Cognitive Behavioral Therapy for Chronic Pain

Virtual delivery (via phone or online video chat) of CBT-CP can address geographic limitations, but some evidence suggests it may not be as effective or acceptable for some individuals.

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

CBT-CP can be administered virtually either via phone or online video chat to address geographical and time barriers that may be especially pertinent for individuals with chronic pain due to a common barrier of discomfort associated with driving long distances. However, there are some limitations to the effectiveness of CBT when conducted remotely.

When CBT-CP is delivered via phone, the quality of the provider's relationship with the individual can affect the effectiveness of the intervention.

When CBT-CP is delivered online, participants report appreciating the availability and variety of materials, the increased access to CBT-CP, and their ability to complete the materials on their schedule. However, participants also commented that the interventions could feel too rushed, repetitive, or not personalized to their own needs.