An Evaluation of the Effectiveness of a Cognitive Behavioural Therapy-Based Multidisciplinary Pain Management Programme for Adults Living with Chronic Pain

Chronic pain is a complex entity that can lead to individuals experiencing long-term disability. Furthermore, the interaction of physiological, psychological and social factors can intensify the pain experience. Evidence suggests that cognitive behavioural therapy-based pain management programmes (CBT-PMP) are an effective treatment for chronic pain. The aim of this study was to evaluate the effectiveness of the Blackpool Pain Management Service's CBT-PMP, and to explore the association between changes in pain-related disability, pain self-efficacy and depression. This retrospective study was based on pre and post-treatment outcome data for 65 patients (mean age of 50 years; 83% female) who completed the CBT- PMP between the years 2010–2014. Paired sample t -tests and Wilcoxon signed-rank tests demonstrated significant improvements over time for all of the outcome measures: pain self-efficacy ( p < .001, d = .89), fear of movement ( p < .001, d = .76), pain catastrophizing ( p < .001, d = .78), depression ( p < .001, d = .76), pain-related disability ( p = .001, d = .45), pain intensity ( p < .001, d = .55) and pain experience - affective ( p < .001, d = .55) and sensory ( p < .001, d =.49), as well as physical measures - 20-metre timed walk ( p < .001, r = –.48) and sit-stand ( p < .001, r = –.49). Hierarchical multiple regression analyses showed that after controlling for baseline pain-related disability ( Δ R² = .11, p = .010) and pre to post-treatment change in pain intensity ( Δ R² = .11, p = .007), changes in pain self-efficacy and depression ( Δ R² = .21, p < . 001) significantly predicted change in pain-related disability. These findings indicate that, overall, patients who attended the Blackpool Pain Management Service's CBT-PMP experienced significant improvements in their physical and psychological wellbeing. Furthermore, this study provides convincing evidence that changes in pain self-efficacy and depression are strongly associated with change in pain-related disability.