Cognitive-behavioral therapy (CBT), a form of counseling, works well for some chronic pain problems. In this study, researchers explore ways to improve this treatment method. They also try to find factors that might predict who would benefit from CBT.
Patients in the study were adults from a university dental school facial pain clinic. Everyone had face and/or jaw pain for at least three months. The patients were divided into two groups.
The CBT group received four sessions of therapy every other week over a period of eight weeks. The second (control) group received education. Everyone still had their usual treatment in the pain clinic. Relaxation techniques were also taught to each patient.
Results were analyzed for anyone who completed at least three of the four scheduled sessions. CBT worked better and faster at both the six month and the 12-month check up. Relaxation methods used to cope with pain did not seem to effect CBT outcomes.
Factors that improved CBT results included increased sense of control over pain, decreased belief that pain was disabling, and improved ability to use self-efficacy to manage pain. Self-efficacy is the confidence a patient has that he or she can decrease their own pain.
The authors suggest these findings support the need to improve multidisciplinary programs. CBT can be more effective and efficient when patients are taught how to stop worrying about their pain. The patient’s sense of control over pain levels decreases disability. Changing patient beliefs about pain may be the best way to help chronic pain patients cope.