title: Guided Internet-delivered cognitive behavioural therapy for chronic pain patients who have residual symptoms after rehabilitation treatment: randomized controlled trial.
abstract: BACKGROUND
  Chronic pain can be treated with cognitive behavioural therapy delivered in multidisciplinary settings. However, relapse is likely, and there is a need for cost-effective secondary interventions for persons with residual problems after rehabilitation. The aim of the present study was to investigate the effects of a guided Internet-delivered cognitive behavioural intervention for patients who had completed multidisciplinary treatment at a pain management unit.
  
  
  METHODS
  A total of 72 persons with residual pain problems were included in the study and were randomized to either treatment for 8 weeks or to a control group who were invited to participate in a moderated online discussion forum. The participants had different chronic pain conditions, and a majority were women (72%). Twenty-two percent of the participants dropped out of the study before the post-treatment assessment.
  
  
  RESULTS
  Intent-to-treat analyses demonstrated differences on the catastrophizing subscale of the Coping Strategies Questionnaire (Cohen's d = 0.70), in favour of the treatment group but a small within-group effect. Differences were also found on other measures of pain-related distress, anxiety and depressive symptoms. A 6-month follow-up exhibited maintenance of improvements.
  
  
  CONCLUSIONS
  We conclude that Internet-delivered treatment can be partly effective for persons with residual problems after completed pain rehabilitation.
authors.affiliation: Department of Psychology, Uppsala University, Uppsala, Sweden. monica.buhrman@psyk.uu.se
authors.forename: M
authors.initials: M
authors.lastname: Buhrman
authors.forename: A
authors.initials: A
authors.lastname: Fredriksson
authors.forename: G
authors.initials: G
authors.lastname: Edström
authors.forename: D
authors.initials: D
authors.lastname: Shafiei
authors.forename: C
authors.initials: C
authors.lastname: Tärnqvist
authors.forename: B
authors.initials: B
authors.lastname: Ljótsson
authors.forename: T
authors.initials: T
authors.lastname: Hursti
authors.forename: T
authors.initials: T
authors.lastname: Gordh
authors.forename: G
authors.initials: G
authors.lastname: Andersson
mesh_terms: D000328:Adult; D001007:Anxiety / Q000628:therapy; D001008:Anxiety Disorders / Q000534:rehabilitation / Q000628:therapy; D059350:Chronic Pain / Q000534:rehabilitation / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D013813:Therapy, Computer-Assisted / Q000379:methods; D016896:Treatment Outcome