Can we improve cognitive–behavioral therapy for chronic back pain treatment engagement and adherence? A controlled trial of tailored versus standard therapy
| Autor: | John W. Burns, Mark P. Jensen, John J. Sellinger, Patricia H. Rosenberger, Mary I. Dallas, Alicia A. Heapy, Marc Shulman, Warren R. Nielson, Robert D. Kerns, Rebecca Czlapinski, David K. Chatkoff |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Motivational interviewing Severity of Illness Index Medical Records law.invention Treatment and control groups Randomized controlled trial law Adaptation Psychological Severity of illness Back pain medicine Humans Applied Psychology Analysis of Variance Motivation Cognitive Behavioral Therapy business.industry Chronic pain Middle Aged medicine.disease Cognitive behavioral therapy Clinical trial Connecticut Psychiatry and Mental health Back Pain Physical therapy Patient Compliance Female Chronic Pain medicine.symptom business Clinical psychology |
| Zdroj: | Health Psychology. 33:938-947 |
| ISSN: | 1930-7810 0278-6133 |
| Popis: | This study evaluated whether tailored cognitive-behavioral therapy (TCBT) that incorporated preferences for learning specific cognitive and/or behavioral skills and used motivational enhancement strategies would improve treatment engagement and participation compared with standard CBT (SCBT). We hypothesized that participants receiving TCBT would show a lower dropout rate, attend more sessions, and report more frequent intersession pain coping skill practice than those receiving SCBT. We also hypothesized that indices of engagement and adherence would correlate with pre- to posttreatment changes in outcome factors.One hundred twenty-eight of 161 consenting persons with chronic back pain who completed baseline measures were allocated to either TCBT or SCBT using a modified randomization procedure. Participants completed daily ratings of pain coping skill practice and goal accomplishment during treatment, as well as measures of pain severity, disability, and other key outcomes at the end of treatment.No significant differences between treatment groups were noted on measures of treatment engagement or adherence. However, these factors were significantly related to some pre- to posttreatment improvements in outcomes, regardless of treatment condition.Participants in this study evidenced a high degree of participation and adherence, but treatment tailored to take into account participant preferences, and that employed motivational enhancement strategies, failed to increase treatment participation over and above SCBT for chronic back pain. Evidence that participation and adherence were associated with positive outcomes supports continued clinical and research efforts focusing on these therapeutic processes. |
| Databáze: | OpenAIRE |
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