Pilot study of a basic individualized cognitive behavioral therapy program for chronic pain in Japan

Area of Science:

• Psychiatry
• Rehabilitation Medicine
• Clinical Psychology

Background:

• Chronic pain presents a significant global health challenge, with cognitive behavioral therapy (CBT) being a recommended intervention.
• Development and implementation of CBT programs for chronic pain have lagged in Asian countries, including Japan.
• This study addresses the need for culturally adapted and feasible CBT interventions for chronic pain in Japan.

Purpose of the Study:

• To develop a basic individualized CBT for chronic pain (CBT-CP) tailored for the Japanese context.
• To assess the feasibility and preliminary efficacy of this CBT-CP program.
• To lay the groundwork for future large-scale randomized controlled trials in Japan.

Main Methods:

• An open-label, before-after pilot study conducted in five Japanese tertiary care hospitals.
• Fifteen eligible outpatients with chronic pain (duration ≥ 3 months) participated in an eight-session CBT-CP program.
• Outcomes including quality of life (EQ5D-5L), pain severity, disability, catastrophizing, self-efficacy, and depressive symptoms were assessed at baseline, post-treatment, and 3-month follow-up.

Main Results:

• Medium effect sizes were observed for the primary outcome (EQ5D-5L score) from baseline to post-treatment and 3-month follow-up.
• Medium to large effect sizes were found for improvements in mental and role/social quality of life, disability, catastrophizing, self-efficacy, and depressive symptoms.
• The program demonstrated an acceptably low dropout rate (14%) with no severe adverse events.

Conclusions:

• The developed CBT-CP program shows promise as a feasible and potentially effective treatment for chronic pain in Japan.
• The findings strongly support the need for a larger randomized controlled trial to further validate CBT-CP's efficacy.
• This study represents a crucial first step in adapting and implementing evidence-based psychological interventions for chronic pain in Japan.