Loading…
Identify and break the boom-bust pattern — doing too much on good days and crashing on bad days.
The boom-bust cycle is one of the main barriers to recovery: on a good day you overdo it (boom), which causes a flare-up the next day (bust), leading to rest, recovery, and then another boom. This worksheet helps you spot the pattern and plan a more sustainable, paced approach.
Introduce when the client's activity pattern shows a boom-bust cycle — overactivity on 'good days' followed by increased pain and underactivity on subsequent days. This is one of the most common maintaining patterns in chronic pain.
Help the client map their own boom-bust pattern using diary data. Explain how overactivity on good days leads to pain flare-ups, which leads to rest and avoidance, which leads to deconditioning, which makes the next bout of activity more painful. Frame pacing as an alternative to this cycle.
For clients who are predominantly avoidant (all bust, no boom), focus on graded activity rather than pacing. For those whose 'boom' is driven by external demands (work, caring responsibilities), incorporate problem-solving around modifying demands.
Avoid presenting pacing as 'doing less' — for clients who are already underactive, this message is counterproductive. Always frame pacing as 'doing the right amount consistently' which for some clients means doing more. Ensure the client does not interpret pacing as giving in to pain.
Activity pacing involves setting time-based rather than task-based goals, taking planned breaks before pain increases, and gradually increasing baseline activity levels. The key insight for clients is that consistent moderate activity leads to better outcomes than alternating between high and low activity.
Suitable for clients working with chronic pain, boom-bust, pacing, cbt, activity management, cfs. This tool can be used as a standalone worksheet or as part of a structured homework plan.
Create a free account to access 10 worksheets per month.
Plan a gradual, time-based increase in activity from a sustainable baseline — not guided by pain, but by a pre-set schedule.
Create a plan for managing pain flare-ups — covering prevention, early action, and what to do at each level of severity.
Track pain levels alongside activity, mood, and coping strategies to identify patterns.
Identify and challenge catastrophic thoughts about pain — helplessness, magnification, and rumination.