TY - JOUR
AU - G. P. Beehler
AU - J. L. Murphy
AU - P. R. King
AU - K. M. Dollar
AU - L. K. Kearney
AU - A. Haslam
AU - M. Wade
AU - W. R. Goldstein
A1 - 
AB - OBJECTIVES: Although cognitive behavioral therapy is an effective intervention for chronic pain, it is a lengthy treatment typically applied only in specialty care settings. The aim of this project was to collect preliminary effectiveness data for Brief Cognitive Behavioral Therapy for Chronic Pain (Brief CBT-CP), an abbreviated, modular form of treatment designed for use in primary care. METHODS: A clinical demonstration project was conducted in which Brief CBT-CP was delivered to primary care patients by 22 integrated care providers practicing in the Primary Care Behavioral Health model of Veterans Health Administration primary care clinics. Brief measures were used at each appointment to collect patient-reported clinical outcomes. RESULTS: One hundred eighteen patients provided sufficient data for analysis (male, 75%; mean age, 51.4 y). Multilevel modeling suggested that a composite measure of pain intensity and functional limitations showed statistically significant improvements by the third appointment (Cohen's d=0.65). Pain-related self-efficacy outcomes showed a similar pattern of results but of smaller effect size (Cohen's d=0.22). The exploratory analysis identified that Brief CBT-CP modules addressing psychoeducation and goal setting, pacing, and relaxation training were associated with the most significant gains in treatment outcomes. DISCUSSION: These findings provide early support for the effectiveness of Brief CBT-CP when delivered by providers in every day Primary Care Behavioral Health settings. Results are discussed in relation to the need for additional research regarding the potential value of employing safe, population-based, nonpharmacological approaches to pain management in primary care.
AD - VA Center for Integrated Healthcare, VA Western New York Healthcare System.; School of Public Health and Health Professions.; James A. Haley Veterans' Hospital.; Department of Neurology, University of South Florida College of Medicine, Tampa, FL.; VA Center for Integrated Healthcare, VA Western New York Healthcare System.; Department of Counseling, School, and Educational Psychology, University at Buffalo, The State University of New York, Buffalo.; VA Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY.; VA Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY.; Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX.; Albuquerque VA Medical Center, Albuquerque, NM.; VA Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY.; VA Center for Integrated Healthcare, VA Western New York Healthcare System.
BT - The Clinical journal of pain
C5 - Education & Workforce; Healthcare Disparities
CP - 10
CY - United States
DO - 10.1097/AJP.0000000000000747
IS - 10
JF - The Clinical journal of pain
LA - eng
M1 - Journal Article
N2 - OBJECTIVES: Although cognitive behavioral therapy is an effective intervention for chronic pain, it is a lengthy treatment typically applied only in specialty care settings. The aim of this project was to collect preliminary effectiveness data for Brief Cognitive Behavioral Therapy for Chronic Pain (Brief CBT-CP), an abbreviated, modular form of treatment designed for use in primary care. METHODS: A clinical demonstration project was conducted in which Brief CBT-CP was delivered to primary care patients by 22 integrated care providers practicing in the Primary Care Behavioral Health model of Veterans Health Administration primary care clinics. Brief measures were used at each appointment to collect patient-reported clinical outcomes. RESULTS: One hundred eighteen patients provided sufficient data for analysis (male, 75%; mean age, 51.4 y). Multilevel modeling suggested that a composite measure of pain intensity and functional limitations showed statistically significant improvements by the third appointment (Cohen's d=0.65). Pain-related self-efficacy outcomes showed a similar pattern of results but of smaller effect size (Cohen's d=0.22). The exploratory analysis identified that Brief CBT-CP modules addressing psychoeducation and goal setting, pacing, and relaxation training were associated with the most significant gains in treatment outcomes. DISCUSSION: These findings provide early support for the effectiveness of Brief CBT-CP when delivered by providers in every day Primary Care Behavioral Health settings. Results are discussed in relation to the need for additional research regarding the potential value of employing safe, population-based, nonpharmacological approaches to pain management in primary care.
PP - United States
PY - 2019
SN - 1536-5409; 0749-8047
SP - 809
EP - 817
EP - 
T1 - Brief Cognitive Behavioral Therapy For Chronic Pain: Results From a Clinical Demonstration Project in Primary Care Behavioral Health
T2 - The Clinical journal of pain
TI - Brief Cognitive Behavioral Therapy For Chronic Pain: Results From a Clinical Demonstration Project in Primary Care Behavioral Health
U1 - Education & Workforce; Healthcare Disparities
U2 - 31318726
U3 - 10.1097/AJP.0000000000000747
VL - 35
VO - 1536-5409; 0749-8047
Y1 - 2019
Y2 - Oct
ER -