Cognitive Behavioral Group Therapy for Chronic Pain

Treatment

DIAGNOSIS: Chronic Pain

TREATMENT: Cognitive Behavioral Group Therapy for Chronic Pain

BRIEF SUMMARY

Basic premise: Group cognitive-behavioral therapy (CBT) operates under the assumptions chronic pain is real, is stress-related, and the experience of pain involves psychological, biological, and social factors. The main goal of group CBT is to improve patients’ functioning despite the presence of persistent pain. It targets maladaptive thought patterns that interfere with behaviors that can lead to improved functioning and decreased disability. The four core cognitively focused components of this approach include the stress-appraisal-pain connection, pain-related automatic thoughts, pain-related intermediate beliefs, and pain-related core beliefs. Group CBT teaches patients to replace negative, maladaptive automatic thoughts with more rational, accurate thoughts. This is assumed to decrease distress and cultivate a greater sense of control over pain. Paired with persistent behavioral changes, the patient is more empowered to live in a way that cultivates a sense of wellbeing.

TREATMENT RESOURCES

SUPPORTING STUDIES

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https://doi.org/10.1016/0304-3959(92)90240-C

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https://doi.org/10.1016/S0738-3991(97)00996-8

Bourgault, P., Lacasse, A., Marchand, S., Courtemanche-Harel, R., Charest, J., Gaumond, I., Barcellos de Souza, J., & Choinière, M. (2015). Multicomponent interdisciplinary group intervention for self-management of fibromyalgia: A mixed-methods randomized controlled trial. PLoS ONE, 10(5), 1-26. e0126324.

https://doi.org/10.1371/journal.pone.0126324

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https://doi.org/10.1080/10582450802161796

Harris, A., Moe, T. F., Eriksen, H. R., Tangen, T., Lie, S. A., Tveito, T. H., & Reme, S. E. (2017). Brief intervention, physical exercise and cognitive behavioural group therapy for patients with chronic low back pain (The CINS trial). European Journal of Pain, 21(8), 1397-1407.

https://doi.org/10.1002/ejp.1041

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https://doi.org/10.1016/S0005-7967(98)00079-5

Johnson, R. E., Jones, G. T., Wiles, N. J., Chaddock, C., Potter, R. G., Roberts, C., Symmons, D. P. M., Watson, P. J., Torgerson, D., J., & Macfarlane, G. J. (2007). Active Exercise, Education, and Cognitive Behavioral Therapy for Persistent Disabling Low Back Pain. Spine, 32(15), 1578-1585.

https://doi.org/10.1097/BRS.0b013e318074f890

Karlsson, B., Burell, G., Anderberg, U., & Svärdsudd, K. (2015). Cognitive behaviour therapy in women with fibromyalgia: A randomized clinical trial. Scandinavian Journal of Pain, 9, 11-21.

https://doi.org/10.1016/j.sjpain.2015.04.027

Lamb, S. E., Hansen, Z., Lall, R., Castelnuovo, E., Withers, E. J., Nichols, V., Potter, R., & Underwood, M. R. (2010). Group cognitive behavioural treatment for low-back pain in primary care: A randomised controlled trial and cost-effectiveness analysis. The Lancet, 375(9718), 916-923.

https://doi.org/10.1016/S0140-6736(09)62164-4

Lami, M. J., Martínez, M. P., Miró, E., Sánchez, A. I., Prados, G., Cáliz, R., & Vlaeyen, J. W. S. (2018). Efficacy of combined cognitive-behavioral therapy for insomnia and pain in patients with fibromyalgia: A randomized controlled trial. Cognitive Therapy and Research, 42(1), 63-79.

https://doi.org/10.1007/s10608-017-9875-4

Linden, M., Scherbe, S., & Cicholas, B. (2014). Randomized controlled trial on the effectiveness of cognitive behavior group therapy in chronic back pain patients. Journal of Back and Musculoskeletal Rehabilitation, 27(4), 563-568.

https://doi.org/10.3233/BMR-140518

Linton, S. J., Boersma, K., Jansson, M., Svärd, L., & Botvalde, M. (2005). The Effects of Cognitive-Behavioral and Physical Therapy Preventive Interventions on Pain-Related Sick Leave A Randomized Controlled Trial. The Clinical Journal of Pain, 21(2), 109-119.

https://doi.org/10.1097/00002508-200503000-00001

Linton, S. J., & Ryberg, M. (2001). A cognitive-behavioral group intervention as prevention for persistent neck and back pain in a non-patient population: A randomized controlled trial. Pain, 90(1-2), 83-90.

https://doi.org/10.1016/S0304-3959(00)00390-0

Sleptsova, M., Wössmer, B., Grossman, P., & Langewitz, W. (2013). Culturally sensitive group therapy for Turkish patients suffering from chronic pain: A randomised controlled intervention trial. Swiss Medicine Weekly, 143, w13875

https://doi.org/10.4414/smw.2013.13875

Smeets, R. J., Vlaeyen, J. W., Hidding, A., Kester, A. D., van der Heijden, G. J., van Geel, A. C., & Knottnerus, J. A. (2006). Active rehabilitation for chronic low back pain: cognitive-behavioral, physical, or both? First direct post-treatment results from a randomized controlled trial [ISRCTN22714229]. BMC Musculoskeletal Disorders, 7, 5.

https://doi.org/10.1186/1471-2474-7-5

Thieme, K., Flor, H., & Turk, D. C. (2006). Psychological pain treatment in fibromyalgia syndrome: efficacy of operant behavioural and cognitive behavioural treatments. Arthritis Research & Therapy, 8(4), R121.

https://doi.org/10.1186/ar2010

Thorn, B. E., Day, M. A., Burns, J., Kuhajda, M. C., Gaskins, S. W., Sweeney, K., McConley, R., Ward, L. C., & Cabbil, C. (2011). Randomized trial of group cognitive behavioral therapy compared with a pain education control for low-literacy rural people with chronic pain. Pain, 152(12), 2710-2720.

https://doi.org/10.1016/j.pain.2011.07.007

Thorn, B. E., Eyer, J. C., Van Dyke, B. P., Torres, C. A., Burns, J. W., Kim, M., Newman, A. K., Campbell, L. C., Anderson, B., Block, P. R., Bobrow, B. J., Brooks, R., Burton, T. T., Cheavens, J. S., DeMonte, C. M., DeMonte, W. D., Edwards, C. S., Jeong, M., Mulla, M. M., . . . Tucker, D. H. (2018). Literacy-adapted cognitive behavioral therapy versus education for chronic pain at low-income clinics. Annals of Internal Medicine, 2018, 471-480.

https://doi.org/10.7326/M17-0972

Wilson, D., Mackintosh, S., Nicholas, M. K., Moseley, G. L., Costa, D., & Ashton-James, C. (2018). Are group size and composition associated with treatment outcomes in group cognitive behavioural therapy for chronic pain?. Pain, 159(4), 783–792.

https://doi.org/10.1097/j.pain.0000000000001144

Vitiello, M. V., McCurry, S. M., Shortreed, S. M., Balderson, B. H., Baker, L. D., Keefe, F. J., Rybarczyk, B. D., & Von Korff, M. (2013). Cognitive-behavioral treatment for comorbid insomnia and osteoarthritis pain in primary care: The Lifestyles Randomized Controlled Trial. Journal of the American Geriatrics Society, 61(6), 947-956.

https://doi.org/10.1111/jgs.12275

DIAGNOSIS: Chronic Pain

TREATMENT: Cognitive Behavioral Group Therapy for Chronic Pain

BRIEF SUMMARY

TREATMENT RESOURCES

TREATMENT MANUALS

WORKBOOKS and WORKSHEETS

ADDITIONAL RESOURCES

SUPPORTING STUDIES

OTHER TREATMENTS FOR Chronic Pain