Guided Internet-delivered cognitive behavioural therapy for chronic pain patients who have residual symptoms after rehabilitation treatment: randomized controlled trial

Eur J Pain. 2013 May;17(5):753-65. doi: 10.1002/j.1532-2149.2012.00244.x. Epub 2012 Nov 9.

Abstract

Background: Chronic pain can be treated with cognitive behavioural therapy delivered in multidisciplinary settings. However, relapse is likely, and there is a need for cost-effective secondary interventions for persons with residual problems after rehabilitation. The aim of the present study was to investigate the effects of a guided Internet-delivered cognitive behavioural intervention for patients who had completed multidisciplinary treatment at a pain management unit.

Methods: A total of 72 persons with residual pain problems were included in the study and were randomized to either treatment for 8 weeks or to a control group who were invited to participate in a moderated online discussion forum. The participants had different chronic pain conditions, and a majority were women (72%). Twenty-two percent of the participants dropped out of the study before the post-treatment assessment.

Results: Intent-to-treat analyses demonstrated differences on the catastrophizing subscale of the Coping Strategies Questionnaire (Cohen's d = 0.70), in favour of the treatment group but a small within-group effect. Differences were also found on other measures of pain-related distress, anxiety and depressive symptoms. A 6-month follow-up exhibited maintenance of improvements.

Conclusions: We conclude that Internet-delivered treatment can be partly effective for persons with residual problems after completed pain rehabilitation.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anxiety / therapy
  • Anxiety Disorders / rehabilitation
  • Anxiety Disorders / therapy
  • Chronic Pain / rehabilitation
  • Chronic Pain / therapy*
  • Cognitive Behavioral Therapy / methods*
  • Female
  • Humans
  • Internet
  • Male
  • Middle Aged
  • Surveys and Questionnaires
  • Therapy, Computer-Assisted / methods
  • Treatment Outcome