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Guided Internet-delivered cognitive behavioural therapy for chronic pain patients who have residual symptoms after rehabilitation: Randomized controlled trial
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
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2013 (English)In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 17, no 5, 753-765 p.Article in journal (Refereed) Published
Abstract [en]

Background Chronic pain can be treated with cognitive behavioural therapy delivered in multidisciplinary settings. However, relapse is likely, and there is a need for cost-effective secondary interventions for persons with residual problems after rehabilitation. The aim of the present study was to investigate the effects of a guided Internet-delivered cognitive behavioural intervention for patients who had completed multidisciplinary treatment at a pain management unit. Methods A total of 72 persons with residual pain problems were included in the study and were randomized to either treatment for 8 weeks or to a control group who were invited to participate in a moderated online discussion forum. The participants had different chronic pain conditions, and a majority were women (72%). Twenty-two percent of the participants dropped out of the study before the post-treatment assessment. Results Intent-to-treat analyses demonstrated differences on the catastrophizing subscale of the Coping Strategies Questionnaire (Cohen's d=0.70), in favour of the treatment group but a small within-group effect. Differences were also found on other measures of pain-related distress, anxiety and depressive symptoms. A 6-month follow-up exhibited maintenance of improvements. Conclusions We conclude that Internet-delivered treatment can be partly effective for persons with residual problems after completed pain rehabilitation.

Place, publisher, year, edition, pages
2013. Vol. 17, no 5, 753-765 p.
National Category
Psychology (excluding Applied Psychology)
Identifiers
URN: urn:nbn:se:uu:diva-183338DOI: 10.1002/j.1532-2149.2012.00244.xISI: 000316810000013PubMedID: 23139021OAI: oai:DiVA.org:uu-183338DiVA: diva2:562448
Available from: 2012-10-24 Created: 2012-10-24 Last updated: 2017-12-07Bibliographically approved
In thesis
1. Guided Internet-Based Cognitive Behaviour Therapy for Chronic Pain
Open this publication in new window or tab >>Guided Internet-Based Cognitive Behaviour Therapy for Chronic Pain
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Chronic pain is a one of the most common causes of disability and sick leave. Psychological factors play a central role in the experience of pain and are important in the management of pain. However, for many people with chronic pain CBT is not available. There is a need to develop alternative ways to deliver treatments that reach more individuals with chronic pain. Internet-based treatments have been shown to be effective for several disorders and recent research suggests that internet-based CBT for chronic pain can be effective. The present thesis included four randomized controlled studies with the aim of evaluating whether guided internet-based treatments based on CBT can help individuals with chronic pain regarding psychological variables.

Study I investigated the effects of an internet-based CBT intervention with telephone support for chronic back pain. The study showed reductions in some variables assessed.     

Study II investigated the effects of an internet-based CBT intervention for chronic back pain without telephone support and with a live structured interview before inclusion. It was found that the treatment can reduce some of the distress associated with chronic pain.

Study III investigated the effects of a guided internet-delivered CBT as a secondary intervention. Participants were patients who had previously completed multidisciplinary treatment at a pain management unit. Results showed that the internet-based treatment can be a feasible option for persons with residual problems after completed pain rehabilitation. Effects remained at six-month follow-up.   

Study IV focused on the effect of a guided internet-delivered acceptance and commitment therapy (ACT) for persons with chronic pain. Results suggest that an internet-delivered ACT treatment can help persons with chronic pain. Effects remained at six-month follow-up.

In conclusion, guided internet-based CBT can decrease distress associated with chronic pain.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2012. 81 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Social Sciences, ISSN 1652-9030 ; 83
Keyword
Chronic pain, Cognitive Behaviour Therapy, Internet, Acceptance and Commitment Therapy, Guided self-help, Secondary intervention
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:uu:diva-183326 (URN)978-91-554-8516-0 (ISBN)
Public defence
2012-12-07, Sal IV, Universitetshuset, Uppsala, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2012-11-15 Created: 2012-10-24 Last updated: 2013-01-23Bibliographically approved

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Buhrman, MonicaFredriksson, AndersHursti, TimoGordh, Torsten

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