The effectiveness of in-person psychological interventions for chronic pain populations has been widely studied. The current retrospective pilot study evaluates the effectiveness of a 10-week integrative telehealth pain group intervention consisting of cognitive, behavioral, mindfulness, and lifestyle strategies on anxiety, depression, pain catastrophizing, pain interference, and pain intensity. Participants at a large multidisciplinary hospital are referred internally from various medical departments within the hospital. The present study consists of data from 9 group cohorts from October 2020 to June 2022. The study included 86 patients, with 52 completing all 10 weeks of the intervention with post-questionnaire data available. Measures assessing anxiety, depression, pain catastrophizing, pain interference, and pain intensity at baseline and at the completion of the intervention. A series of paired samples t-tests were used to assess change in each outcome measure from baseline to after completion of the program. All the outcome variables including anxiety, depression, pain interference, pain intensity, and pain catastrophizing showed statistically significant reductions after the intervention compared to baseline assessments. There were no significant differences in any of the demographic variables (age, gender, ethnicity, education level) or chronic pain condition between participants who did and did not complete the program. Preliminary data suggest that this 10-week integrative telehealth pain group intervention significantly lowered anxiety, depression, pain catastrophizing, pain interference, and pain intensity from pre- to post-intervention. Larger, randomized controlled studies are needed to validate these results.
Pain catastrophizing as a treatment process variable in cognitive behavioural therapy for adults with chronic pain
AbstractBackgroundInterdisciplinary cognitive behavioural therapy (CBT) for chronic pain is effective at improving function, mood and pain interference among individuals with disabling chronic pain. Traditionally, CBT assumes that cognitive change is an active therapeutic ingredient in the determination of treatment outcome. Pain catastrophizing, a cognitive response style that views the experience of pain as uncontrollable, permanent and destructive, has been identified as an important maladaptive cognition which contributes to difficulties with the management of chronic pain. Consequently, pain catastrophizing is commonly targeted in CBT for chronic pain.ObjectivesTo examine change trajectories in pain catastrophizing during treatment and assess the relevance of these trajectories to outcomes at posttreatment.MethodsParticipants included individuals with chronic pain (N = 463) who completed a 3‐week program of interdisciplinary CBT. Pain catastrophizing was assessed weekly over the 3 weeks of treatment and latent growth curve modelling was used to identify trajectories of change.ResultsFindings indicated the presence of two classes of linear change, one with a significant negative slope in pain catastrophizing (i.e. improved class) and the other with a non‐significant slope (i.e. unchanged class). Next, latent growth mixture modelling examined treatment outcome in relation to class membership. These results indicated that individuals in the ‘improved’ PCS class had significantly greater improvement in pain interference and mood, as well as physical and mental quality of life compared to the ‘unchanged’ class.ConclusionsImplications for our findings, in relation to the CBT model, are discussed.