Cognitive Behavioral Therapy for Chronic Pain: Research Brief

Cognitive-Behavioral Therapy for Individuals with Chronic Pain
Behavior Research and Therapy, February 2015

An estimated 100 million American adults suffer from chronic pain and Cognitive Behavioral Therapy (CBT) is now a mainstream treatment either as a stand-alone or in conjunction with other medical or rehabilitation treatments. Pain catastrophizing i.e. the magnification of the threat of, rumination about, and perceived inability to cope with pain has consistently been found to be associated with greater physical and psychosocial dysfunction. 

Highlights from the Study

Many individuals with chronic pain also have mood, anxiety and sleep disorders which also respond well to CBT. Over three decades there have been numerous studies on the efficacy of CBT methods like thought recording, behavioral activation, cognitive restructuring, problem-solving training, practice between sessions and were found to be on par and even better in certain types of pain compared to medicine and rehabilitation treatment. But over a 5 year period CBT maintained its efficacy over the usual care for pain. Follow-up studies have shown an improvement in pain intensity, depression and pain interfering activities after 3 months of CBT. Preliminary studies have shown encouraging improvements in arthritis and fibromyalgia pains as well. 

CBT has been tailored and found to be beneficial for special populations like children and older adults. Recurrent and chronic pain, especially headaches, is common among children and adolescents.  There were improvements in symptoms compared to placebo. Chronic pain increases over the lifespan and at the rate of 47-63% over the age of 65. Learning CBT can also have a positive impact on these individuals to manage co-morbid conditions such as diabetes and heart disease. Problems of access are being addressed by use of technology including phone, telehealth services and various monitoring and self-management Web based applications. This also reduces the stigma of seeking out psychological treatment and enhances compliance. 

At the Feeling Good Institute, therapists are skilled at using CBT to manage a variety of symptoms including insomnia, anxiety and depression that are related to chronic pain. The TEAM approach that all therapists use also takes into account the individual’s motivation to change and their fears that cause the pain catastrophizing before moving on to the 100 or more methods available to to bring about rapid and sustainable change.

Learn about the essential skills for effective cognitive behavior therapy and how we set therapists up for success.

Citation:
Ehde, Dawn M., Dilworth, T.M., Turner, J.A (2014), Cognitive-Behavioral Therapy for Individuals with Chronic Pain, Efficacy, Innovations, and Directions for Research. American Psychologist, February-March 2014