CBT for Chronic Pain

What Is CBT for Pain?

Cognitive behavioral therapy (CBT) for chronic pain helps you identify and change unhelpful thoughts and behaviors related to pain. It's the most studied psychological treatment for chronic pain and is recommended in treatment guidelines worldwide.¹

The CBT Model²

Thoughts, feelings, behaviors, and body sensations are connected
Changing one affects the others
Unhelpful patterns can be identified and changed
You can learn skills to manage pain better

What CBT Targets

Unhelpful Thoughts

Catastrophizing ("This will never get better")
All-or-nothing thinking
Focusing only on pain
Negative predictions

Unhelpful Behaviors

Avoidance of activities
Overdoing on good days
Reduced activity overall
Social withdrawal

CBT Techniques³

Cognitive Techniques

Identifying negative thoughts
Evaluating evidence for thoughts
Developing balanced thinking
Problem-solving

Behavioral Techniques

Activity pacing
Graded exposure to feared activities
Pleasant activity scheduling
Relaxation training

What to Expect

Typically 8-12 sessions
Structured sessions with specific goals
Homework between sessions
Active participation required
Skills you keep for life

Evidence³

Reduces pain intensity
Decreases disability
Improves mood
Reduces catastrophizing
Effects can be long-lasting

Finding CBT

Pain psychologists
Clinical psychologists with pain training
Pain rehabilitation programs
Online CBT programs

It's Not About "Thinking Away" Pain

CBT doesn't claim pain is "all in your head." It acknowledges pain is real while teaching practical skills to reduce suffering and improve function.

References

Williams AC, Eccleston C, Morley S. Psychological therapies for the management of chronic pain (excluding headache) in adults. Cochrane Database Syst Rev. 2012;11:CD007407.
Ehde DM, Dillworth TM, Turner JA. Cognitive-behavioral therapy for individuals with chronic pain. Am Psychol. 2014;69(2):153-166.
Knoerl R, Lavoie Smith EM, Weisberg J. Chronic pain and cognitive behavioral therapy: an integrative review. West J Nurs Res. 2016;38(5):596-628.