Chronic Pain: The Case for Cognitive Behavioral Therapy

How Effective Is CBT?

Although CBT has been evaluated in many studies, concepts of pain and its social and psychological byproducts are not easily measured. The research is also plagued by variations in protocol quality and therapist abilities.

Most studies and meta-analytical reviews conclude that there is significant evidence of efficacy, though the benefits are modest.1

“It’s not like taking a pill. CBT takes work and commitment,” Dr Rostafinski said. “The patient and the therapist need to have realistic expectations. The benefits are subtle, not dramatic.”

Additional research is needed to learn more about why CBT works, what components work best, and which patients benefit most. Future studies may also be able to refine CBT protocols and determine ways to integrate techniques into primary care.1

How to Find a CBT Practitioner

Not all psychotherapists are trained in how to use CBT for chronic pain. According to Dr Rostafinski, good resources for primary care providers include:

 

  • University medical center pain management clinics;
  • Private, multidisciplinary pain management clinics;
  • State psychological association; and
  • The American Psychological Association website, which includes a feature to find psychologists practicing in your area. Pain psychology can be specified in the search.

For many patients living with chronic pain, learning how to live as well as possible is a huge benefit. Chronic pain may be inevitable, but chronic suffering may not have to be.1

 

References

Ehde DM, Dillworth TM, Turner JA. Cognitive-behavioral therapy for individuals with chronic pain. Am Psychol. 2014;69(2):153-166. doi: 10.1037/a0035747.

National Institutes of  Health. MedlinePlus: Chronic pain:  symptoms, diagnosis, and treatment.  Available at: www.nlm.nih.gov/medlineplus/magazine/issues/spring11/articles/spring11pg5-6.html. Accessed April 25, 2016.

American Academy of Pain Medicine. Use of opioids for the treatment of chronic pain.  February 2013. Available at: www.painmed.org/files/use-of-opioids-for-the-treatment-of-chronic-pain.pdf. Accessed April 25, 2016.

Association for Behavioral and Cognitive Therapies. What is cognitive behavioral therapy (CBT)? Available at: http://www.abct.org/Information/?m=mInformation&fa=_WhatIsCBTpublic. Accessed April 25, 2016.