Replication of a cognitive behavioral therapy for chronic pain group protocol by therapists in training

Abstract

According to the American Psychological Association (Division 12), there is strong, long-standing research support for cognitive behavioral therapy (CBT) to treat chronic pain. Furthermore, meta-analytic comparisons have shown CBT to be highly efficacious. However, not all researchers agree with this conclusion. The purpose of the current pilot study was to determine whether a CBT outpatient, group-based treatment facilitated by junior therapists benefited veterans who suffer from mixed idiopathic, chronic, noncancer pain, thus replicating results from effective CBT programs from the past. A sample of 46 veterans aged 33 to 81 years with chronic, noncancer pain who participated in an outpatient CBT pain group therapy protocol at a Midwestern Veterans Affairs Medical Center between November 3, 2009, and September 2, 2010 was evaluated. All participants completed a pre- and postintervention assessment. Paired-samples t tests were conducted to evaluate the impact of the program on veterans’ scores on assessment measures. No significant difference was found between the pre- and posttest primary outcome measures of pain intensity. A significant difference was established between the pre- and posttest secondary outcome measure of catastrophizing. However, there were no other significant differences found among the remaining pre- and posttest secondary outcome measures of pain interference, disability, and psychological distress. Training junior therapists on how to use CBT protocols may be enhanced by paying greater attention to what mechanisms are responsible for the desired outcomes among veterans with chronic pain.

Keywords :

• Chronic pain
• cognitive behavioral therapy
• group psychotherapy
• junior therapists
• veterans

Acknowledgments

An earlier version of this paper was presented at the National Pain Week 2012 conference and the regional American Pain Society–Midwest conference in 2012. That version of this paper was modified to reflect the comments received at the conferences. The author would like to thank all the veterans and junior therapists/supervisors who made this research possible, especially Bonnie Yap, Scott Sperling, and Susan Payvar. The author would also like to thank the staff members at the Jesse Brown VA Medical Center anesthesiology/pain clinic department for their vision and ongoing support of the pain psychology training program. Permission was obtained from the Department of Symptom Research to use the BPI in a publication and research trial. Permission was obtained from MAPI Research Trust, Lyon, France, to use the ODI in a publication and research trial. Permission to use the BSI-18 is inherent in the qualified purchase of the test materials.

Declaration of interest

The author reports no conflicts of interest. The author alone is responsible for the content and writing of the paper.