Guided Internet-Based Cognitive Behaviour Therapy for Chronic Pain

University dissertation from Uppsala : Acta Universitatis Upsaliensis

Abstract: 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.