Cognitive behavioral therapy (CBT) and pain education for people with chronic pain: Tests of treatment mechanisms., 2020, Thorn et al

Andy

Andy

Retired committee member
Objectives: The goals of the study were to determine to what degree changes in pain-related cognition during cognitive behavioral treatment (CBT) and pain education (EDU) represented treatment mechanisms and whether these cognitive changes worked to a larger extent to produce favorable outcomes in CBT than in EDU.

Method: Reported here are secondary analyses of a randomized control trial (N = 290) comparing CBT, EDU, and treatment as usual for low-literacy, low-socioeconomic-status people with chronic pain. We excluded the treatment as usual condition from these analyses and included measures collected at a midtreatment epoch. Treatment was 10 weekly group sessions. Results: Linear mixed models revealed nonsignificant differences in pre- to mid- to posttreatment changes in pain catastrophizing and pain self-efficacy between CBT and EDU. The same was true for outcome measures. Cross-lagged analyses revealed significant relationships between pre- to midtreatment changes in catastrophizing and self-efficacy and mid- to posttreatment changes in outcomes. However, relationships between pre- to midtreatment changes in outcomes and mid- to posttreatment changes in catastrophizing and self-efficacy were also significant.

Conclusions: Results suggest a complex set of mechanistic relationships. Instead of a unidirectional path from designated mechanism to designated outcome, our results suggest reciprocal influences whereby cognitive changes may beget outcome improvements and vice versa. Results also suggest that cognitive changes do not occur solely in a treatment that uses cognitive restructuring to foster such changes but may occur as a function of providing people with detailed information regarding the biopsychosocial nature of chronic pain.
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Paywall, https://doi.apa.org/doiLanding?doi=10.1037/ccp0000612
Sci hub, no access
 
I might be missing it, but it does not say how they collected the results so I presume it was the usual questionnaires.

no matter how the outcomes were measured, unless they are completely objective the results are just as likely to reflect how psychological treatments change the way people fill out forms as to show

"that cognitive changes do not occur solely in a treatment that uses cognitive restructuring to foster such changes but may occur as a function of providing people with detailed information regarding the biopsychosocial nature of chronic pain"
 
whole careers in creative writing is this sort of psuedo science really what ambitious young people sign up for . the education industry is doing an enron conning significant sums from gullible would be professionals . marketing must be truly amazing to get students to leave their brains and dignity in the bin outside the lecture halls .
 
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