Behaviour therapy and cognitive behaviour therapy for chronic low back pain : a single case series
Medical interventions have limited success when applied to individuals with chronic
low back pain. Psychological interventions have been developed in order to offer a
way of managing chronic pain. These are generally based on behavioural or cognitive
behavioural theories. Research indicates that both behaviour therapy (BT) and
cognitive behaviour therapy (CBT) are effective in the treatment of chronic pain.
However, it is unclear whether CBT is effective as a stand-alone treatment or if it has
an additive effect following the presentation ofBT. Chronic pain can affect
individuals in a number of ways. Depression, disability and pain related anxiety were
considered in the present study. Six participants took part in this single case design
study, a multiple baseline was implemented followed by either six or 12 weeks of
intervention. Three individuals received BT followed by CBT, the remaining three
received CBT alone. Findings of the study were mixed. When BT was considered
there were no consistent findings. There was no evidence that CBT added anything to
BT when disability was considered. There was weak evidence that psychological
distress may respond to CBT following the presentation ofBT. CBT showed mixed
results regarding the daily measures of negative pain related beliefs. Phase change
measures often showed a different picture to daily measures. There was limited
evidence that CBT could provide a decrease in disability and psychological distress.
While no firm conclusions could be drawn regarding negative pain related thoughts.
Methodological and theoretical issues were discussed in relation to the findings.
Suggestions for futures research were also presented.