Enhancing Motivation for Change in the Management of Chronic Painful Conditions: a Review of Recent Literature

  • Brett AnkawiEmail author
  • Robert D. Kerns
  • Sara N. Edmond
Psychological and Behavioral Aspects of Headache and Pain (D Buse, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Psychological and Behavioral Aspects of Headache and Pain


Purpose of Review

The purpose of this review is to evaluate and summarize recent empirical research investigating motivational factors for management of chronic pain and headache disorders.

Recent Findings

Research on motivation for non-pharmacological treatment of chronic pain and headache disorders has identified factors that influence initiation of and adherence to treatment. To address common factors that inhibit initiation of treatment (i.e., cost, time commitment), several electronic treatments have been developed. Self-efficacy is the most commonly studied psychosocial influence on treatment adherence, with evidence that it is positively correlated with adherence. Other studies have sought to improve adherence to treatment using motivational interviewing interventions.


There is currently limited research on how to enhance motivation for initial adherence to non-pharmacological treatment for chronic pain and headache disorders. Instead of enhancing motivation, researchers have looked to reduce barriers to treatment with electronic health treatments; however, many of these studies have focused on intervention feasibility, rather than efficacy or effectiveness. Numerous studies have identified a relationship between self-efficacy and treatment adherence. Although motivational interviewing interventions have been shown to improve adherence to treatment, there is little evidence that they improve treatment outcomes. Recommendations for further investigation include improving interventions to enhance accessibility and adherence to treatment with the goal of improving outcomes, as well as identifying ways to improve treatment initiation and adherence in patients who are currently engaged in long-term opioid therapy.


Motivation Chronic pain Headache Treatment adherence 


Funding Information

This study was funded by grants from the Department of Veterans Affairs Health Services Research and Development Service (CIN 13-407), the Department of Veterans Affairs VISN1 (CDA 13-350), and from the National Institutes of Health/National Center for Complementary and Integrative Health (RFA-AT-14-005).

Compliance with Ethical Standards

Conflict of Interest

Brett Ankawi, Robert D. Kerns, and Sara N. Edmond declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2019

Authors and Affiliations

  • Brett Ankawi
    • 1
    • 2
    Email author
  • Robert D. Kerns
    • 2
    • 3
  • Sara N. Edmond
    • 2
    • 3
  1. 1.Department of PsychologyOhio UniversityAthensUSA
  2. 2.Pain Research, Informatics, Multimorbidities and Education (PRIME) CenterVA Connecticut Healthcare SystemWest HavenUSA
  3. 3.Yale School of MedicineNew HavenUSA

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