Psychotherapy Research 12(3) 339–354, 2002 © 2002 Society for Psychotherapy Research CHRONIC PAIN PATIENTS: PATTERNS OF CHANGE IN INTERPERSONAL PROBLEMS, PAIN INTENSITY, AND DEPRESSION-ANXIETY Kirsti Monsen Jon T. Monsen University of Oslo Martin Svartberg Norwegian University of Science and Technology Odd E. Havik University of Bergen This work was supported by Norwegian Research Council, Medicine and Health, Grant 120349, Nor- wegian Hydro A/S, and Confederation of the Norwegian Business and Industry. The authors are indebted to Michael Seltzer for helpful advice on data analysis and to Trine Eklund for administering the collection of follow-up data. Correspondence concerning this article should be addressed to Kirsti Monsen, Melkevn.24, 07790, Oslo, Norway. E-mail: jon.monsen@psykologi.uio.no. 339 Patients with pain disorder were treated using psychotherapy, with a specific focus on affect experience and interpersonal problems. Using hierarchical linear modeling, growth curve analyses were performed to examine the patterns of change in interpersonal problems, pain intensity, and depression-anxiety according to specific and general change mod- els. A 3-piece linear model was used to analyze the individual rates of change during the 1st and 2nd halves of the treatment period and during follow-up. The mean rates of change were congruent with the specific change model in that interpersonal problems decreased significantly dur- ing all 3 phases, whereas pain intensity and depression-anxiety changed significantly during the 2nd phase only. Correlational analyses of indi- vidual rates of change indicated that improvement in depression-anxiety was a strong predictor of subsequent improvement in interpersonal prob- lems and a lesser degree of pain, supporting the general change model. The current study is part of a study of chronic pain disorder. Previous articles have reported the effects of psychotherapy for this group of patients (Monsen & Monsen, 2000), and the relationships among psychological factors, bodily conditions, and pain intensity have been analyzed and discussed (Monsen & Havik, 2001). In this study, we explore some questions related to patterns of change in psychotherapy. In the literature, several models of change processes in psychotherapy have been described. Kolden (1996) classified these into general change models and specific change models according to their levels of generalization. At a generic level, we find models describing change processes that are assumed to be common across differ- ent theories of psychotherapy. Frank (1973) and Frank and Frank (1991) suggested