ReThink Pain: Testing Online Cognitive Behavioral Therapy for Pain Management

Chronic pain affects about 100 million American adults — more than those affected by heart disease, cancer, and diabetes combined. Despite treatments that include surgery, medication, rehabilitative and physical therapy, and complementary and alternative approaches, many people with chronic pain will never recover to the point where they are pain free.

Instead, research has shown that teaching patients how to cope with their personal responses to pain can help minimize pain’s impact on their activities of daily living. Cognitive behavioral therapy (CBT), a psychotherapeutic approach that teaches techniques for recognizing and restructuring negative thoughts and behaviors, has been successfully used to help chronic pain sufferers in group and individual settings. CBT shows patients how to handle the social and psychological aspects of chronic pain, including depression, anger, and anxiety, while developing self-management skills like activity scheduling and good sleep habits to manage symptoms.

Individuals not only need to learn these techniques, but to practice them, by watching videos, completing exercises, and taking quizzes. This psycho-educational component of CBT has been increasingly offered online by companies that leverage the interactivity of e-learning to help people with issues like depression, anxiety, and insomnia.

However, CBT for chronic pain, delivered by therapists, has had only limited availability to patients due to cost, provider availability, and reimbursement issues. To increase access to the psycho-educational aspects of CBT for chronic pain sufferers, CHCF has engaged Empower Interactive, creator of the Good Days Ahead program for depression and anxiety, to produce ReThink Pain. This online program includes modules that address topics such as setting goals, reducing stress, and tracking medication use and will be tested with patients referred by these community health centers:

  • BAART Programs (multiple sites in California)
  • Family Health Center (UCSF San Francisco General Hospital)
  • Maxine Hall Health Center (San Francisco Department of Public Health)
  • Southeast Health Center (San Francisco Department of Public Health)
  • Tom Waddell Urban Health (San Francisco Department of Public Health)

This pilot aims to reduce the costs and stigma associated with care while increasing access and improving outcomes for patients with chronic pain. An external evaluation of this pilot will be conducted and results will be made available in 2015.

For more information, see the Institute of Medicine (IOM) report on chronic pain through the External Link below.