The DOI matches its Crossref record; 71 of the 72 references it cites were found in a registry or an index.
Systematic review and meta-analysis of randomized controlled trials of cognitive behaviour therapy and behaviour therapy for chronic pain in adults, excluding headache
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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In the citing paper
“Over the past 30 years, a substantial body of empirical evidence has accrued establishing the efficacy of psychosocial treatment of chronic pain beyond the effects of standard medical care”
From Mindfulness and cognitive-behavioral interventions for chronic pain: Differential effects on daily pain reactivity and stress reactivity (2015) · cites this paper as Morley, Eccleston, & Williams, 1999
In the citing paper
“An early systematic review in 1999 [28], which was subsequently updated in 2012 as a Cochrane review [29], concluded that Cognitive Behavioral Therapy (CBT) (on which PMPs are based) is an effective intervention in the armoury of the management of chronic pain.”
In the citing paper
“Cognitive–behavioural therapy (CBT) is the standard psychological treatment for people with chronic pain6–11”
In the citing paper
“Cognitive Behavioral Therapy (CBT) has a significant record of success in the treatment of chronic pain (e.g., Hoffman, Papas, Chatkoff, & Kerns, 2007; Morley, Eccleston, & Williams, 1999).”
From Acceptance and values-based action in chronic pain: A three-year follow-up analysis of treatment effectiveness and process (2011) · cites this paper as Morley, Eccleston, & Williams, 1999
In the citing paper
“In such cases, Cognitive Behavioural Therapies (CBT) are often effectively used to change the client's focus from the pain itself, to the impact the pain is having on their functioning 5, 6 .”
From The Effectiveness of an Acceptance and Commitment Therapy Self-help Intervention for Chronic Pain. (2010) · cites this paper as [6]
In the citing paper
“Usually, the effects of CBT for CLBP are moderate, around d = .6 (Chou et al., 2017; Morley et al., 1999).”
From Exposure and CBT for chronic back pain: An RCT on differential efficacy and optimal length of treatment (2018) · cites this paper as Morley et al., 1999
In the citing paper
“During the past 20 years, numerous studies have demonstrated that behavioral and psychosocial protocols can benefit patients with persistent pain.”
From Psychological aspects of persistent pain: Current state of the science (2004) · cites this paper as [82]
In the citing paper
“| 16 | Cognitive coping and appraisal | Wait list | 0.50 | 69 |”
From The empirical status of cognitive-behavioral therapy: A review of meta-analyses (2006) · cites this paper as Morley et al. (1999)
In the citing paper
“| 15 | Social role functioning | Wait list | 0.61 | 73 |”
From The empirical status of cognitive-behavioral therapy: A review of meta-analyses (2006) · cites this paper as Morley et al. (1999)
In the citing paper
“| 24 | Mood | | 0.06 | 53 |”
From The empirical status of cognitive-behavioral therapy: A review of meta-analyses (2006) · cites this paper as Morley et al. (1999)
In the citing paper
“| 23 | Cognitive coping and appraisal | | 0.33 | 63 |”
From The empirical status of cognitive-behavioral therapy: A review of meta-analyses (2006) · cites this paper as Morley et al. (1999)
In the citing paper
“| 5 | Pain expression behavior | Wait list | 0.49 | 69 |”
From The empirical status of cognitive-behavioral therapy: A review of meta-analyses (2006) · cites this paper as Morley et al. (1999)
In the citing paper
“Morley et al. (1999) | 16 | Pain experience | Wait list | 0.33 | 63 |”
From The empirical status of cognitive-behavioral therapy: A review of meta-analyses (2006) · cites this paper as Morley et al. (1999)
In the citing paper
“| 17 | Pain experience | Heterogeneous collection of treatments (not including behavior therapy or biofeedback) | 0.26 | 60 |”
From The empirical status of cognitive-behavioral therapy: A review of meta-analyses (2006) · cites this paper as Morley et al. (1999)
In the citing paper
“| 7 | Activity level | Wait list | 0.48 | 69 |”
From The empirical status of cognitive-behavioral therapy: A review of meta-analyses (2006) · cites this paper as Morley et al. (1999)
In the citing paper
“| 22 | Mood | Wait list | 0.40 | 66 |”
From The empirical status of cognitive-behavioral therapy: A review of meta-analyses (2006) · cites this paper as Morley et al. (1999)
In the citing paper
“| 8 | Pain expression behavior | | 0.31 | 62 |”
From The empirical status of cognitive-behavioral therapy: A review of meta-analyses (2006) · cites this paper as Morley et al. (1999)
In the citing paper
“| 10 | Social role functioning | | 0.10 | 54 |”
From The empirical status of cognitive-behavioral therapy: A review of meta-analyses (2006) · cites this paper as Morley et al. (1999)
In the citing paper
“Cognitive treatments were significantly superior to waiting list on all domains except the expression of pain behavior, with a weighted grand mean ES of 0.46.”
From The empirical status of cognitive-behavioral therapy: A review of meta-analyses (2006) · cites this paper as Morley, Eccleston, and Williams (1999)
In the citing paper
“Across domains, the effect sizes for cognitive treatments were generally larger than those for behavior therapy, although there were fewer trials with behavior therapy.”
From The empirical status of cognitive-behavioral therapy: A review of meta-analyses (2006) · cites this paper as Morley, Eccleston, and Williams (1999)
In the citing paper
“When CBT was compared to a heterogeneous collection of alternative treatments (not including behavior therapy or biofeedback), it was found to be superior in reducing pain experience, increasing positive cognitive coping and appraisal, and reducing behavioral expression of pain.”
From The empirical status of cognitive-behavioral therapy: A review of meta-analyses (2006) · cites this paper as Morley, Eccleston, and Williams (1999)
In the citing paper
“These findings are consistent with previous studies demonstrating the benefits of cognitive and behaviorally oriented approaches to managing FM delivered in traditional face-to-face formats [40; 68; 67; 61].”
From Internet-enhanced management of fibromyalgia: A randomized controlled trial (2010) · cites this paper as [40]
In the citing paper
“Both types of interventions can improve a person’s quality of life, pain acceptance, functioning, and self-efficacy while also having the potential to reduce pain, depressive symptoms, and distress [10-18].”
From A User-Centered Approach to an Evidence-Based Electronic Health Pain Management Intervention for People With Chronic Pain: Design and Development of EPIO (2020) · cites this paper as [16]
In the citing paper
“CBT- and ACT-based psychological interventions have been shown to be effective, improving quality of life, depressive symptoms, and pain acceptance for people living with chronic pain [10,11,13,14,16,66,67].”
From A User-Centered Approach to an Evidence-Based Electronic Health Pain Management Intervention for People With Chronic Pain: Design and Development of EPIO (2020) · cites this paper as [16]
In the citing paper
“One of the important challenges to be met within current CBT approaches to chronic pain is the challenge of treatment processes or mechanisms. 62,64,74,94”
From The Psychological Flexibility Model: A Basis for Integration and Progress in Psychological Approaches to Chronic Pain Management (2014) · cites this paper as [64]
In the citing paper
“Generally the evidence for CBT for chronic pain is supportive.4, 22”
From A Trial of a Brief Group-Based Form of Acceptance and Commitment Therapy (ACT) for Chronic Pain in General Practice: Pilot Outcome and Process Results (2013) · cites this paper as [22]
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Metadata
- 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 › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › 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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