Remote CBT-Based Therapy Yields Modest Improvements in Chronic Pain
By Elana Gotkine HealthDay Reporter
MONDAY, July 28, 2025 -- Remote-scalable cognitive behavioral therapy (CBT)-based chronic pain (CP) treatments yield modest improvements in high-impact chronic pain compared with usual care, according to a study published online July 23 in the Journal of the American Medical Association.
Lynn L. DeBar, Ph.D., M.P.H., from the Kaiser Permanente Center for Health Research in Portland, Oregon, and colleagues examined the effectiveness of remote, scalable CBT-CP treatments (telehealth and self-completed online) for individuals with high-impact chronic pain. A total of 2,331 eligible patients with high-impact chronic musculoskeletal pain were enrolled and randomly assigned to one of two remote, eight-session CBT-based skills training treatments -- health coach-led telephone/videoconferencing (health coach; 778 participants) or online self-completed program (painTRAINER; 776 participants) -- or usual care plus a resource guide (777 participants).
The researchers found that the adjusted percentages of participants achieving a 30 percent or greater decrease in the pain severity score were 32.0, 26.6, and 20.8 percent in the health coach group, the painTRAINER group, and the usual care group, respectively, at three months. Compared with control, both intervention groups were significantly more likely to attain a minimal clinically important difference in pain severity (relative risks, 1.54 and 1.28 for health coach and painTRAINER, respectively, versus usual care); the health coach program was more effective than the online self-completed painTRAINER program (relative risk, 1.20). At six and 12 months, statistically significant benefits were observed for both intervention groups versus usual care.
"Centralizing delivery of the CBT-CP-based programs via telephone/videoconferencing and online interventions is effective, with potential for widespread dissemination into clinical care and health care organizations nationwide," the authors write.
An institution holds the copyright to painTRAINER on behalf of one of the authors.
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Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.
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Posted July 2025
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