Efficacy of cognitive behavioural therapy for patients with chronic pain in Singapore

The use of Cognitive Behavioural Therapy (CBT) techniques to manage chronic pain is relatively new and understudied in Singapore. Using data collected from group CBT programmes carried out at the Singapore General Hospital (SGH), we seek to explore the efficacy of the programme on pain intensity, self-efficacy, attitudes towards pain, and emotional factors. We also examined the efficacy of the longer 6- to 9-day group programme versus an abridged 2-day version called the Pacing Programme covering only some aspects of the full group programme.

Twenty-nine adult patients underwent the intensive 6- to 9-day group programme while another 10 patients underwent the abridged 2-day group programme. The more extensive group programme encompassed teaching patients cognitive-behavioural methods of coping with pain, such as setting goals, pacing, cognitive restructuring by thinking in more positively, distraction, problem solving, sleep hygiene, communication skills, ability to cope with changes, and relaxation techniques. The abridged programme focused mainly on developing pacing skills. Patients were required to fill out questionnaires at the beginning of the programme, end of the programme, and at the 1-month and 6-month follow-ups to monitor progress.

Preliminary results for the intensive 6- to 9-day group programme indicate decrease in pain and pain distress levels, improvements in management of pain, increased confidence to carry out activities despite pain, increased positive self-statements and decreased negative self-statements, decrease in fear of harm and pathophysiological beliefs, as well as decreases in the levels of depression, anxiety, and stress. The abridged 2-day programme yielded little change in pain and pain distress levels, but a slight increase in confidence to carry out activities despite pain.

These preliminary results provide some evidence supporting the efficacy of CBT techniques in chronic pain management and contribute to the growing body of evidence for the effectiveness of psychological and behavioural techniques in the management of chronic pain.