Effects of a non‐pharmacological approach for chronic pain management in patients with haemophilia: efficacy of cognitive‐behavioural therapy associated with physiotherapy

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.

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Cognitive-behavioural therapy for chronic pain: determining what works for the person in front of you

British Journal of Pain ◽

10.1177/2049463718820054 ◽

2018 ◽

Vol 13 (1) ◽

pp. 4-5

Author(s):

Whitney Scott

Keyword(s):

Chronic Pain ◽

Cognitive Behavioural Therapy ◽

Behavioural Therapy ◽

What Works ◽

Cognitive Behavioural

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

British Journal of Pain ◽

10.1177/2049463719895803 ◽

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.

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Cognitive-behavioural interventions

Oxford Textbook of Paediatric Pain ◽

10.1093/med/9780199642656.003.0050 ◽

2013 ◽

pp. 519-530 ◽

Cited By ~ 1

Author(s):

Deirdre E. Logan ◽

Rachael M. Coakley ◽

Brittany N. Barber Garcia

Keyword(s):

Chronic Pain ◽

Pain Management ◽

Practical Problem ◽

Psychological Treatment ◽

Behavioural Therapy ◽

Behavioural Interventions ◽

Empirically Supported ◽

Cognitive Behavioural ◽

Hands On ◽

Cognitive Behavioural Interventions

Cognitive-behavioural therapy (CBT) is the most commonly researched and empirically supported psychological treatment for the management of paediatric pain. CBT is a brief, goal-oriented psychotherapy treatment using a hands-on, practical problem-solving approach (Kendall, 2012). It is based on the concept that thoughts, feelings, and behaviours are causally interrelated. This chapter offers an overview of CBT and its application to pain management, describes specific cognitive-behavioural strategies commonly used for paediatric acute and chronic pain problems, presents the empirical evidence supporting these approaches, and highlights key considerations and emerging directions in the use of CBT and related treatments for paediatric pain.

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Online group pain management for chronic pain: Preliminary results of a novel treatment approach to teletherapy

Journal of Telemedicine and Telecare ◽

10.1177/1357633x19870369 ◽

2019 ◽

pp. 1357633X1987036

Author(s):

Timothy Y Mariano ◽

Limeng Wan ◽

Robert R Edwards ◽

Asimina Lazaridou ◽

Edgar L Ross ◽

...

Keyword(s):

Chronic Pain ◽

Pain Management ◽

Group Discussion ◽

Preliminary Investigation ◽

Skills Training ◽

Chronic Pain Patient ◽

Behavioural Therapy ◽

Pain Patient ◽

Cognitive Behavioural ◽

Online Group

Objective This pilot study was designed to determine the feasibility, tolerability, safety, and efficacy of group teletherapy for persons with chronic pain. The aim was to present preliminary outcomes of an open trial of group cognitive behavioural therapy (CBT) teletherapy compared with an in-person chronic pain patient group. Methods We recruited 47 chronic pain patients to participate in an 8-session, 2-hour-per-week, online, structured, CBT-oriented pain management group using WebEx and compared them with 46 subjects who participated in a parallel, content-matched, in-person, weekly group. Both groups included goal setting, skills training, relaxation exercises, group discussion, and practice assignments. All subjects completed baseline measures, which were repeated post-treatment. Those in the online group participated in weekly telephone interviews and rated the perceived helpfulness of the remote group. Results The average age of the online group participants was 54.5 ( ± 14.3) years and 70.2% were female, compared with 59.7 ( ± 13.0) years of age and 57.8% females among the in-person group members. On follow-up, both CBT groups showed modest improvements on the outcome measures. Results of this preliminary investigation comparing online teletherapy with in-person CBT suggest similar benefit. Many participants in the online group rated their experience as very helpful (62.5%; 7–10/10) and most would recommend this programme to others (93.7%; 7–10/10). Discussion Preliminary findings suggest that online group CBT may be as effective in improving coping among persons with chronic pain as in-person groups. More rigorous controlled trials are needed to adequately assess the outcome benefit of online teletherapy for chronic pain.

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