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1) CBT examination for chronic pain. The diagnostic evaluation of patients with chronic pain has shifted significantly from measuring personality structure and diagnosing psychopathology to broader psychosocial areas. The CBT approach in diagnosis focuses on the patient's pain, analyzes the causative agents and circumstances of pain, examines the emotional, cognitive and behavioral components, detects consequences, examines supportive factors, assesses treatment outcome and suitability for CBT, establishes goals and treatment plan. Basic steps of CBT: Preliminary orientation examination; Detailed examination of CB, including measurement; Behavioral, cognitive and functional analysis, formulation and definition of the problem; Establishment of the goal of therapy; Creation of a therapeutic plan ;End of therapy. A preliminary examination of a patient with chronic pain leads to the identification of all problem areas, the definition of specific treatment goals, for example, risky behavior (smoking, alcoholism, diet), poor compliance with doctor's recommendations (taking medications, doing exercises), physical inactivity, fear of pain and avoidance behavior, sleep disturbances, partner or family difficulties, stress, depression, anger and difficulties in expressing emotions (Kerns, Otis, Marcus, 2001). A detailed CBT assessment, including measurement, is tailored to address each problem encountered patient, including pain, life history and current living situation. This is done through conversation, self-assessment, information from family members, observation of behavior, etc. Self-assessment complements the conversation, the patient describes behavior, thinking, situations in which pain appears and its consequences. Scheme of cognitive-behavioral conversation: Name: Age: Date of examination: Diagnosis upon admission to the Pain Treatment Center: Previous treatment: Pain. What is currently hurting you? Where does it hurt? What is the nature of your pain? How long have you been in pain? How often does the pain occur? When is the pain the worst? In what situations? In whose presence? Do any of your relatives experience similar pain as you? How bad is the pain now (intensity)? How many times have you experienced pain in the past week and how severe? What makes the pain worse? What reduces pain? If the pain suddenly disappears, how does it affect your life? Do any changes occur, and what exactly? Does this have positive or negative consequences? How do your family, colleagues, and friends react to your pain? How do they explain your pain problems? Do they help, protect, criticize, or ignore you? Immediate consequences: What do you do to relieve the pain? What do doctors do? What does the family do? How do your emotions change? What are you thinking about? How does pain intensity and physical symptoms change? Long-term effects: How does feeling pain affect your life? How does pain limit you? How does pain affect your work, family life, intimate relationships, social relationships, hobbies? What did you do before and now, due to pain, are forced to stop doing or have limited this activity? The last event. When was the last time the pain appeared? How did you feel, what did you experience? What physical sensations did you experience, what did you feel in your body? What were you thinking at that moment? What have you done to reduce the pain? Personal history and pain. Have you received psychiatric treatment? Do you smoke? Do you drink alcohol regularly? What illnesses, surgeries, injuries have you experienced? Work history and pain. What was your performance at school, how did you feel in the team? Do you have higher education? What is your current job? Is sitting and standing position predominant at work, physically hard work, mental stress? You are on a full (partial) disability pension, youunemployed, incapacitated? Do you receive any compensation payments from your employer? Social benefits? What obstacles are preventing you from returning to work? Social history and pain. Are you single, divorced, widowed (for how long)? Children (age)? Where do you live, how big is the apartment, joint (separate) household? Financial, housing, partner, sexual or work problems? Are you satisfied with the quality of care provided by doctors, nurses and other staff? What do you expect from the treatment? Plans for the future. Description of behavior - observation. On the way to the outpatient clinic In the outpatient clinic In the ward facial expressions motor skills vocalization verbalization purposeful behavior complaints, disputes communication with the family through “painful behavior.” For each individual problem, the patient is asked how much the individual problems bother him, how often they occur, and how they interfere with his life. It is necessary to measure how much the patient suffers from pain (intensity), how often it hurts (frequency) and to what extent the pain interferes with his life at work, at home, in his free time. Questionnaires and rating scales are used at the beginning of therapy, then to determine changes during the treatment process, after the end of therapy and at follow-up. Conversation with the patient’s loved ones, involvement or participation of the family together with the patient in the treatment process itself, can make it more effective to carry out certain CBT methods in the home environment, which are strongly recommended in the case of patients suffering from chronic pain. In the case of anxious patients, a behavioral experiment is used. The patient is faced with a frightening pain situation in the doctor's office, and can be asked to describe what he is feeling and what he is thinking. Based on the data obtained from the CBT examination, behavioral, cognitive and functional analysis is performed. Behavioral analysis within The ABC diagram examines what exactly causes the pain (A), what happens to the patient when the pain is felt (B - physical symptoms, emotions, cognitions and behavior), and what immediate, long-term, positive and negative consequences the pain leads to (C). Cognitive testing determines whether certain thoughts are a trigger mechanism for pain. Chronic pain is often accompanied by depression and anxiety, in which cognitive processes become key. In painful states, thoughts, ideas, expectations, assessment of the situation, oneself and the future contribute to the emergence of internal dialogue, which can become a causative agent of pain and have consequences. Patients with chronic pain are very rarely aware of this. It is advisable to focus on identifying cognitive events (thoughts and ideas), cognitive processes (for example, black-and-white thinking: “No one has helped me with my pain yet, no one will help me!”) and schemas. Using a functional analysis, it is important to find out why the patient is in pain, why the pain continues, what, who and how reinforces the pain, its impact on everyday life and on the system of interpersonal relationships. As part of the functional analysis, it is necessary to determine what skills the patient lacks in order to he was able to better cope with the problems associated with chronic pain, what skills he has and what he uses.2) Assessment and methods for chronic pain. Measurement (using self-report measures and questionnaires) is an important way to assess the effectiveness of therapy. Taking regular measurements will provide more accurate data on the frequency, duration and intensity of pain, and this will allow us to evaluate treatment and monitor whether it is working as originally intended. To assess the intensity and frequency of pain and measure affective impact, the most common The Visual Analoque Scale (VAS) is used in the following form: no pain - the worst pain imaginable. When pain is located, the question usually arises: where]

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