Cognitive behavioral therapy for the management of multiple sclerosis–related pain: a randomized clinical trial
Gromisch, Elizabeth S.
Kerns, Robert D.
Lo, Albert C.
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Citation (published version)Elizabeth S Gromisch, Robert D Kerns, Rebecca Czlapinski, Beth Beenken, John Otis, Albert C Lo, John Beauvais. "Cognitive Behavioral Therapy for the Management of Multiple Sclerosis–Related Pain: A Randomized Clinical Trial." International Journal of MS Care, https://doi.org/10.7224/1537-2073.2018-023
BACKGROUND: Pain is a common and often debilitating symptom among persons with multiple sclerosis (PwMS). Besides interfering with daily functioning, pain in MS is associated with higher levels of depression and anxiety. While cognitive-behavioral therapy (CBT) for pain has been found to be an effective treatment in other populations, there has been a dearth of research in PwMS. METHODS: PwMS with at least moderate pain severity (N = 20) were randomly assigned to one of two groups: CBT plus standard care (CBT/SC) or MS-related education plus standard care (ED/SC), each of which met for 12 sessions. Changes in pain severity, pain interference, and depressive symptom severity from baseline to the 15 week follow-up were assessed using a 2×2 factorial design. Participants also rated their satisfaction with their treatment and accomplishment of personally meaningful behavioral goals. RESULTS: Both treatment groups rated their treatment satisfaction as very high and their behavioral goals as largely met, although only the CBT/SC group's mean goal accomplishment ratings represented significant improvement. While there were no significant differences between groups post-treatment on the three primary outcomes, there was an overall improvement over time for pain severity, pain interference, and depressive symptom severity. CONCLUSIONS: CBT or education-based programs may be helpful adjunctive treatments for PwMS experiencing pain.