title: Randomized controlled trial on the effectiveness of cognitive behavior group therapy in chronic back pain patients.
abstract: BACKGROUND
  It is empirically well documented that psychotherapy is vital in the treatment of chronic back pain.
  
  
  OBJECTIVE
  To test in this randomized controlled clinical trial whether cognitive behavior group therapy is effective in respect to pain tolerance and disability apart from the effects on somatization in general and additional to the effects of a multimodal inpatient orthopedic rehabilitation programme.
  
  
  METHODS
  Fifty-three patients were randomly assigned to an intervention group, receiving six sessions of "cognitive behavior group therapy for back pain" (CBT-BP), and 50 to a control group who got unspecific occupational therapy sessions instead. Patients were suffering from chronic back pain for at least six months. All patients were treated for 21 days in an orthopedic inpatient rehabilitation unit with a multimodal orthopedic treatment, including active physical therapy, patient education or motivation to exercise.
  
  
  RESULTS
  In both groups there is a significant improvement over time in the Symptom Checklist (SCL-90), the Rating of Health Locus of Control Attributions, the Fear Avoidance Beliefs Questionnaire (FABQS) and a Visual Analogue Pain Scale (VAS-pain). There are significant interactions between treatment group and VAS-pain and the FABQS, showing a superior improvement in the intervention group, while no significant superiority is found for the SCL.
  
  
  CONCLUSIONS
  The experience of pain can be altered directly and not only through improvement of depression or general somatoform complaints. The study replicates other research and increases the evidence base for this mode of treatment. The treatment effect can be called specific as it is found additional to a multimodal inpatient care programme.
authors.affiliation: Research Group Psychosomatic Rehabilitation, Charité University Medicine, Berlin, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Linden
authors.affiliation: Department of Psychosomatic and Orthopedic Rehabilitation, Rehabilitation Center of the German Federal Pension Agency, Frankenhausen, Germany.
authors.forename: Sieghard
authors.initials: S
authors.lastname: Scherbe
authors.affiliation: Department of Psychosomatic and Orthopedic Rehabilitation, Rehabilitation Center of the German Federal Pension Agency, Frankenhausen, Germany.
authors.forename: Burkhard
authors.initials: B
authors.lastname: Cicholas
mesh_terms: D000328:Adult; D001416:Back Pain / Q000523:psychology* / Q000534:rehabilitation / Q000628:therapy*; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy; D017288:Pain Threshold; D010353:Patient Education as Topic; D026741:Physical Therapy Modalities; D011615:Psychotherapy, Group / Q000379:methods*; D016896:Treatment Outcome
keywords: Cognitive behavior therapy; fear avoidance beliefs; locus of control; low back pain; pain; rehabilitation