The five areas model

Pain scientists have shown that a biopsychosocial approach is more effective in managing chronic pain than the traditional medical model.

This is why Cognitive Behavioural Therapy (CBT), with its ‘five areas’ model of person centred care, is increasingly seen as a useful framework for encouraging the development of self management skills.

Ten Footsteps to Living Well with Pain builds on this five areas model, encouraging people to see how the different dimensions of their life have all been impacted by their pain – and how, in turn, making changes in their life can have a positive effect on how they experience their pain.

A summary of the five areas model

We are all affected by our environment (both current and past). We also have a biological or physical aspect, as well as feelings, behaviours and thoughts. And each area is connected to all the others.


Physical symptoms or changes noticed in the body, like tiredness, pain, loss of appetite, a disease-specific symptom, breathlessness, cough, diarrhoea.


Moods, emotions or feelings and are described usually in one word, for example, sad, happy, glad, cross, worried.


Thinking in words, images or pictures, memories and beliefs (rules) about self, other people, the world outside the self and the future in our minds.


Behaviours can also be called actions, so what you do more of, do less of, or stop doing.


Your environment (or your present/past life situation which you live each day) includes relationships, family, community, religious/cultural background, workplace, hobbies, health care services and staff, housing.
Each of these five areas is interconnected and they affect each other. Using the five areas model can help to make sense of overwhelming problems by breaking them down into smaller parts.
For example, your thoughts about a certain situation can often affect how you feel both physically and emotionally, as well as how you act in response.

Read more about the five areas model

The NHS website has some useful basic information about the five areas model and how CBT works. Learn more here.