The effectiveness of cognitive behavioural therapy for pain in childhood and adolescence: a meta-analytic review

2016 ◽  
Vol 33 (4) ◽  
pp. 251-264 ◽  
Author(s):  
A. Lonergan
Keyword(s):  
Chronic Pain ◽  
Pain Intensity ◽  
Cognitive Behavioural Therapy ◽  
Functional Disability ◽  
Behavioural Therapy ◽  
Medium Effect ◽  
Care Providers ◽  
Cognitive Behavioural ◽  
Analytic Review ◽  
Pain Duration

ObjectivesA variety of chronic painful conditions are present in the paediatric population. Patients with chronic pain often experience considerable scepticism and avoidance by health care providers. This meta-analytic review aimed to utilise well-designed studies, in examining the effectiveness of cognitive behavioural therapy (CBT) in the treatment of chronic pain in children and adolescents.MethodsNine randomized controlled trial studies examining CBT for chronic pain were reviewed. Outcome measures were child reported pain intensity, pain duration and functional disability.ResultsCBT had a large effect on pain intensity for recurrent abdominal pain (RAP), a small effect on headaches, and a medium effect on fibromyalgia. CBT had a medium effect on pain duration across pain types. CBT had a large effect on functional disability for RAP, a small effect on fibromyalgia and a moderate effect on headaches. Findings are limited by the small number of studies and varied control conditions.ConclusionsCBT may be effective in reducing child reported pain symptomology. Future studies using a larger sample and examining the differential impact of varied control conditions are needed.

scholarly journals Comparative evaluation of group-based mindfulness-based stress reduction and cognitive behavioural therapy for the treatment and management of chronic pain: A systematic review and network meta-analysis

2019 ◽  
Vol 22 (1) ◽  
pp. 26-35 ◽  
Author(s):  
Eve-Ling Khoo ◽  
Rebecca Small ◽  
Wei Cheng ◽  
Taylor Hatchard ◽  
Brittany Glynn ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Intensity ◽  
Cognitive Behavioural Therapy ◽  
Stress Reduction ◽  
Physical Functioning ◽  
Behavioural Therapy ◽  
Cochrane Library ◽  
Depression Symptoms ◽  
Cognitive Behavioural ◽  
Mindfulness Based Stress Reduction

QuestionThis review compares mindfulness-based stress reduction (MBSR) to cognitive-behavioural therapy (CBT) in its ability to improve physical functioning and reduce pain intensity and distress in patients with chronic pain (CP), when evaluated against control conditions.Study selection and analysisOvid MEDLINE, EmbaseClassic+Embase, PsycINFO and the Cochrane Library were searched to identify randomised controlled trials. The primary outcome measure was physical functioning. Secondary outcomes were pain intensity and depression symptoms. We used random and fixed effects (RE and FE) network meta-analyses (NMA) to compare MBSR, CBT and control interventions on the standardised mean difference scale.FindingsTwenty-one studies were included: 13 CBT vs control (n=1095), 7 MBSR vs control (n=545) and 1 MBSR vs CBT vs control (n=341). Of the 21 articles, 12 were determined to be of fair or good quality. Findings from RE NMA for change in physical functioning, pain intensity and depression revealed clinically important advantages relative to control for MBSR and CBT, but no evidence of an important difference between MBSR and CBT was found.ConclusionsThis review suggests that MBSR offers another potentially helpful intervention for CP management. Additional research using consistent measures is required to guide decisions about providing CBT or MBSR.

scholarly journals A 13-Weeks Mindfulness Based Pain Management Program Improves Psychological Distress in Patients with Chronic Pain Compared with Waiting List Controls

2016 ◽  
Vol 12 (1) ◽  
pp. 49-58 ◽  
Author(s):  
Tonny Elmose Andersen ◽  
Henrik Bjarke Vægter
Keyword(s):  
Chronic Pain ◽  
Psychological Distress ◽  
Pain Management ◽  
Pain Intensity ◽  
Cognitive Behavioural Therapy ◽  
Mindfulness Meditation ◽  
Behavioural Therapy ◽  
Waiting List ◽  
Convenience Sample ◽  
Cognitive Behavioural

Background: Eradication of pain is seldom an option in chronic pain management. Hence, mindfulness meditation has become popular in pain management. Objective: This pilot study compared the effect of a 13-weeks cognitive behavioural therapy program with integrated mindfulness meditation (CBTm) in patients with chronic non-malignant pain with a control condition. It was hypothesised that the CBTm program would reduce pain intensity and psychological distress compared to the control condition and that level of mindfulness and acceptance both would be associated with the reduction in pain intensity and psychological distress. Methods: A case-control design was used and data were collected from a convenience sample of 70 patients with chronic non-malignant pain. Fifty patients were consecutively recruited to the CBTm intervention and 20 patients matched waiting list controls. Assessments of clinical pain and psychological distress were performed in both groups at baseline and after 13 weeks. Results: The CBTm program reduced depression, anxiety and pain-catastrophizing compared with the control group. Increased level of mindfulness and acceptance were associated with change in psychological distress with the exception of depression, which was only associated with change in level of mindfulness. Surprisingly, changes in level of mindfulness did not correlate with changes in acceptance. Conclusions: The results indicate that different mechanisms are targeted with cognitive behavioural therapy and mindfulness. The finding that changes in level of mindfulness did not correlate with changes in acceptance may indicate that acceptance is not a strict prerequisite for coping with pain related distress.

scholarly journals Is the psychological composition of the therapeutic group associated with individual outcomes in group cognitive behavioural therapy for chronic pain?

2019 ◽  
pp. 204946371989580
Author(s):  
Dianne Wilson ◽  
Shylie Mackintosh ◽  
Michael K Nicholas ◽  
G Lorimer Moseley ◽  
Daniel S J Costa ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Fear Avoidance ◽  
Therapeutic Group ◽  
Individual Outcomes ◽  
Psychological Attributes ◽  
Group Cognitive Behavioural Therapy ◽  
Cognitive Behavioural ◽  
Mixed Modelling

This study explored whether the psychological composition of a group, with respect to mood, catastrophising, fear of movement and pain self-efficacy characteristics at baseline, is associated with individuals’ treatment outcomes following group cognitive behavioural therapy (CBT)-based programmes for chronic pain. Retrospective analyses of outcomes from two independently run CBT-based pain management programmes (Programme A: N = 317 and Programme B: N = 693) were conducted. Mixed modelling analyses did not consistently support the presence of associations between group median scores of depression, catastrophising or fear avoidance with outcomes for individuals in either programme. These results suggest that the psychological profiles of groups are not robust predictors of individual outcomes in CBT groups for chronic pain. By implication, efforts made to consider group composition with respect to psychological attributes may be unnecessary.

Are group size and composition associated with treatment outcomes in group cognitive behavioural therapy for chronic pain?

Pain ◽  
2018 ◽  
Vol 159 (4) ◽  
pp. 783-792 ◽  
Author(s):  
Dianne Wilson ◽  
Shylie Mackintosh ◽  
Michael K. Nicholas ◽  
G. Lorimer Moseley ◽  
Daniel Costa ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Treatment Outcomes ◽  
Cognitive Behavioural Therapy ◽  
Group Size ◽  
Behavioural Therapy ◽  
Group Cognitive Behavioural Therapy ◽  
Cognitive Behavioural ◽  
Group Size And Composition

An evaluation of an out patient program of cognitive behavioural therapy for chronic pain.

Pain ◽  
1987 ◽  
Vol 30 ◽  
pp. S58 ◽  
Author(s):  
J. B. Skinner ◽  
A. Erskine ◽  
I. Rubenstein ◽  
M. Taylor ◽  
S. Pearse
Keyword(s):  
Chronic Pain ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Cognitive Behavioural

Physical Activity of Patients With Chronic Pain Receiving Acceptance and Commitment Therapy or Cognitive Behavioural Therapy

2014 ◽  
Vol 31 (2) ◽  
pp. 131-143 ◽  
Author(s):  
Katherine VanBuskirk ◽  
Scott Roesch ◽  
Niloofar Afari ◽  
Julie Loebach Wetherell
Keyword(s):  
Physical Activity ◽  
Chronic Pain ◽  
Cognitive Behavioural Therapy ◽  
Acceptance And Commitment Therapy ◽  
Psychological Treatment ◽  
Behavioural Therapy ◽  
Tailored Interventions ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
Cognitive Behavioural

Physical activity is positively related to various indices of quality of life and is found to reduce symptoms in individuals with chronic pain. This manuscript presents findings from a post hoc analysis investigating whether treatment-related improvements from psychological treatment for chronic pain are mediated by changes in physical activity (PA). Secondary analyses sought to determine predictor variables of PA in patients with chronic pain and to determine the relationship between objective and self-report measurements of PA. The effect of psychological treatment on physical activity was assessed using accelerometers in a sample of participants with chronic pain in a randomised controlled trial comparing 8 weeks of acceptance and commitment therapy (ACT) to cognitive behavioural therapy (CBT). Participants wore actigraph accelerometers for 7 consecutive days at baseline, post-treatment, and at 6-month follow-up. Hierarchical linear modelling analyses found that the variance in physical activity was not significantly predicted by time (b = 104.67, p = .92) or treatment modality (b = −1659.34, p = .57). Women had greater increases in physical activity than did men (b = 6804.08, p = .02). Current ‘gold standard’ psychological treatments for chronic pain were not found to significantly increase physical activity, an important outcome to target in the treatment of physical and mental health. These results suggest that tailored interventions with greater emphasis on exercise may complement psychological treatment for chronic pain. In particular, gender-tailored interventions may capitalise on physical activity differences found between men and women.

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