Psychological Approaches to Pain Relief: 77 Studies



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Psychological Interventions for Pain:

77 Studies Published in 2014-2020

Kenneth S. Pope, Ph.D., ABPP

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I gathered following citations and excerpts to help therapists, counselors, and other clinicians who wish to keep abreast of research studies investigating psychological interventions for pain.

Here are citations & excerpts from 77 studies published in 2014-2020:

Aggarwal, V. R., et al. (2019). "The effectiveness of self-management interventions in adults with chronic orofacial pain: A systematic review, meta-analysis and meta-regression." European Journal of Pain [online prior to print]. Excerpt: "This systematic review provides clear evidence for effectiveness of combined biomedical and psychological interventions (incorporating self-management approaches) on long-term outcomes in the management of chronic orofacial (principally TMD) pain. Self-management should be a priority for early intervention in primary care in preference to invasive, irreversible and costly therapies."

Åkerblom, S., et al. (2020). "Treatment outcomes in group-based cognitive behavioural therapy for chronic pain: An examination of ptsd symptoms." European Journal of Pain: Published online in advance of print. Excerpt: "Pain-focused CBT programs yield clinically meaningful improvements in pain and comorbid symptoms of depression and anxiety, but may have little effect on comorbid PTSD. This raises the issue of whether current pain-focused CBT programs can be modified to improve outcomes for comorbid conditions, perhaps by better targeting of psychological flexibility, and/or whether separate treatment of PTSD may be associated with improved pain outcomes."

Akerblom, S., et al. (2015). "The mediating role of acceptance in multidisciplinary cognitive-behavioral therapy for chronic pain." The Journal of Pain 16(7): 606-615. Excerpt: "Accumulated results like these suggest that acceptance of pain may be a general mechanism by which CBT-based treatments achieve improvements in functioning. More specific targeting of pain-related acceptance in treatment may lead to further improvements in outcome…. The results highlight the role of pain-related acceptance as an important treatment process even when not explicitly targeted during treatment."

Al-Ghamdi, N. A., et al. (2020). "Virtual reality analgesia with interactive eye tracking during brief thermal pain stimuli: A randomized controlled trial (crossover design)." Front Hum Neurosci 13. Excerpt: "Interactive eye tracking increased the analgesic effectiveness of immersive virtual reality. Compared to the passive non-interactive VR condition, during the interactive eye tracked VR condition, participants reported significant reductions in worst pain...during the interactive condition compared to during passive VR."

Alschuler, K. N., et al. (2020). "Feasibility and acceptability of a single-session, videoconference-delivered group intervention for pain in multiple sclerosis." Rehabilitation Psychology: Published online in advance of print. Excerpt:"This brief, highly accessible intervention targeting pain coping in individuals with early MS is feasible and acceptable."

Aronowitz, S. V., et al. (2020). "Mixed studies review of factors influencing receipt of pain treatment by injured Black patients." Journal of Advanced Nursing 76(1): 34-46. Excerpt: "The results indicate that healthcare provider characteristics, racial myths about pain sensitization and assumed criminality all impact provider treatment decision-making and the receipt of pain treatment by injured Black patients."

Birnie, et al. (2014). "Systematic review and meta-analysis of distraction and hypnosis for needle-related pain and distress in children and adolescents." Journal of Pediatric Psychology 39(8): 783-808. Excerpt: "Findings showed strong support for distraction and hypnosis for reducing pain and distress from needle procedures. The quality of available evidence was low, however."

Bloot, L., et al. (2015). "The process of change in pain during cognitive-behavior therapy for chronic fatigue syndrome." The Clinical Journal of Pain 31(10): 914-921.Excerpt: "Pain reduction can partly be explained by a reduction of symptom focusing and increased physical functioning. Additional, yet unknown cognitive-behavioral factors also play a role in the reduction of pain."

Bonnert, M., et al. (2019). "Internet-delivered exposure-based cognitive-behavioral therapy for adolescents with functional abdominal pain or functional dyspepsia: A feasibility study." Behavior Therapy 50(1): 177-188.Excerpt: "We saw a significant and large effect on the primary outcome, pain intensity, at posttreatment...that were sustained or further improved at follow-up 6 months after treatment. This study demonstrated that exposure-based Internet-CBT, tailored for adolescents with FAP or FD, is a feasible treatment that potentially improves pain intensity, gastrointestinal symptoms, and quality of life."

Bowker, E. and D. Dorstyn (2016). "Hypnotherapy for disability-related pain: A meta-analysis." Journal of Health Psychology 21(4): 526-539. Excerpt: "Meta-analytic techniques were utilised to evaluate 10 controlled studies. Hypnotherapy produced significant short-term improvements in fatigue, pain experience and affect. However, a lack of significance was noted at 3- to 6-month follow-up."

Burns, J. W., et al. (2015). "Does change occur for the reasons we think it does? A test of specific therapeutic operations during cognitive-behavioral treatment of chronic pain." Excerpt: "Findings indicated that: (1) participants receiving the Relaxation module improved more than other groups in relaxation skills, and improved substantially on other coping skills, as well; (2) participants receiving Exercise and Cognitive Coping modules showed mixed improvements and did not improve more than other groups on exercise use or cognitive coping, respectively; and (3) measures of patient-therapist working alliance and patient expectations of treatment benefit at session three correlated significantly with some coping skills changes."

Burns, J. W., et al. (2015). "Specific and general therapeutic mechanisms in cognitive behavioral treatment of chronic pain." Journal of Consulting and Clinical Psychology 83(1): 1-11. Excerpt: "Because the CBT conditions produced comparable improvements, we combined them. Precontemplation and action attitudes toward pain self-management showed significant quadratic trends over assessments such that 67% and 94.1% (respectively) of total pre–post changes occurred in the first 4 weeks. Outcomes showed only significant linear trends. Cross-lagged regressions revealed that pretreatment-to-4-week changes in action attitudes and 4-week levels of working alliance were related significantly with 4-week-to-posttreatment changes in pain intensity and interference but not vice versa and that 3-week patient expectations were related to 4-week-to-posttreatment changes in interference. Analyses in which mechanism factors were entered simultaneously revealed nonsignificant unique effects on outcomes…. Adopting an action attitude early in treatment may represent a specific CBT mechanism but with effects held largely in common with 2 general mechanisms. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

Cano-García, F. J., et al. (2017). "Evaluation of a psychological intervention for patients with chronic pain in primary care." Frontiers in Psychology 8. Excerpt: "The patients participated in 10 psychological intervention sessions, one per week, in groups of 13–14 people, which addressed psychoeducation for pain; breathing and relaxation; attention management; cognitive restructuring; problem-solving; emotional management; social skills; life values and goal setting; time organization and behavioral activation; physical exercise promotion; postural and sleep hygiene; and relapse prevention…. The intervention was successful, although improvement tended to decline at follow-up, and the detailed design gave the program assessment a high degree of standardization and specification."

Cayoun, B., et al. (2017). "Immediate and lasting chronic pain reduction following a brief self-implemented mindfulness-based interoceptive exposure task: A pilot study." Mindfulness. Excerpt: "Participants using the MIET repeatedly over 15 days learned not to identify with pain and focused on four subcomponents of interoception (mass, motion, temperature, and cohesiveness) while remaining equanimous. This led to significant reduction in pain anxiety (p = .001; d = 0.96), pain duration (p = .01; d = 0.86), and pain intensity after each 30-s exposure (p < .001; d = 1.37). These effects were maintained, and some further improved, at 2-month follow-up. Marked decrease in depression, anxiety and stress were also observed (p < .001; d = 0.81)."

Cederberg, J. T., et al. (2015). "Acceptance as a mediator for change in acceptance and commitment therapy for persons with chronic pain?" International Journal of Behavioral Medicine (Published online in advance of print publication). Excerpt: "In summary, the results suggest that acceptance may have a mediating effect on change in physical functioning in ACT for persons with chronic pain."

Chavooshi, B., et al. (2016). "A randomized double-blind controlled trial comparing Davanloo intensive short-term dynamic psychotherapy as Internet-delivered vs treatment as usual for medically unexplained pain: A 6-month pilot study." Psychosomatics: Journal of Consultation and Liaison Psychiatry 57(3): 292-300. Excerpt: "The results of this pilot trial demonstrate that 16 weeks of ISTDP delivered by Skype can significantly improve pain intensity and clinical symptoms of medically unexplained pain."

Chavooshi, B., et al. (2017). "Telemedicine vs. in-person delivery of intensive short-term dynamic psychotherapy for patients with medically unexplained pain: A 12-month randomized, controlled trial." Journal of Telemedicine and Telecare 23(1): 133-141. Excerpt: " ISTDP seems most effective when delivered in person in treating MUP patients with highly comorbid conditions with benefits maintained over 12 months."

Cherkin, D. C., et al. (2016). "Effect of mindfulness-based stress reduction vs cognitive behavioral therapy or usual care on back pain and functional limitations in adults with chronic low back pain: A randomized clinical trial." JAMA: Journal of the American Medical Association 315(12): 1240-1249. Excerpt: "Among adults with chronic low back pain, treatment with MBSR or CBT, compared with usual care, resulted in greater improvement in back pain and functional limitations at 26 weeks, with no significant differences in outcomes between MBSR and CBT. These findings suggest that MBSR may be an effective treatment option for patients with chronic low back pain."

Cherkin, Daniel C., et al. "Effect of Mindfulness-Based Stress Reduction vs Cognitive Behavioral Therapy or Usual Care on Back Pain and Functional Limitations in Adults With Chronic Low Back Pain: A Randomized Clinical Trial." JAMA 315.12 (2016): 1240-1249. Excerpt: "Among adults with chronic low back pain, both MBSR and CBT resulted in greater improvement in back pain and functional limitations at 26 and 52 weeks when compared with usual care. There were no meaningful differences in outcomes between MBSR and CBT. The effects were moderate in size, which has been typical of evidence-based treatments recommended for chronic low back pain.4 These benefits are remarkable given that only 51% of those randomized to receive MBSR and 57% of those randomized to receive CBT attended at least 6 of the 8 sessions. The findings of this study are consistent with the conclusions of a 2011 systematic review,35 which reported that "acceptance-based" interventions such as MBSR have beneficial effects on the physical and mental health of patients with chronic pain, comparable to those of CBT."

Curtis, R. and J. O'Beso (2017). "Pain management coaching: The missing link in the care of individuals living with chronic pain." Journal of Applied Biobehavioral Research. Excerpt: "These findings support the implementation of a CTPSCP as an effective adjunctive intervention, potentiating the standard medical treatments."

Czamanski-Cohen, et al. (2014). "CB-ART—The use of a hybrid cognitive behavioral and art based protocol for treating pain and symptoms accompanying coping with chronic illness." The Arts in Psychotherapy 41(4): 320-328. Excerpt: "We found that the CB-ART protocol is beneficial in reducing distress of women coping with pain, anxiety and depressive symptoms. We also found that the protocol is equally efficacious in individual and group modalities. Art making provides an opportunity to externalize distressing experiences. The concrete nature of the art product provides a platform for examining mental imagery, practicing coping skills, examining and changing maladaptive cognitions and behaviors."

Czamanski-Cohen, J., et al. (2014). "CB-ART—The use of a hybrid cognitive behavioral and art based protocol for treating pain and symptoms accompanying coping with chronic illness." The Arts in Psychotherapy 41(4): 320-328. Excerpt: "We found that the CB-ART protocol is beneficial in reducing distress of women coping with pain, anxiety and depressive symptoms. We also found that the protocol is equally efficacious in individual and group modalities. Art making provides an opportunity to externalize distressing experiences. The concrete nature of the art product provides a platform for examining mental imagery, practicing coping skills, examining and changing maladaptive cognitions and behaviors."

DasMahapatra, P., et al. (2015). "Mediators and moderators of chronic pain outcomes in an online self-management program." The Clinical Journal of Pain 31(5): 404-413. Excerpt: "Compared with controls, experimental participants evidenced significant improvement in pain, emotional functioning, and coping strategies from baseline to follow-up."

Davis, M. C., et al. (2015). "Mindfulness and cognitive–behavioral interventions for chronic pain: Differential effects on daily pain reactivity and stress reactivity." Journal of Consulting and Clinical Psychology 83(1): 24-35. Excerpt: "For individuals with RA, M produces the broadest improvements in daily pain and stress reactivity relative to CBT-P and E. These findings also highlight the utility of a diary-based approach to evaluating the treatment-related changes in responses to daily life."

Dhokia, M., et al. (2020). "A randomized-controlled pilot trial of an online compassionate mind training intervention to help people with chronic pain avoid analgesic misuse." Psychology of Addictive Behaviors: Published online in advance of print publication. Excerpt: "he results show that exercises based on CMT principles and techniques and delivered online can reduce analgesic use, risk of analgesic dependence, and some aspects of self-criticism and impulsivity."

Ehde, D. M., et al. (2014). "Cognitive-behavioral therapy for individuals with chronic pain: Efficacy, innovations, and directions for research." American Psychologist 69(2): 153-166. Excerpt: "Over the past three decades, cognitive-behavioral therapy (CBT) has become a first-line psychosocial treatment for individuals with chronic pain. Evidence for efficacy in improving pain and pain-related problems across a wide spectrum of chronic pain syndromes has come from multiple randomized controlled trials. CBT has been tailored to, and found beneficial for, special populations with chronic pain, including children and older adults. Innovations in CBT delivery formats (e.g., Web-based, telephone-delivered) and treatments based on CBT principles that are delivered by health professionals other than psychologists show promise for chronic pain problems."

Fales, J., et al. (2015). "Sleep outcomes in youth with chronic pain participating in a randomized controlled trial of online cognitive-behavioral therapy for pain management." Behavioral Sleep Medicine 13(2): 107-123. Excerpt: "Although pain improved with online-CBT, no changes were observed in sleep outcomes. Shorter pretreatment sleep duration was associated with less improvement in posttreatment functioning."

Fisher, et al. (2014). "Systematic review and meta-analysis of psychological therapies for children with chronic pain." Journal of Pediatric Psychology 39(8): 763-782. Excerpt: "35 included studies revealed that across all chronic pain conditions, psychological interventions reduced pain symptoms and disability posttreatment. Individual pain conditions were analyzed separately…. For headache pain, higher treatment dose led to greater reductions in pain. No effect of dosage was found for other chronic pain conditions."

Flor, H. (2014). "Psychological pain interventions and neurophysiology: Implications for a mechanism-based approach." American Psychologist 69(2): 188-196. Excerpt: "A number of psychological pain treatments have been examined with respect to their effects on brain activity, ranging from cognitive- and operant behavioral interventions, meditation and hypnosis, to neuro- and biofeedback, discrimination training, imagery and mirror treatment, as well as virtual reality and placebo applications. These treatments affect both ascending and descending aspects of pain processing and act through brain mechanisms that involve sensorimotor areas as well as those involved in affective-motivational and cognitive-evaluative aspects. The analysis of neurophysiological changes related to effective psychological pain treatment can help to identify subgroups of patients with chronic pain who might profit from different interventions, can aid in predicting treatment outcome, and can assist in identifying responders and nonresponders, thus enhancing the efficacy and efficiency of psychological interventions."

Gardner-Nix, et al. (2014). "Exploring the effectiveness of a mindfulness-based chronic pain management course delivered simultaneously to on-site and off-site patients using telemedicine." Mindfulness 5(3): 223-231. Excerpt: "Program participants showed significant improvements in mental health, pain catastrophizing, and suffering levels, while the controls remained relatively unchanged. Neither group showed significant changes in the physical quality of life measures or usual pain levels. The present study lends support for the effectiveness of mind–body interventions in improving mental health and suffering in chronic pain sufferers seeking help in tertiary pain clinic settings. It also provides evidence for the usefulness of a mindfulness-based program modified specifically for the chronic pain population, and supports its delivery through telemedicine."

Garland, et al. (2014). "Mindfulness-oriented recovery enhancement for chronic pain and prescription opioid misuse: Results from an early-stage randomized controlled trial." Journal of Consulting and Clinical Psychology 82(3): 448-459. Excerpt: "Compared with SG participants, participants in MORE evidenced significantly less stress arousal…and desire for opioids…, and were significantly more likely to no longer meet criteria for opioid use disorder immediately following treatment (p = .05); however, these effects were not sustained at follow-up."

George, M. C., et al. (2017). "A mixed-methods pilot study of mindfulness-based stress reduction for HIV-associated chronic pain." Behavioral Medicine 43(2): 108-119. Excerpt: "Qualitative analysis revealed a strong sense of community in both groups, but only MBSR was perceived as useful for relaxation and pain relief."

Georgescu, R., et al. (2020). "Psychological interventions using virtual reality for pain associated with medical procedures: A systematic review and meta-analysis." Psychological Medicine 50(11): 1795-1807. Excerpt: "Though VR-based interventions reduced pain for patients undergoing medical procedures, inferring clinical effectiveness is precluded by the predominance of small trials, with substantial risk of bias, and by incomplete reporting."

Hansen, K. E., et al. (2017). "Long-term effects of mindfulness-based psychological intervention for coping with pain in endometriosis: A six-year follow-up on a pilot study." Nordic Psychology 69(2): 100-109. Excerpt: "Although conclusions remain preliminary until tested in a randomized controlled trial, results presented in this article indicate that mindfulness-based psychological treatment of chronic pain seems very relevant to women with endometriosis with the potential to improve quality of life."

Herbert, M. S., et al. (2017). "Telehealth versus in-person acceptance and commitment therapy for chronic pain: A randomized noninferiority trial." The Journal of Pain 18(2): 200-211. Excerpt: "The noninferiority hypothesis was supported for the primary outcome and several secondary outcomes. Treatment satisfaction was similar between groups; however, significantly more participants withdrew during treatment in the VTC group compared with the IP group, which was moderated by activity level at baseline. These findings generally suggest that ACT delivered via VTC can be as effective and acceptable as IP delivery for chronic pain."

Hilton, L., et al. (2017). "Mindfulness meditation for chronic pain: Systematic review and meta-analysis." Annals of Behavioral Medicine 51(2): 199-213. Excerpt: "We found low-quality evidence that mindfulness meditation is associated with a small decrease in pain compared with all types of controls in 30 RCTs. Statistically significant effects were also found for depression symptoms and quality of life…. While mindfulness meditation improves pain and depression symptoms and quality of life, additional well-designed, rigorous, and large-scale RCTs are needed to decisively provide estimates of the efficacy of mindfulness meditation for chronic pain."

Hosseinzadegan, F., et al. (2017). "Efficacy of self-hypnosis in pain management in female patients with multiple sclerosis." International Journal of Clinical and Experimental Hypnosis 65(1): 86-97. Excerpt: "Repeated-measures analysis showed a significant difference between the groups; pain was lower in the self-hypnosis group but was not maintained after 4 weeks. Self-hypnosis could effectively decrease the intensity and could modify quality of pain in female patients with multiple sclerosis."

Hughes, L. S., et al. (2017). "Acceptance and commitment therapy (ACT) for chronic pain: A systematic review and meta-analyses." The Clinical Journal of Pain 33(6): 552-568. Excerpt: "ACT was more clinically effective than controls on a number of outcomes."

Igna, R., et al. (2014). "Mindfulness-based cognitive-behavior therapy (MCBT versus virtual reality (VR) enhanced CBT, versus treatment as usual for chronic back pain. A clinical trial." Journal of Evidence-Based Psychotherapies 14(2): 229-247. Excerpt: "Results show that only the level of pain was significantly lower in the MCBT group than in the PHM group, but the results were not different from the CBT group. Effects were not mediated by the hypothesized variables."

Jafari, H., et al. (2020). "Can slow deep breathing reduce pain? An experimental study exploring mechanisms." The Journal of Pain: Published online in advance of print publication. Excerpt: "SDB [slow deep breathing] is more efficacious to attenuate pain when breathing is paced at a slow rhythm with an expiration that is long relative to inspiration, but the underlying mechanisms remain to be elucidated."

Jensen, M. P. and D. R. Patterson (2014). "Hypnotic approaches for chronic pain management: Clinical implications of recent research findings." American Psychologist 69(2): 167-177. Excerpt: "Clinical trials show that hypnosis is effective for reducing chronic pain, although outcomes vary between individuals.... Neurophysiological studies reveal that hypnotic analgesia has clear effects on brain and spinal-cord functioning that differ as a function of the specific hypnotic suggestions made, providing further evidence for the specific effects of hypnosis."

Johannsen, M., et al. (2017). "Mindfulness-based cognitive therapy (mbct) is cost-effective compared to a wait-list control for persistent pain in women treated for primary breast cancer—results from a randomized controlled trial." Psycho-Oncology. Excerpt: "Our results suggest that MBCT is a cost-effective pain intervention for women treated for breast cancer."

Johnson, A. J., et al. (2017). "Feasibility of music and hypnotic suggestion to manage chronic pain." International Journal of Clinical and Experimental Hypnosis 65(4): 452-465. Excerpt: "This preliminary study supports the use of a combined hypnotic suggestion and music intervention for chronic pain."

Kemani, M. K., et al. (2018). "Evaluation of an intensive interdisciplinary pain treatment based on acceptance and commitment therapy for adolescents with chronic pain and their parents: A nonrandomized clinical trial." Journal of Pediatric Psychology 43(9): 981-994. Excerpt: "Results indicated that treatment had positive effects for parents and adolescents, and a significant positive relationship between changes in parent psychological flexibility and adolescent pain acceptance was found."

Kerns, et al. (2014). "Can we improve cognitive–behavioral therapy for chronic back pain treatment engagement and adherence? A controlled trial of tailored versus standard therapy." Health Psychology 33(9): 938-947. Excerpt: "Participants in this study evidenced a high degree of participation and adherence, but treatment tailored to take into account participant preferences, and that employed motivational enhancement strategies, failed to increase treatment participation over and above SCBT for chronic back pain. Evidence that participation and adherence were associated with positive outcomes supports continued clinical and research efforts focusing on these therapeutic processes"

Kerns, R. D., et al. (2014). "Can we improve cognitive–behavioral therapy for chronic back pain treatment engagement and adherence? A controlled trial of tailored versus standard therapy." Health Psychology 33(9): 938-947. Excerpt: "Participants in this study evidenced a high degree of participation and adherence, but treatment tailored to take into account participant preferences, and that employed motivational enhancement strategies, failed to increase treatment participation over and above SCBT for chronic back pain. Evidence that participation and adherence were associated with positive outcomes supports continued clinical and research efforts focusing on these therapeutic processes."

Lami, M. J., et al. (2017). "Efficacy of combined cognitive-behavioral therapy for insomnia and pain in patients with fibromyalgia: A randomized controlled trial." Cognitive Therapy and Research. Excerpt: "CBT-IP group exhibited the best clinical response pattern overall."

Lin, J., et al. (2018). "A web-based acceptance-facilitating intervention for identifying patients' acceptance, uptake, and adherence of Internet- and mobile-based pain interventions: Randomized controlled trial." Journal of Medical Internet Research 20(8). Excerpt: "This study shows that acceptance can be much higher in a sample participating in an internet- and mobile-based intervention efficacy trial than in the target population in routine health care settings."

Lonergan, A. (2016). "The effectiveness of cognitive behavioural therapy for pain in childhood and adolescence: A meta-analytic review." Irish Journal of Psychological Medicine 33(4): 251-264. Excerpt: "CBT 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. "

Loreto-Quijada, et al. (2014). "Differential effects of two virtual reality interventions: Distraction versus pain control." Cyberpsychology, Behavior, and Social Networking 17(6): 353-358. Excerpt: "in comparison with the control condition, the VRC intervention significantly increased pain tolerance, the pain sensitivity range, and the degree of time underestimation. It also increased self-efficacy in tolerating pain and led to a reduction in reported helplessness.

Luiggi-Hernandez, J. G., et al. (2018). "Mindfulness for chronic low back pain: A qualitative analysis." Pain Medicine 19(11): 2138-2145.Excerpt:"The themes identify several ways mindfulness impacts older adults with cLBP, including decreased negative emotions related to chronic pain such as fear of pain, a different perspective or change in awareness about pain, and reducing the significance of pain."

Lynch-Jordan, A. M., et al. (2014). "Differential changes in functional disability and pain intensity over the course of psychological treatment for children with chronic pain." Pain 155(10): 1955-1961. Excerpt: "Results showed an overall significant decline in functional disability over time. Although pain scores reduced slightly from pretreatment to posttreatment, the longitudinal decline over treatment was not statistically significant. As expected, the rate of change of disability was significantly more rapid than pain."

Malfliet, A., et al. (2018). "Effect of pain neuroscience education combined with cognition-targeted motor control training on chronic spinal pain: A randomized clinical trial." JAMA Neurology 75(7): 808-817.Excerpt: "Pain neuroscience education combined with cognition-targeted motor control training appears to be more effective than current best-evidence physiotherapy for improving pain, symptoms of central sensitization, disability, mental and physical functioning, and pain cognitions in individuals with chronic spinal pain. Significant clinical improvements without detectable changes in brain gray matter morphologic features calls into question the relevance of brain gray matter alterations in this population."

Maratos, F. A. and D. Sheffield (2020). "Brief compassion-focused imagery dampens physiological pain responses." Mindfulness: Published online in advance of print publication. Excerpt: "These data demonstrate that using CFI can curtail a physiological stress response to pain, as indicated by increases in sAA in the control imagery condition only, following pain; pain tolerance was not influenced by CFI. Compassion-based approaches may therefore help people cope with the stress associated with pain."

McCracken, L. M. and K. E. Vowles (2014). "Acceptance and commitment therapy and mindfulness for chronic pain: Model, process, and progress." American Psychologist 69(2): 178-187. Excerpt: "This article reviews the progress of CBT in the treatment of chronic pain and the challenges now faced by researchers and clinicians interested in meeting this need for development. It then focuses in greater detail on areas of development within CBT, namely acceptance and commitment therapy (ACT) and mindfulness-based approaches, areas that may hold potential for future progress."

Meade, L. B., et al. (2019). "Behaviour change techniques associated with adherence to prescribed exercise in patients with persistent musculoskeletal pain: Systematic review." British Journal of Health Psychology 24(1): 10-30. Excerpt: "Limited moderate-quality evidence supports using a small number of BCTs to enhance exercise adherence in people with PMSK."

Moore, A. A., et al. (2019). "Establishing the feasibility, acceptability and preliminary efficacy of a multi-component behavioral intervention to reduce pain and substance use and improve physical performance in older persons living with HIV." Journal of Substance Abuse Treatment 100: 29-38. Excerpt: "Findings demonstrate that the CBT/TC/TXT intervention is feasible to implement, acceptable and has preliminary efficacy for reducing substance use and pain and improving physical performance among a vulnerable population of older PLWH."

Murphy, J. L., et al. (2020). "Cognitive behavioral therapy for chronic pain in veterans: Evidence for clinical effectiveness in a model program." Psychological Services: Published online in advance of print publication. Excerpt: "Mixed models of the effects of time indicated significant changes across pretreatment, midtreatment, and treatment conclusion on all outcomes. There was a large effect size (Cohen’s d = 0.78) for pain catastrophizing, and there were medium to large effect sizes (d > 0.60) for worst pain intensity, pain interference, depression, and physical quality of life. Systematic training of therapists and implementation of the VA’s CBT-CP protocol yielded significant patient improvements across multiple domains. This offers strong support for the VA’s CBT-CP as an effective, safe treatment for Veterans with chronic pain and highlights it as a model to increase the availability of training in standardized, pain-focused, evidence-based, behavioral interventions. The findings suggest that the broad dissemination of such training, including in routine, nonpain specialty settings, would improve patient access to effective, nonpharmacological treatment options in both the public and private sectors."

Özalp Gerçeker, G., et al. (2020). "Effects of virtual reality on pain, fear and anxiety during blood draw in children aged 5–12 years old: A randomised controlled study." Journal of Clinical Nursing: Published online in advance of print publication. Excerpt: "Pain scores were found to be lower in the VR-Rollercoaster group and the VR-Ocean Rift group. A statistical difference was found between groups according to self-, parent- and researcher-reported fear and anxiety scores after blood draw. While being in VR-Rollercoaster and VR-Ocean Rift group reduced children's fear and anxiety, being in the control group increased fear levels by 20% and anxiety levels by 34.1%.... VR is an effective method in reducing procedure-related pain, fear and anxiety in children aged 5–12 years old during blood draw.... Evidence-based guidelines and protocols should be created for nonpharmacological methods such as VR for procedural pain and anxiety in children."

Poleshuck, E. L., et al. (2014). "Randomized controlled trial of interpersonal psychotherapy versus enhanced treatment as usual for women with co-occurring depression and pelvic pain." Journal of Psychosomatic Research 77(4): 264-272. Excerpt: "ITT analyses were not significant. In causal modeling analyses, participants assigned to IPT showed significantly more improvement for depression and social interactions, but not for pain…. IPT may be a viable option as part of a comprehensive treatment program for women in medical practices with depression and chronic pain.

Reimnitz, L. and M. J. Silverman (2018). "A randomized pilot study of music therapy in the form of patient-preferred live music on fatigue, energy and pain in hospitalized adult oncology patients on a blood and marrow transplant unit." Arts & Health: An International Journal of Research, Policy and Practice. [published online in advance of print] Excerpt: "Between-group posttest results were statistically significant for fatigue and pain, with the experimental group having less fatigue and pain than the control group.... PPLM can be a preferred and effective intervention to immediately lessen fatigue and pain without pharmacological intervention."

Rischer, K. M., et al. (2020). "Distraction from pain: The role of selective attention and pain catastrophizing." European Journal of Pain: Published online in advance of print. Excerpt: "Engaging in the high load condition significantly reduced perceived intensity and unpleasantness of nociceptive stimuli, compared to the low load condition. The size of the distraction effect correlated significantly with better cognitive inhibition and selective attention abilities, as measured by the flanker task. A moderation analysis revealed a significant interaction between pain catastrophizing and performance in the flanker task in predicting the distraction effect size: Participants who performed well on the flanker task showed more pain reduction, but only when they were average to high pain catastrophizers.... Selective attention abilities and pain catastrophizing seem to be important factors in explaining individual differences in the size of the analgesic response to a distractive task."

Schatz, J., et al. (2015). "Changes in coping, pain, and activity after cognitive-behavioral training: A randomized clinical trial for pediatric sickle cell disease using smartphones." The Clinical Journal of Pain 31(6): 536-547. Excerpt: "CBT coping skills training supported using smartphones can increase coping and reduce pain intensity for children with SCD…"

Slatter, T. (2016). "The use of hypnosis as an adjunct to cognitive-behavioural therapy in the treatment of pain, anxiety, and sleeping difficulties associated with multiple sclerosis." Australian Journal of Clinical & Experimental Hypnosis 41(1): 100-109. Excerpt: "The effectiveness of hypnosis and CBT in combination is demonstrated by the improvement in quality of sleep, a reduction of anxiety and depression, and positive behaviour changes. Chronic pain was decreased in the short term, but not in the long term."

Stewart, M. O., et al. (2015). "National dissemination of cognitive-behavioral therapy for chronic pain in Veterans: Therapist and patient-level outcomes." The Clinical Journal of Pain 31(8): 722-729. Excerpt: "Training in and implementation of CBT-CP in the VA health care system were associated with significant increases in therapist competencies to deliver CBT-CP and improvements in several domains for Veteran patients. Results support the feasibility and effectiveness of broad dissemination of CBT-CP in routine, nonpain specialty settings."

Trost & Parsons (2014). "Beyond distraction: Virtual reality graded exposure therapy as treatment for pain-related fear and disability in chronic pain." Journal of Applied Biobehavioral Research 19(2): 106-126. Excerpt: "In addition to mitigating costs associated with traditional exposure protocols, the VRGET platform facilitates patient treatment engagement, provides real-time assessment of valuable outcome variables such as affective response and kinematic adaptation, and promotes generalizability of treatment gains across clinical and home environments." Ussher, M., et al. (2014). "Immediate effects of a brief mindfulness-based body scan on patients with chronic pain." Journal of Behavioral Medicine 37(1): 127-134. Excerpt: "These data suggest that, in a clinic setting, a brief body scan has immediate benefits for those experiencing chronic pain."

Turner, A. P., et al. (2020). "Behavioral activation and behavioral inhibition: An examination of function in chronic pain." Rehabilitation Psychology: Published online in advance of print publication. Excerpt: "BIS and BAS both contributed to pain-related function; however, BIS displayed stronger associations with both pain interference and positive function despite pain."

Vallabh, P. K., et al. (2014). "The effect of a cognitive-behavioral therapy chronic pain management program on perceived stigma: A clinical controlled trial." Journal of Pain Management 7(4): 291-299. Excerpt: "Stigmatization was high in our patients. While treatment was successful in reducing anxiety and pain-related disability, CBT had no effect on perceived stigma across groups. Including a family member or friend early in treatment reduced perceived stigma from physicians. Our findings of level of stigmatization in our clinical sample were highly similar to data collected in a clinically and geographically different population. Our outcomes confirmed that stigma is prevalent in chronic pain. Pain-focused CBT, while effective in its declared objectives, did not mitigate the perception of stigma. While helping reduce perceived stigma may be valuable, it appears that a primary focus should also be to educate and change public views toward chronic pain. "

Vibe Fersum, K., et al. (2019). "Cognitive functional therapy in patients with non-specific chronic low back pain—a randomized controlled trial 3-year follow-up." European Journal of Pain. [published online in advance of print] Excerpt: "Significantly greater reductions in disability were observed for the CFT group, with ODI scores at 3 years 6.6 points lower in the CFT than the MT-EX group (95%CI:-10.1 to −3.1, p < 0.001, standardized effect size = 0.70). There was no significant difference in pain intensity between the groups at 3 years (0.6 points 95%CI:-1.4–0.3, p = 0.195). Significantly greater reductions were also observed for the CFT group for Hopkins Symptoms Checklist and Fear-Avoidance Belief Questionnaire (Work). Conclusions CFT is more effective at reducing disability, depression/anxiety and pain-related fear, but not pain, at 3-year follow-up than MT-EX. Significance Cognitive functional therapy (CFT) was more effective than manual therapy and exercise (MT-EX) in reducing disability at 3-year follow-up, in people with non-specific chronic low back pain. The sustained reduction in disability without concomitant reductions in pain intensity in the CFT group suggests a de-coupling of the pain—disability relationship. CFT resulted in long-lasting reductions in anxiety and depression, and pain-related fear regarding work compared to MT-EX. The findings support the long-term benefits of a individualized behaviourally orientated intervention that targets pain beliefs, functional restoration and lifestyle factors."

Vowles, K. E., et al. (2014). "Acceptance and commitment therapy for chronic pain: Evidence of mediation and clinically significant change following an abbreviated interdisciplinary program of rehabilitation." The Journal of Pain 15(1): 101-113. Excerpt: "At the 3-month follow-up, 46.2% of patients achieved clinically significant change, and 58.9% achieved reliable change, in at least 1 key measure of functioning (depression, pain anxiety, and disability). Changes in measures of psychological flexibility significantly mediated changes in disability, depression, pain-related anxiety, number of medical visits, and the number of classes of prescribed analgesics. These results add to the growing body of evidence supporting interdisciplinary acceptance and commitment therapy for chronic pain, particularly with regard to the clinical significance of an abbreviated course of treatment."

Waters, S. J., et al. (2016). "Self-system therapy for distress associated with persistent low back pain: A randomized clinical trial." Psychotherapy Research 26(4): 472-483. Excerpt: "Patients receiving SST showed significantly greater improvement in depressive symptoms. Reduction in self-discrepancy predicted reduction in depressive symptoms only within the SST condition."

Wetherell, J. L., et al. (2015). "Age moderates response to acceptance and commitment therapy vs. Cognitive behavioral therapy for chronic pain." International Journal of Geriatric Psychiatry (Published online in advance of print publication). Excerpt: "Older adults were more likely to respond to ACT, and younger adults to CBT, both immediately following treatment and at 6-month follow-up. There were no significant differences in credibility, expectations of positive outcome, attrition, or satisfaction, although there was a trend for the youngest adults (ages 18–45 years) to complete fewer sessions…. These data suggest that ACT may be an effective and acceptable treatment for chronic pain in older adults."

Wolf, T. G., et al. (2016). "Hypnosis and local anesthesia for dental pain relief—Alternative or adjunct therapy?—A randomized, clinical-experimental crossover study." International Journal of Clinical and Experimental Hypnosis 64(4): 391-403. Excerpt: "This prospective randomized clinical crossover trial was designed to compare hypnosis and local anesthesia for experimental dental pain relief…. The pain threshold was lower under hypnosis…. Local anesthesia was superior to hypnosis and is a safe and effective method for pain relief in dentistry. Hypnosis seems to produce similar effects observed under sedation. It can be used in addition to local anesthesia and in individual cases as an alternative for pain control in dentistry."

Yoshino, A., et al. (2015). "Effectiveness of group cognitive behavioral therapy for somatoform pain disorder patients in Japan: A preliminary non-case-control study." Psychiatry and Clinical Neurosciences 69(12): 763-772. Excerpt: "We found that pain intensity, anxiety, depressive symptoms, and social functioning all significantly improved after treatment compared with the wait-list period, and the improvements in pain intensity, depressive symptoms, and social functioning were sustained at 12 months following the completion of CBT. There were strong positive correlations (P < 0.01) among pre- and post-treatment changes in the affective dimension of pain, depression, anxiety, and pain catastrophizing. … These results show that the present CBT program was effective for Japanese patients with somatoform pain disorder and that gains were maintained over the long term."

Yu, K. C., et al. (2020). "A preliminary study of an online pain management programme for patients with ankylosing spondylitis." Counselling & Psychotherapy Research: Published online in advance of print publication. Excerpt: "The overall results indicate that this online pain management programme can improve sleep quality and reduce pain interference and catastrophic responses to pain in ankylosing spondylitis patients, albeit being not very effective for mitigating the intensity of pain. Moreover, male and female patients can benefit equally from the online programme."

Zetterqvist, V., et al. (2018). "Acceptance-based behavioural treatment for insomnia in chronic pain: A clinical pilot study." Journal of Contextual Behavioral Science 9: 72-79. Excerpt: "Significant improvements were seen in most outcomes, and results were maintained at follow-up, with large effects on primary outcome (ISI) at post-treatment g′= 2.02, 95% CI [0.90–3.14], and at follow-up g′= 1.69, 95% CI [.59, 2.78]. At follow-up twelve (75.0%) of the patients were classified as responders, of which five (31.2%) were remitters.... Results overall showed a satisfying degree of feasibility with regards to retention, treatment compliance and completion of planned assessments."

Zimmaro, L. A., et al. (2020). "Greater mindfulness associated with lower pain, fatigue, and psychological distress in women with metastatic breast cancer." Psycho-Oncology 29(2): 263-270. Excerpt: "Overall, higher mindfulness was associated with lower symptom levels including lower pain severity, pain interference, fatigue, anxiety, depression, and sleep disturbance. However, degree of association varied by mindfulness facet. Non-reactivity, nonjudging, and describing showed the most frequent associations and largest effect sizes across symptoms, while observing showed the least frequent associations and lowest effect sizes."


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