Efficacy of Telephone-Delivered Cognitive Behavioral Therapy for Chronic Pain

Summary

Principal Investigator: D M Ehde
Affiliation: University of Washington
Country: USA
Abstract: The overall objective of the study is to increase our understanding of whether and how a cognitive therapy intervention reduces pain and pain-related dysfunction in persons with chronic pain secondary to a disability. Specifically, the project will: (1) evaluate the efficacy of a telephone-delivered cognitive therapy intervention for pain in a sample of adults with chronic pain and acquired amputation, multiple sclerosis, or spinal cord injury via a randomized clinical trial;and (2) study the potential mechanisms of the effects of cognitive therapy by determining whether treatment-related changes in cognitions (specifically catastrophizing cognitions and control beliefs) mediate the effects of the intervention on pain. These aims will be accomplished by randomly assigning persons with disabilities and chronic pain (N = 160) to one of two conditions. In the first condition, the telephone-delivered cognitive therapy condition, participants will received cognitive therapy specifically instructing them in cognitive strategies (e.g., recognition of maladaptive thinking, cognitive restructuring, thought stopping) targeting pain catastrophizing, control beliefs, and other negative thoughts about pain. The intervention will be provided over the telephone to mitigate access barriers to treatment faced by many persons with pain and disability. The second condition will be a telephone-delivered pain education condition in which participants will receive education about chronic pain, but no instruction in cognitive or behavioral pain management strategies;the second condition will thus serve as an attention control condition. If the study hypotheses are supported, and the telephone-delivered cognitive therapy condition is shown to be efficacious in reducing pain and improving functioning relative to the education condition, the intervention used in this proposal will serve as a basis for a telephone-delivered treatment that could stand alone or be incorporated into interdisciplinary biopsychosocial interventions for pain in persons with disabilities. These findings will also advance the field of pain treatments by furthering our theoretical understanding of hypothesized, but rarely tested, mechanisms thought to underlie the efficacy of cognitive therapy for chronic pain. Public Health Relevance Paragraph: A compelling argument for the proposed study is to address the lack of clinical trials aimed at treating chronic pain in persons with disabilities;despite its high prevalence, the chronic pain problems experienced by persons with disabilities are not being adequately addressed. Given pain itself can be quite disabling, chronic pain as a secondary condition has the potential to contribute to disability and poor quality of life over and above the effects of the primary disability itself (Dworkin, 1997;Fordyce, 1976). The proposed study recognizes the importance of including persons with pain secondary to a disability in the study and treatment of chronic pain and acknowledges the need for developing effective treatments that are accessible yet low cost.
Funding Period: ----------------2010 - ---------------2011-
more information: NIH RePORT

Top Publications

  1. pmc Co-occurring depression and pain in multiple sclerosis
    Kevin N Alschuler
    Department of Rehabilitation Medicine, University of Washington School of Medicine, Box 358815, 1536 North 115th Street, Seattle, WA 98133, USA Electronic address
    Phys Med Rehabil Clin N Am 24:703-15. 2013
  2. doi Cognitive-behavioral therapy for individuals with chronic pain: efficacy, innovations, and directions for research
    Dawn M Ehde
    Department of Rehabilitation Medicine, University of Washington
    Am Psychol 69:153-66. 2014
  3. pmc Prevalence and impact of pain in multiple sclerosis: physical and psychologic contributors
    Adam T Hirsh
    Veterans Affairs Puget Sound Health Care System, University of Washington, Seattle, WA, USA
    Arch Phys Med Rehabil 90:646-51. 2009
  4. pmc Sex differences in pain and psychological functioning in persons with limb loss
    Adam T Hirsh
    Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA 98195 6490, USA
    J Pain 11:79-86. 2010

Scientific Experts

  • Adam T Hirsh
  • Dawn M Ehde
  • Kevin N Alschuler
  • Judith A Turner
  • Tiara M Dillworth
  • Mark P Jensen

Detail Information

Publications5

  1. pmc Co-occurring depression and pain in multiple sclerosis
    Kevin N Alschuler
    Department of Rehabilitation Medicine, University of Washington School of Medicine, Box 358815, 1536 North 115th Street, Seattle, WA 98133, USA Electronic address
    Phys Med Rehabil Clin N Am 24:703-15. 2013
    ..Additionally, the article discusses how existing treatments of pain and depression could be adapted to address shared mechanisms and overcome barriers to treatment utilization. ..
  2. doi Cognitive-behavioral therapy for individuals with chronic pain: efficacy, innovations, and directions for research
    Dawn M Ehde
    Department of Rehabilitation Medicine, University of Washington
    Am Psychol 69:153-66. 2014
    ....
  3. pmc Prevalence and impact of pain in multiple sclerosis: physical and psychologic contributors
    Adam T Hirsh
    Veterans Affairs Puget Sound Health Care System, University of Washington, Seattle, WA, USA
    Arch Phys Med Rehabil 90:646-51. 2009
    ..To characterize the prevalence and impact of pain in veterans with multiple sclerosis (MS) and to assess their association with demographic, biologic, and psychologic variables...
  4. pmc Sex differences in pain and psychological functioning in persons with limb loss
    Adam T Hirsh
    Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA 98195 6490, USA
    J Pain 11:79-86. 2010
    ..This study did not find prominent sex differences in pain specific to limb loss. However, several sex differences in the overall biopsychosocial experience of pain did emerge that are consistent with the broader literature...