Cognitive Behavioral Therapy for Chronic Pain

Cognitive Behavioral Therapy for Chronic Pain (CBT-CP) helps people learn skills to better manage their chronic pain by focusing on the relationship between thoughts, emotions, and behaviors.

Cognitive Behavioral Therapy – Evidence Rating: Low to Moderate Quality

Evidence describing cognitive behavioral therapy for pain comes from multiple systematic reviews citing low to moderate quality evidence. These reviews draw from randomized control trials that sampled from populations with conditions including low back pain, fibromyalgia, and neck pain. Trials included in these systematic reviews generally had small sample sizes and did not report long-term outcomes, which limited the quality of their findings. Studies examining real-world application of CBT-CP have more consistently identified patient-level barriers to its uptake, but future research is needed to understand for whom CBT-CP is most efficacious, as well as provider- and system-level barriers to its use.

Evidence-based Scale

Cognitive Behavioral Therapy (CBT) helps people learn skills to better manage their chronic pain. CBT is conducted over a series of sessions with a therapist, focusing on the relationship between thoughts, emotions and behaviors. The skills learned in these sessions can be used to treat a range of mental, behavioral, and physical health conditions — including chronic pain. The goal of CBT for chronic pain (CBT-CP) is to help improve overall physical function, the psychological distress of living with chronic pain, and social functioning by addressing feelings of isolation that often accompany chronic pain.

Importantly, CBT-CP does not have a standardized protocol. Instead, the approach can be adapted to address each individual’s specific challenges and needs. CBT-CP is among the most effective psychotherapy interventions for chronic pain. It can help people experiencing chronic pain by improving their personal pain management strategies, identifying and correcting unhelpful thinking or decreasing their reliance on unhelpful pain-coping strategies, and supporting balanced physical activity to reduce pain and improve physical and emotional health.