Cognitive behavior therapy (CBT) for pain management is based on the notion that pain is a complex experience that is influenced by its underlying pathophysiology and also by an individual’s cognitions, affect and behavior. CBT focusses on the influence that thoughts have on a beliefs, and ultimately behavior. Therapy focusses on changing negative thoughts and replacing them with more positive ones, to effect positive change.

CBT for pain management has three main components.

Firstly, the patients are taught to understand that they play a role in managing their own pain, by understanding that their cognitions and behavior can affect the pain experience.

Secondly, the patient is taught coping skills training. The patient is taught strategies such as progressive relaxation to decrease muscle tension, reduce emotional distress and divert attention from pain. Other techniques are activity pacing and pleasant activity pacing that help patients learn to divert attention from severe pain. Cognitive restructuring is used to help patients identify and challenge overly negative pain-related thoughts and to replace them with more adaptive and positive thoughts.

Thirdly, patients are taught about the application and maintenance of learned coping skills.  Patients are encouraged to apply their coping skills to a wider range of daily situations. Patients are taught problem solving methods that enable them to analyses and develop plans for dealing with pain flare ups and other challenging situations.

CBT management for pain is typically carried out weekly for 8-10 sessions.

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