Guided Internet‐delivered cognitive behavioural therapy for chronic pain patients who have residual symptoms after rehabilitation treatment: Randomized controlled trial

Buhrman, M.; Fredriksson, A.; Edström, G.; Shafiei, D.; Tärnqvist, C.; Ljótsson, B.; Hursti, T.; Gordh, T.; Andersson, G.

doi:10.1002/j.1532-2149.2012.00244.x

Cited by 60Digital Mental Health InterventionsMusculoskeletal pain and rehabilitationPain Management and Treatment

Guided Internet‐delivered cognitive behavioural therapy for chronic pain patients who have residual symptoms after rehabilitation treatment: Randomized controlled trial

Buhrman, M., Fredriksson, A., Edström, G., Shafiei, D., Tärnqvist, C., Ljótsson, B., Hursti, T., Gordh, T. +1 more·2013·European Journal of Pain

DOI 10.1002/j.1532-2149.2012.00244.x

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Abstract

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 C oping S trategies Q uestionnaire ( C ohen'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.

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Qualitative data were analyzed using a thematic analysis process with coding reliability, and authors further analyzed findings and discussed until consensus was achieved.
“Qualitative data (ie, derived from 267 follow-up phone call notes, equaling approximately 55 single-line pages) were uploaded by coauthor K.B. to the software program NVivo version 12 (QSR International, Victoria, Australia) and analyzed using a thematic analysis process (ie, coding reliability).12,14 Authors L.S.N., E.B., and E.B.S. then further analyzed findings and discussed until consensus was”
From Living well with chronic pain: a 12-month randomized controlled trial revealing impact from the digital pain self-management program EPIO (2024) · cites this paper as [12]
Only a few studies on iCBT have investigated the effect of an intervention aiming to support self-management following participation in a traditional pain management program.
“Additionally, only a few studies on iCBT have investigated the effect of an intervention aiming to support self-management following participation in a traditional pain management program [19,20].”
From A Smartphone-Based Intervention With Diaries and Therapist Feedback to Reduce Catastrophizing and Increase Functioning in Women With Chronic Widespread Pain. Part 2: 11-month Follow-up Results of a Randomized Trial (2013) · cites this paper as [19]
In a study of persons with persistent symptoms after multidisciplinary pain management rehabilitation who received 8 weeks of guided iCBT, there was a medium between-group effect between intervention and active control, but a small within-group effect on catastrophizing after the intervention, and improvements were maintained after 6 months.
“In the third study, persons with persistent symptoms after multidisciplinary pain management rehabilitation received 8 weeks of guided iCBT. There was a medium between-group effect between the intervention group and the active control group, but a small within-group effect on catastrophizing after the intervention, and the improvements were maintained after 6 months [19].”
From A Smartphone-Based Intervention With Diaries and Therapist Feedback to Reduce Catastrophizing and Increase Functioning in Women With Chronic Widespread Pain. Part 2: 11-month Follow-up Results of a Randomized Trial (2013) · cites this paper as [19]
Most iCBT interventions for chronic pain are based on weekly modules with self-help material and involve weekly written communication with a therapist.
“Most iCBT interventions for chronic pain are based on weekly modules with self-help material and involve weekly written communication with a therapist [16,19].”
From A Smartphone-Based Intervention With Diaries and Therapist Feedback to Reduce Catastrophizing and Increase Functioning in Women With Chronic Widespread Pain. Part 2: 11-month Follow-up Results of a Randomized Trial (2013) · cites this paper as [19]
The effects on catastrophizing in that iCBT trial remained at 6-month follow-up, but more long-term effects are not reported.
“The effects on catastrophizing were remained at 6-month follow-up, but more long-term effects are not reported [19].”
From A Smartphone-Based Intervention With Diaries and Therapist Feedback to Reduce Catastrophizing and Increase Functioning in Women With Chronic Widespread Pain. Part 2: 11-month Follow-up Results of a Randomized Trial (2013) · cites this paper as [19]

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Additional file 2 of The impact of technology systems and level of support in digital mental health interventions: a secondary meta-analysis
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Additional file 7 of The impact of technology systems and level of support in digital mental health interventions: a secondary meta-analysis
Sasseville, M., LeBlanc, A., Tchuente, J., Boucher, M., Dugas, M., Mbemba, G. I. C., Barony, R., Chouinard, M., Beaulieu, M., Beaudet, N., et al. (2023) · Figshare · doi:10.6084/m9.figshare.22767530
Additional file 3 of The impact of technology systems and level of support in digital mental health interventions: a secondary meta-analysis
Sasseville, M., LeBlanc, A., Tchuente, J., Boucher, M., Dugas, M., Mbemba, G. I. C., Barony, R., Chouinard, M., Beaulieu, M., Beaudet, N., et al. (2023) · Figshare · doi:10.6084/m9.figshare.22767518
Additional file 4 of The impact of technology systems and level of support in digital mental health interventions: a secondary meta-analysis
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Additional file 6 of The impact of technology systems and level of support in digital mental health interventions: a secondary meta-analysis
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Additional file 5 of The impact of technology systems and level of support in digital mental health interventions: a secondary meta-analysis
Sasseville, M., LeBlanc, A., Tchuente, J., Boucher, M., Dugas, M., Mbemba, G. I. C., Barony, R., Chouinard, M., Beaulieu, M., Beaudet, N., et al. (2023) · Figshare · doi:10.6084/m9.figshare.22767524
Additional file 1 of The impact of technology systems and level of support in digital mental health interventions: a secondary meta-analysis
Sasseville, M., LeBlanc, A., Tchuente, J., Boucher, M., Dugas, M., Mbemba, G. I. C., Barony, R., Chouinard, M., Beaulieu, M., Beaudet, N., et al. (2023) · Figshare · doi:10.6084/m9.figshare.22767512
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Guided Internet-Based Cognitive Behaviour Therapy for Chronic Pain
Buhrman, M. (2012) · KTH Publication Database DiVA (KTH Royal Institute of Technology)
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Authors: Buhrman, M., Fredriksson, A., Edström, G., Shafiei, D., Tärnqvist, C., Ljótsson, B., Hursti, T., Gordh, T., & Andersson, G.
Affiliations: Uppsala University (SE)
Karolinska Institutet (SE)
Linköping University (SE)
Corresponding author: Buhrman, M.
ORCID: Buhrman, M.
Fredriksson, A.
Shafiei, D.
Ljótsson, B.
Hursti, T.
Gordh, T.
Andersson, G.
Venue: European Journal of Pain
Publisher: Wiley
Published: 2012-11-09
Volume: 17
Issue: 5
Pages: 753-765
ISSN: 1090-3801 (ISSN-L)
1532-2149
DOI: 10.1002/j.1532-2149.2012.00244.x
OpenAlex: W1917597118
Semantic Scholar: 70a7f009827e8332e3c7b88f43154430a7a38a7f
Cited by: 60
References: 54
Citations by year: 2026: 3 · 2025: 1 · 2024: 3 · 2023: 15 · 2022: 3 · 2021: 4 · 2020: 1 · 2019: 4 · 2018: 3 · 2017: 6 · 2016: 4 · 2015: 6 · 2014: 4 · 2013: 3
FWCI: 5.87
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: European Journal of Pain (publishedVersion)
PubMed (publishedVersion)
Funders: Akademiska Sjukhuset
Topics: Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Keywords: chronic pain, internet-based cognitive behavioral therapy, pain rehabilitation, relapse, pain catastrophizing, pain-related distress, anxiety, depressive symptoms, maintenance of treatment effects
MeSH terms: Adult, Anxiety, Anxiety Disorders, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Therapy, Computer-Assisted, Cognitive Behavioral Therapy, Treatment Outcome, Internet, Chronic Pain

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Guided Internet‐delivered cognitive behavioural therapy for chronic pain patients who have residual symptoms after rehabilitation treatment: Randomized controlled trial

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