustment and showed a tendency toward lower levels of pain and psychological disability and higher scores on measures of coping attempts and ratings of the perceived effectiveness of pain-coping strategies . CONCLUSION These findings suggest that spouse-assisted CST has potential as a method for reducing pain and disability in OA patients OBJECTIVE To evaluate the long-term effects of a spouse-assisted coping skills intervention in patients with osteoarthritis ( OA ) of the knees , and to evaluate how pre- to posttreatment changes in marital adjustment and self-efficacy relate to long-term improvements in pain , psychological disability , physical disability , pain coping , and pain behavior . METHODS A followup study was conducted with 88 OA patients who had been r and omly assigned to 1 of 3 treatment conditions : 1 ) spouse-assisted coping skills training ( spouse-assisted CST ) , 2 ) a conventional CST intervention with no spouse involvement , and 3 ) an arthritis education-spousal support ( AE-SS ) control condition .  To evaluate long-term outcome , comprehensive measures of self-efficacy , marital adjustment , pain , psychological disability , physical disability , pain coping , and pain behavior were collected from these individuals at 6 and 12 months posttreatment . RESULTS Data analysis revealed that , at 6-month followup , patients in the spouse-assisted CST condition scored higher on measures of coping and self-efficacy than those in the AE-SS control group . At 6-month followup , patients who received CST without spouse involvement showed a significantly higher frequency of coping attempts and reported higher levels of marital adjustment than those in the AE-SS control group . At 12-month followup , patients in the spouse-assisted CST condition had significantly higher overall self-efficacy than those in the AE-SS control condition . In addition , patients in both the spouse-assisted CST and CST only conditions tended to show improvements in physical disability at the 12-month followup . Individual differences in outcome were noted at the 12-month followup . Patients in the spouse-assisted CST condition who reported initial ( pre- to posttreatment ) increases in marital adjustment had lower levels of psychological disability , physical disability , and pain behavior at 12-month followup . However , for patients in the conventional CST and AE-SS control conditions , increases in marital adjustment occurring over the initial phase of treatment were related to increases in pain and decreases in scores on the Pain Control in Rational Thinking factor of the Coping Strategies Question naire . Finally , patients in the spouse-assisted CST condition who showed pre- to posttreatment increases in self-efficacy were more likely to show decreases in pain , psychological disability , and physical disability at 12-month followup . CONCLUSIONS These findings suggest that spouse-assisted CST can enhance self-efficacy and improve the coping abilities of OA patients in the long term . Individual differences in the long-term outcome of spouse-assisted CST were noted , with some patients ( those showing increases in marital satisfaction and self-efficacy ) showing much better outcomes than others Fifty-six chronic low back pain ( CLBP ) patients participated in a controlled , prospect i ve 5-yr follow-up study evaluating the long-term effects of five-session couple therapy .  Twenty-eight patients were included both in the treatment group and in the  control group  . Outcome measures were self-reported psychological distress , marital satisfaction , health locus of control , pain and disability as well as clinical examinations . The reliability of the outcome measures was statistically analysed and found acceptable . At the 5-yr follow-up assessment s , psychological distress was found to be decreased in the treatment group and increased in controls . The difference between the groups was significant . No difference was found in the other self-reported or clinical outcome measures . We conclude that couple therapy has a prolonged beneficial effect on the mental well-being of CLBP patients & NA ; This study tested the separate and combined effects of spouse‐assisted pain coping skills training ( SA‐CST ) and exercise training ( ET ) in a sample of patients having persistent osteoarthritic knee pain . Seventy‐two married osteoarthritis ( OA ) patients with persistent knee pain and their spouses were r and omly assigned to : SA‐CST alone , SA‐CST plus ET , ET alone , or st and ard care ( SC ) . Patients in SA‐CST alone , together with their spouses , attended 12 weekly , 2‐h group sessions for training in pain coping and couples skills . Patients in SA‐CST+ET received spouse‐assisted coping skills training and attended 12‐weeks supervised ET . Patients in the ET alone condition received just an exercise program . Data analyses revealed : ( 1 ) physical fitness and strength :  the SA‐CST+ET and ET alone groups had significant improvements in physical fitness compared to SA‐CST alone and patients in SA‐CST+ET and ET alone had significant improvements in leg flexion and extension compared to SA‐CST alone and SC , ( 2 ) pain coping : patients in SA‐CST+ET and SA‐CST alone groups had significant improvements in coping attempts compared to ET alone or SC and spouses in SA‐CST+ET rated their partners as showing significant improvements in coping attempts compared to ET alone or SC , and ( 3 ) self‐efficacy : patients in SA‐CST+ET reported significant improvements in self‐efficacy and their spouses rated them as showing significant improvements in self‐efficacy compared to ET alone or SC . Patients receiving SA‐CST+ET who showed increased self‐efficacy were more likely to have improvements in psychological disability . An intervention that combines spouse‐assisted coping skills training and exercise training  can improve physical fitness , strength , pain coping , and self‐efficacy in patients suffering from pain due to osteoarthritis This study examined the comparative efficacy of three interventions : a spouse-assisted coping skills training protocol for patients undergoing a multidisciplinary pain management programme ( SA-MPMP ) , conventional patient-oriented multidisciplinary pain management programme ( P-MPMP ) and st and ard medical care ( SMC ) .  Thirty-six chronic low back pain ( CLBP ) patients and their spouses were r and omly assigned to one of the three conditions . The SA-MPMP condition consisted of seven , weekly , 2-h , group sessions of training in dyadic pain coping and couple skills , delivered by a clinical psychologist with support of a multidisciplinary team of specialists , to patients together with their spouses . P-MPMP consisted of the SA-MPMP training delivered to the patient only ( i.e. , no spouse participation and assistance ) . The SMC condition entailed continuation of routine treatment , entailing medical care only . Data analysis revealed that , at the 12-month follow-up time point , patients receiving SA-MPMP had significant improvements in kinesiophobia and rumination about pain compared to those receiving P-MPMP and SMC . In patients suffering from CLBP , an intervention that combines spouse-assisted coping skills training with a multidisciplinary pain management programme can improve fear of movement and rumination about low back pain UNLABELLED The current study tested whether a therapeutic assessment improved pain and well-being in couples facing chronic pain . Couples ( N = 47 ) in which 1 spouse had chronic pain completed surveys about pain , mood , marital satisfaction , and empathy , followed by an interview and an assessment session to which they were r and omly assigned : a tailored assessment of their marriage and pain coping that incorporated motivational interviewing strategies , or a control condition that included education about the gate control theory of pain . Multilevel modeling revealed that couples in the 
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Discussion : This review outlined strategies included in couple interventions for chronic pain that are derived from the cognitive-behavioral therapy , acceptance and commitment therapy , and operant behavioral traditions , but delivered relationally .
Therapists working with ICPs and their partners may integrate these strategies into their practice to help couples who are managing chronic pain