title: Cognitive behavioral therapy, self-efficacy, and depression in persons with chronic pain.
abstract: Chronic pain is a complex and often disabling condition compounded by depression and poor self-efficacy. The purpose of this evidence-based project was to explore the relationship of cognitive behavioral therapy (CBT)-focused groups with self-efficacy and depression in persons with chronic pain at an intensive interdisciplinary 3-week pain rehabilitation center (PRC). The project sample consisted of 138 persons admitted to a PRC and scoring ≥27 on the Center for Epidemiological Study Depression Scale (CES-D) and then completing the Pain Self-Efficacy Questionnaire (PSEQ). After completing the PRC program, including CBT-focused groups, discharge CES-D and PSEQ scores were analyzed. A comparison group of CES-D scores from 134 persons admitted to the PRC from a 9-month time period preceding the addition of the CBT-focused groups was also examined. There was a significant increase in self-efficacy after participation in the intensive pain rehabilitation program including CBT-focused groups. Patient groups both before and after introduction of CBT-focused groups showed the same rate of improvement on the depression scores, suggesting that persons who participated in CBT-focused groups improved equally compared with persons who did not participate in these groups. Ninety-three percent of the participants expressed satisfaction with the CBT groups. This evidence-based practice is well supported in the literature and can be implemented with knowledgeable staff and engaged stakeholders.
authors.affiliation: Department of Psychiatry and Psychology, Pain Rehabilitation Center, Mayo Clinic, Rochester, Minnesota. Electronic address: nash.virginia@mayo.edu.
authors.forename: Virginia R
authors.initials: VR
authors.lastname: Nash
authors.affiliation: Winona State University, 859 30th Avenue South East, Rochester, Minnesota.
authors.forename: Julie
authors.initials: J
authors.lastname: Ponto
authors.affiliation: Department of Psychiatry and Psychology, Pain Rehabilitation Center, Mayo Clinic, Rochester, Minnesota.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Townsend
authors.affiliation: Winona State University, 859 30th Avenue South East, Rochester, Minnesota.
authors.forename: Pamela
authors.initials: P
authors.lastname: Nelson
authors.affiliation: Psychology Department, Minnesota State University, Mankato, Minnesota.
authors.forename: Miranda N
authors.initials: MN
authors.lastname: Bretz
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000451:nursing / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000451:nursing / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods* / Q000451:nursing; D011582:Psychological Theory; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D016896:Treatment Outcome