In a 2011 non-randomized controlled trial conducted in Germany, Tlach and Hampel studied patients with chronic low back pain (CLBP) and depression, comparing a treatment group receiving Cognitive Behavioral Therapy (CBT) plus treatment as usual (TAU) (n=44) against a control group receiving only TAU (n=40).
A study by Boersma et al. (2019) found no significant differences in pain intensity when comparing cognitive behavioral therapy (CBT) and hybrid therapy (exposure in vivo and dialectical behavior therapy) at both post-treatment and follow-up.
The systematic review excluded Cognitive Behavioral Therapy (CBT)-based interventions that did not include a control group.
A study by Migliorini et al. (2016) identified significant differences in improved stress symptoms at follow-up in favor of cognitive behavioral therapy (CBT) compared to treatment as usual (TAU), with a small effect size (d = 0.47).
The systematic review could not examine whether specific forms of cognitive behavioral therapy (CBT) are more effective than others due to the limited number of randomized controlled trials (RCTs).
A study by Boersma et al. (2019) identified significant differences in the reduction of depressive symptoms at follow-up in favor of hybrid therapy (exposure in vivo and dialectical behavior therapy) compared to cognitive behavioral therapy (CBT), with a small effect size (d = 0.25).
Schlicker et al. (2020) and Baumeister et al. (2021) found no significant differences in work capacity at post-treatment or follow-up when comparing cognitive behavioral therapy (CBT) to treatment as usual (TAU).
In a study by Schlicker et al. (2020) in Germany, patients with chronic low back pain (CLBP) and depression were treated with either Cognitive Behavioral Therapy (CBT) combined with Treatment As Usual (TAU) or TAU alone, delivered via weekly online sessions.
In a systematic review of cognitive behavioral therapy-based interventions, four out of six studies (66%) found significant differences in the reduction of depressive symptoms at follow-up in favor of cognitive behavioral therapy (CBT) compared to treatment as usual (TAU), with effect sizes (d) ranging from 0.75 to 0.26.
The CBT intervention in the Aragonès et al. (2019) study consisted of 9 sessions of 120 minutes each, delivered by a psychologist and a primary care physician, and focused on optimized management of major depression, care management, and psychoeducation for chronic pain and depression.
In a study comparing Mindful Self-Compassion (MSC) and Cognitive Behavioral Therapy (CBT), the MSC intervention had a 33% dropout rate, and the CBT intervention had a 23% dropout rate.
In a 2016 randomized controlled trial conducted in Australia, Migliorini et al. studied patients with chronic spinal cord injury and depression or anxiety, comparing a treatment group receiving CBT (n=34) against a waitlist control group (n=25).
The systematic review compared CBT-based interventions against active treatments (such as other psychological interventions) or inactive treatments (such as wait-list, usual care, attention control, or psychological placebo).
The study by Ólason et al. (2018) in Iceland evaluated the efficacy of CBT combined with treatment as usual (TAU) versus TAU alone for patients with chronic pain and depression or anxiety.
The systematic review examined the efficacy of Cognitive Behavioral Therapy (nine studies), Mindfulness-based Interventions (three studies), Acceptance and Commitment Therapy (one study), and Behavioral Activation Therapy for Depression (one study).
Evidence regarding the efficacy of Cognitive Behavioral Therapy (CBT) for pain self-efficacy, pain-related disability, fear avoidance, kinesiophobia, working capacity, and social functioning is inconsistent or insufficient.
The systematic review search strategy utilized a Boolean search string combining three categories: (1) pain-related terms (e.g., chronic pain, neuropathic pain, fibromyalgia), (2) psychological distress terms (e.g., depression, anxiety, stress, emotional regulation), and (3) intervention terms (e.g., psychotherapy, cognitive behavioral therapy, mindfulness, acceptance and commitment therapy).
In a study by Torrijos-Zarcero et al. (2021) in Spain, patients with chronic pain, depression, and anxiety were treated in a randomized controlled trial comparing Mindfulness-Based Stress Reduction (MSC) (n=62) against Cognitive Behavioral Therapy (CBT) (n=61) using weekly face-to-face sessions.
Cognitive behavioral therapy (CBT) interventions for anxiety were evaluated across 6 studies, involving 270 participants in the intervention group and 255 in the control group, with 83% of studies showing positive results at post-treatment and 75% at follow-up.
The Mindful Self-Compassion (MSC) intervention was delivered by a psychiatrist and an art therapist, while the Cognitive Behavioral Therapy (CBT) intervention was delivered by clinical psychologists.
Traditional Cognitive-Behavioral Therapy (CBT) has beneficial effects in adults with chronic pain, according to Williams et al. (2020).
Two studies (Buhrman et al., 2015; Gasslander et al., 2022) found no significant differences between cognitive behavioral therapy (CBT) and treatment as usual (TAU) at post-treatment regarding the reduction of fear of anxiety symptoms.
In the Torrijos-Zarcero et al. (2021) study, the Mindfulness-Based Stress Reduction (MSC) intervention group had a mean age of 48.29 (SD = 10.17) with 90.3% females, while the Cognitive Behavioral Therapy (CBT) control group had a mean age of 49.25 (SD = 11.39).
In the systematic review, all nine studies evaluating Cognitive Behavioral Therapy (CBT) performed baseline comparisons, and all but one study (Boersma et al., 2019) compared CBT with an inactive control group (usual care).
A single study (Torrijos-Zarcero et al., 2021) indicated significant differences in anxiety, pain interference, pain acceptance, pain catastrophizing, and self-compassion at post-treatment in favor of Mindfulness-Based Interventions (MBI) compared to Cognitive Behavioral Therapy (CBT).
Different forms of Cognitive Behavioral Therapy (CBT) are frequently applied to chronic pain and related conditions like anxiety and depression, and appear effective when explored independently, according to research by Churchill et al. (2013), Cuijpers et al. (2013), Buhrman et al. (2016), and Pasarelu et al. (2017).
Torrijos-Zarcero et al. (2021) found no significant differences in quality-of-life improvement when comparing Mindfulness-Based Interventions (MBI) to Cognitive Behavioral Therapy (CBT).
The initial database search for the systematic review of cognitive behavioral therapy-based interventions yielded 1,230 published articles.
One study (Ólason et al., 2018) identified significant differences in improved social functioning at follow-up in favor of Cognitive Behavioral Therapy (CBT) compared to Treatment As Usual (TAU), with a medium effect size (d = 0.51).
The systematic review excluded studies that combined pharmacological and Cognitive Behavioral Therapy (CBT)-based interventions.
Traditional CBT is beneficial for many varied conditions, a conclusion supported by Fordham et al. (2021), though there remains substantial room for improvement in its application.
Boersma et al. (2019) demonstrated significant changes in the reduction of pain interference in hybrid therapy (exposure in vivo and dialectical behavior therapy) compared to Cognitive Behavioral Therapy (CBT) at post-treatment with a very small effect size (d = 0.02) and at follow-up with a small effect size (d = 0.25).
The systematic review included CBT-based interventions delivered via various formats, including face-to-face, online, and blended formats.
Four out of six studies (67%) found significant differences in improving quality of life at post-treatment in favor of Cognitive Behavioral Therapy (CBT) compared to Treatment As Usual (TAU), with medium to invaluable effect sizes (d ranging from 0.78 to 0.02).
Torrijos-Zarcero et al. (2021) indicated a significant difference in the reduction of pain interference at post-treatment in favor of Mindfulness-Based Interventions (MBI) compared to Cognitive Behavioral Therapy (CBT), with a very small effect size (d = 0.07).
Veehof, Trompetter, Bohlmeijer, and Schreurs (2016) conducted a meta-analytic review titled 'Acceptance- and mindfulness-based interventions for the treatment of chronic pain', published in Cognitive Behaviour Therapy.
Cognitive Behavioral Therapy (CBT) is the most applied psychological approach to chronic pain, according to McCracken (2023).
De Jong et al. (2016, 2018) found no significant differences in anxiety symptoms at post-treatment or follow-up when comparing Cognitive Behavioral Therapy (CBT) to Treatment As Usual (TAU).
Pardos-Gascón et al. (2021) conducted a systematic review comparing the efficacy of cognitive-behavioral therapy and mindfulness-based therapies for chronic pain, published in the International Journal of Clinical and Health Psychology.
Two studies (Buhrman et al., 2015; Gasslander et al., 2022) indicated significant differences in increased pain acceptance at post-treatment in favor of Cognitive Behavioral Therapy (CBT) compared to Treatment As Usual (TAU), with very small (d = 0.12) and small (d = 0.30) effect sizes, but no significant differences were found at follow-up.
Baumeister et al. (2021) found significant differences in pain self-efficacy between Cognitive Behavioral Therapy (CBT) and Treatment As Usual (TAU) at post-treatment with a small effect size (d = 0.39) and at follow-up with a small effect size (d = 0.33).
Cognitive Behavioral Therapy (CBT) shows evidence of benefit in improving pain interference and pain acceptance at post-treatment, but not at follow-up, with small effect sizes (Buhrman et al., 2015; Gasslander et al., 2022).
In a systematic review of cognitive behavioral therapy-based interventions, three out of four studies (75%) showed significant differences in the reduction of anxiety symptoms at follow-up in favor of cognitive behavioral therapy (CBT) compared to treatment as usual (TAU), with effect sizes (d) ranging from 1.07 to 0.27.
Buhrman et al. (2015) found no significant differences in cognitive and behavioral coping strategies at follow-up when comparing cognitive behavioral therapy (CBT) to treatment as usual (TAU).
Cognitive behavioral therapy (CBT) interventions for stress were evaluated in 1 study, involving 34 participants in the intervention group and 25 in the control group, with 100% of studies showing positive results at post-treatment.
In the systematic review, five out of nine studies evaluated Cognitive Behavioral Therapy (CBT) as the only therapeutic component, while the remaining four studies evaluated CBT combined with other components.
Gasslander et al. (2022) found no significant differences between cognitive behavioral therapy (CBT) and treatment as usual (TAU) at post-treatment regarding kinesiophobia and life control.
Cognitive Behavioral Therapy (CBT)-based interventions for depression or chronic pain show consistent efficacy with previous systematic reviews (Lorenzo-Luaces et al., 2018; López-López et al., 2019; Williams et al., 2020), though the magnitude of the effect is modest.
Eight out of nine studies evaluating Cognitive Behavioral Therapy (CBT) assessed outcomes at pre-intervention, post-intervention, and follow-up time points.
In a study comparing Mindful Self-Compassion (MSC) and Cognitive Behavioral Therapy (CBT) for patients, the MSC intervention consisted of formal meditation combined with formal and informal self-compassion practices, while the CBT intervention consisted of psychoeducation, relaxation, and cognitive restructuring.
Torrijos-Zarcero et al. (2021) reported a significant difference in increasing pain acceptance at post-treatment in favor of Mindfulness-Based Interventions (MBI) compared to Cognitive Behavioral Therapy (CBT), with a very small effect size (d = 0.19).
All nine studies evaluating Cognitive Behavioral Therapy (CBT) assessed depressive symptoms as the primary outcome, while three studies assessed anxiety symptoms as a co-primary outcome.
In the systematic review, three out of four studies of traditional Cognitive Behavioral Therapy reported significant differences in the reduction of anxiety symptoms at follow-up compared to treatment as usual, with effect sizes (d) ranging from 1.07 to 0.27.
Two studies (Buhrman et al., 2015; Gasslander et al., 2022) found no significant differences in pain catastrophizing between Cognitive Behavioral Therapy (CBT) and Treatment As Usual (TAU) at post-treatment, and one study (Buhrman et al., 2015) found no significant differences at follow-up.
De Jong et al. (2016, 2018) and Torrijos-Zarcero et al. (2021) reported no significant differences in the reduction of pain intensity at post-treatment when comparing Mindfulness-Based Interventions (MBI) to Treatment As Usual (TAU) or Cognitive Behavioral Therapy (CBT).
Traditional cognitive behavioral therapy (CBT) improves depression, anxiety, and quality of life in patients with comorbid chronic pain and clinically relevant psychological distress, but does not improve pain intensity or pain catastrophizing.
Ólason et al. (2018) conducted a randomized controlled trial with a 3-year follow-up on the use of cognitive behavioral therapy for depression and anxiety within an interdisciplinary rehabilitation program for chronic pain, published in the International Journal of Behavioral Medicine.
The systematic review organized information from controlled trials according to the type of intervention, specifically Cognitive Behavioral Therapy (CBT), Mindfulness-Based Interventions (MBI), Acceptance and Commitment Therapy (ACT), and Behavioral Activation Treatment for Depression (BATD).
In a systematic review of cognitive behavioral therapy-based interventions, five out of six studies (83%) showed significant differences in the reduction of anxiety symptoms at post-treatment in favor of cognitive behavioral therapy (CBT) compared to treatment as usual (TAU), with effect sizes (d) ranging from 1.08 to 0.19.
Research interest is increasing in how CBT-based therapies, including Cognitive Behavioral Therapy (CBT), Mindfulness-Based Interventions (MBI), Acceptance and Commitment Therapy (ACT), and Behavioral Activation Treatment for Depression (BATD), can improve the functional status and quality of life in patients with chronic pain experiencing depressive and/or anxiety symptoms.
Khoo et al. (2019) conducted a systematic review and network meta-analysis published in Evidence-Based Mental Health comparing group-based mindfulness-based stress reduction and cognitive behavioral therapy for the treatment and management of chronic pain.
In the systematic review of cognitive behavioral therapy-based interventions, the statistical significance threshold was set at p < 0.05.
Torrijos-Zarcero et al. (2021) reported a significant difference in decreasing pain catastrophizing at post-treatment in favor of Mindfulness-Based Interventions (MBI) compared to Cognitive Behavioral Therapy (CBT), with a very small effect size (d = 0.12).
Torrijos-Zarcero et al. (2021) conducted a study comparing Mindfulness-Based Stress Reduction (MSC) and Cognitive Behavioral Therapy (CBT).
The systematic review synthesized findings by categorizing them into four therapy types: Cognitive Behavioral Therapy (CBT), Mindfulness-Based Interventions (MBI), Acceptance and Commitment Therapy (ACT), and Behavioral Activation Treatment for Depression (BATD).
In the Schlicker et al. (2020) study, the CBT intervention group had a 35% dropout rate at the end of the study and a 60% attendance rate of at least 80% of the total number of sessions.
In a systematic review of cognitive behavioral therapy-based interventions, six out of eight studies (75%) found significant differences in the reduction of depressive symptoms at post-treatment in favor of cognitive behavioral therapy (CBT) compared to treatment as usual (TAU), with effect sizes (d) ranging from 1.31 to 0.18.
Compared to Treatment As Usual (TAU), traditional Cognitive Behavioral Therapy (CBT) reported significant differences in the reduction of depressive and anxiety symptoms and in the increase of quality of life at post-treatment and at follow-up, with effect sizes ranging from very large to small.
The systematic review included Cognitive Behavioral Therapy (CBT)-based interventions only when the comparison group received either an active psychological intervention or an inactive treatment, such as a wait-list, usual care, attention control, or psychological placebo.
Ólason et al. (2018) found no significant differences between cognitive behavioral therapy (CBT) and treatment as usual (TAU) at post-treatment regarding fear avoidance.
The CBT intervention in the Ólason et al. (2018) study consisted of 12 sessions of 45 minutes each, delivered by a multidisciplinary team including psychologists, nurses, occupational therapists, and social workers, and experienced a 34% dropout rate.
Boersma et al. (2019) conducted a study comparing Cognitive Behavioral Therapy (CBT) and hybrid therapy, which consisted of exposure in vivo and Dialectical Behavior Therapy (DBT).
Gasslander et al. (2022) found that cognitive behavioral therapy (CBT) resulted in significant differences in coping strategies of ignoring and catastrophizing at post-treatment compared to treatment as usual (TAU), with small effect sizes of d = 0.38 and d = 0.34.
A study by Boersma et al. (2019) identified no significant differences between cognitive behavioral therapy (CBT) and hybrid therapy (exposure in vivo and dialectical behavior therapy) in the reduction of anxiety symptoms at both post-treatment and follow-up.
Table 4 in the systematic review provides a synthesis of evidence comparing Cognitive Behavioral Therapy (CBT), Mindfulness-Based Interventions (MBI), Acceptance and Commitment Therapy (ACT), or Behavioral Activation Treatment for Depression (BATD) against Treatment as Usual (TAU).
A study by Torrijos-Zarcero et al. (2021) found significant differences in self-compassion at post-treatment in favor of mindfulness-based interventions (MBI) compared to cognitive behavioral therapy (CBT), with a very small effect size (d = 0.05).
In the systematic review, five out of six studies of traditional Cognitive Behavioral Therapy reported significant differences in the reduction of anxiety symptoms at post-treatment compared to treatment as usual, with effect sizes (d) ranging from 1.08 to 0.19.
The study by Aragonès et al. (2019) in Spain evaluated the efficacy of CBT combined with treatment as usual (TAU) versus TAU alone for patients with chronic musculoskeletal pain and major depressive disorder.
A Delphi study by Sharpe et al. (2020) identified three main components of CBT: pain education, increased activity, and some form of cognitive challenge.
The systematic review concludes that traditional Cognitive Behavioral Therapy may produce significant benefits for the improvement of depression, anxiety, and quality of life, but not for pain intensity and pain catastrophizing.
In the Baumeister et al. (2021) study, the CBT intervention group had a dropout rate between 22% and 45% at the end of the study.
Cuijpers et al. (2013) performed a meta-analysis of cognitive-behavioural therapy for adult depression, evaluating its efficacy both alone and in comparison with other treatments.
Two studies (Schlicker et al., 2020; Gasslander et al., 2022) found no significant differences in pain self-efficacy between Cognitive Behavioral Therapy (CBT) and Treatment As Usual (TAU) at post-treatment, and one study (Schlicker et al., 2020) found no significant differences at follow-up.
The systematic review found no significant differences between traditional Cognitive Behavioral Therapy and treatment as usual at post-treatment and follow-up regarding pain intensity and pain catastrophizing.
In a systematic review, two out of three studies (67%) found significant differences in the reduction of pain interference at post-treatment in favor of Cognitive Behavioral Therapy (CBT) compared to Treatment As Usual (TAU), with small to very small effect sizes (d ranging from 0.22 to 0.12).
A study by Baumeister et al. (2021) identified significant differences in improved pain intensity at post-treatment in favor of cognitive behavioral therapy (CBT) compared to treatment as usual (TAU), with a small effect size (d = 0.42).
Torrijos-Zarcero et al. (2021) reported a significant difference in the reduction of anxiety symptoms at post-treatment in favor of Mindfulness-Based Interventions (MBI) compared to Cognitive Behavioral Therapy (CBT), with a very small effect size (d = 0.17).
López-López et al. (2019) conducted a systematic review and network meta-analysis on the process and delivery of cognitive behavioral therapy (CBT) for depression in adults, published in Psychological Medicine.
In the systematic review, four out of six studies of traditional Cognitive Behavioral Therapy reported significant differences in the reduction of depressive symptoms at follow-up compared to treatment as usual, with effect sizes (d) ranging from 0.75 to 0.26.
CBT targeting populations with chronic pain and comorbid psychological distress shows more modest effects than CBT targeting either condition separately, according to Sanabria-Mazo et al. (2020).
In a 2015 randomized controlled trial conducted in Sweden, Buhrman et al. studied patients with chronic pain (CP) and depression, comparing a treatment group receiving CBT plus treatment as usual (TAU) (n=28) against a control group receiving only TAU (n=24).
Traditional Cognitive-Behavioral Therapy (CBT) is effective in patients with emotional disorders, according to Lorenzo-Luaces et al. (2018) and López-López et al. (2019).
Boersma et al. (2019) reported significant differences in the decrease of pain catastrophizing at post-treatment with a small effect size (d = 0.26), but not at follow-up, in favor of hybrid therapy (exposure in vivo and dialectical behavior therapy) compared to Cognitive Behavioral Therapy (CBT).
Fordham et al. (2021) conducted a meta-review of systematic reviews and a panoramic meta-analysis to evaluate the evidence for cognitive behavioral therapy across any condition, population, or context.
Studies exploring pain intensity and pain catastrophizing found no significant differences between traditional Cognitive Behavioral Therapy (CBT) and Treatment As Usual (TAU) at post-treatment and follow-up.
The therapeutic interventions analyzed in the 13 studies included in the systematic review were: Cognitive Behavioral Therapy (69%), Mindfulness-Based Interventions (23%), and Acceptance and Commitment Therapy and Behavioral Activation Treatment for Depression (8%).
Torrijos-Zarcero et al. (2021) found no significant differences in depressive symptoms at post-treatment when comparing Mindfulness-Based Interventions (MBI) to Cognitive Behavioral Therapy (CBT).
Baumeister et al. (2021) found that cognitive behavioral therapy (CBT) led to significant improvements in pain-related disability at post-treatment compared to treatment as usual (TAU), with a small effect size of d = 0.35, though this effect was not maintained at follow-up.
The systematic review included CBT-based interventions for patients with non-oncologic chronic pain and psychological distress, but excluded studies that combined pharmacological and CBT-based interventions.
Two studies (Buhrman et al., 2015; Aragonès et al., 2019) found no significant differences in the reduction of pain interference at follow-up when comparing Cognitive Behavioral Therapy (CBT) to Treatment As Usual (TAU).
Two out of four studies (50%) found significant differences in improving quality of life at follow-up in favor of Cognitive Behavioral Therapy (CBT) compared to Treatment As Usual (TAU), with medium to small effect sizes (d = 0.78 and d = 0.33).
In the systematic review, six out of eight studies of traditional Cognitive Behavioral Therapy reported significant differences in the reduction of depressive symptoms at post-treatment compared to treatment as usual, with effect sizes (d) ranging from 1.31 to 0.18.
One study (Buhrman et al., 2015) found no significant differences between cognitive behavioral therapy (CBT) and treatment as usual (TAU) at follow-up regarding the reduction of fear of anxiety symptoms.
Four studies (Migliorini et al., 2016; Ólason et al., 2018; Aragonès et al., 2019; Schlicker et al., 2020) found no differences in pain intensity at follow-up when comparing cognitive behavioral therapy (CBT) to treatment as usual (TAU).
In a systematic review of cognitive behavioral therapy-based interventions, three studies (Ólason et al., 2018; Schlicker et al., 2020; Gasslander et al., 2022) found no significant differences between treatment groups at post-treatment for the outcomes they explored.