Client/Patient
Individual’s perceptions of CBT-CP and its effectiveness may cause them to reduce or stop treatment.
Barriers
The attrition of individuals in CBT-CP can be a concern, with many dropping out before completing the full course of treatment or never attending a single session.
A lack of understanding of the core principles of CBT and psychotherapy generally can prevent individuals from engaging fully in therapy and benefitting from CBT. Additionally, the individual’s pain experience and beliefs about their pain can impact the effectiveness of CBT-CP.
Some individuals believe that pain is a physical symptom or warning signal reflecting mechanical stress or dysfunction of the body. They may not completely understand their own pain triggers and may perceive a minimal role of their own cognitive function in pain management. Some individuals may also believe that psychotherapeutic approaches to pain management invalidate their physical experience of pain.
Some individuals who are referred to CBT for pain management may not proceed with treatment due to poor patient-provider relationships.
Facilitators
Individuals with more experience with or understanding of pain self-management strategies and greater insight into the connection between behaviors, emotions and their pain tend to get the most benefit from CBT-CP.
A known primary care provider making the introduction to a mental health or CBT provider may help successfully connect individuals referred to CBT with actual treatment.