Cited by 1,597Musculoskeletal pain and rehabilitationPain Management and TreatmentPsychotherapy Techniques and Applications

Systematic review and meta-analysis of randomized controlled trials of cognitive behaviour therapy and behaviour therapy for chronic pain in adults, excluding headache

Morley, Stephen, Eccleston, Christopher, Williams, Amanda·1999·Pain

Abstract

A computer and a hand search of the literature recovered 33 papers from which 25 trials suitable for meta-analysis were identified. We compared the effectiveness of cognitive-behavioural treatments with the waiting list control and alternative treatment control conditions. There was a great diversity of measurements which we grouped into domains representing major facets of pain. Effect sizes, corrected for measurement unreliability, were estimated for each domain. When compared with the waiting list control conditions cognitive-behavioural treatments were associated with significant effect sizes on all domains of measurement (median effect size across domains = 0.5). Comparison with alternative active treatments revealed that cognitive-behavioural treatments produced significantly greater changes for the domains of pain experience, cognitive coping and appraisal (positive coping measures), and reduced behavioural expression of pain. Differences on the following domains were not significant; mood/affect (depression and other, non-depression, measures), cognitive coping and appraisal (negative, e.g. catastrophization), and social role functioning. We conclude that active psychological treatments based on the principle of cognitive behavioural therapy are effective. We discuss the results with reference to the complexity and quality of the trials.

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Crossref · 10.1016/s0304-3959(98)00255-3

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Authors
Morley, S., Eccleston, C., & Williams, A.
Affiliations
  • University of Leeds (GB)
  • University of Bath (GB)
  • University of London (GB)
Corresponding author
Morley, Stephen
Venue
Pain
Published
1999-03-01
Volume
80
Issue
1
Pages
1-13
ISSN
0304-3959 (ISSN-L)
OpenAlex
W2079711079
Cited by
1,597
References
72
Citations by year
2026: 11 · 2025: 16 · 2024: 24 · 2023: 18 · 2022: 32 · 2021: 50 · 2020: 35 · 2019: 43 · 2018: 49 · 2017: 56 · 2016: 63 · 2015: 63 · 2014: 72 · 2013: 90 · 2012: 96
FWCI
5.69
Type
journal article
Language
en
Open access
closed
Locations
  • Pain (publishedVersion)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Topics
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords
cognitive behavioral therapy, behavior therapy, chronic pain, psychological intervention, pain coping, pain catastrophizing, pain expression, depression, social role functioning, treatment effectiveness
MeSH terms
Adult, Behavior Therapy, Chronic Disease, Female, Humans, Male, Middle Aged, Pain, Research Design, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Sample Size, Pain Management

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