Options Short of Short Sale

What are the options for homeowners who are unable to keep up with their payments?  We hear so much about short sales but there are some less painful solutions and some more painful solutions.  I will mention the less painful ones here.  The first is refinancing.  If you still have sufficient equity in the house you may be able to get a new loan with a better rate.  Next is forbearance which normally is utilized when a borrower has a short term income problem.  The bank agrees to hold off from foreclosing and let the homeowner catch up during a specified period.  This is often a formula for disaster.  The next is modification.  Modification is difficult.  The Vice President of Fannie Mae referred to the modification process as "requiring a lot of blocking and tackling".  If a modification is successful, the terms on the loan are altered to improve the borrower's ability to pay.  The final less onorous option is deed in lieu.  Under this circumstance the mortgagor (borrower) hands over the deed to the property instead of succombing to foreclosure.  This immediately relieves the homeowner of his indebtedness and reduces the time and cost the bank will incur in order to take ownership of the property.