The major goal of cognitive behavioral therapy (CBT) is to replace maladaptive patient coping skills, cognitions, emotions, and behaviors with more adaptive ones. It psychosocial therapeutic method is that helps patients to change their irrational thoughts which cause maladaptive behaviors. Similarly, Beck proposed that people have 2 levels of thoughts; first one is automatic thoughts which are generally evaluative, and second one is maladaptive thoughts which CBT try to reframe.
American psychologists Albert Bandura and Donald Meichenbaum describe that pain behavior in terms of the learning theories of operant and classical conditioning. For example, one person goes to the doctor’s office where he experienced pain in the past, he feel same things in every visit. For operant conditioning, sick person often receive care and attention from his family. Each of these reinforces behavior of patient.
Patient with chronic low back pain (CLBP) may experience anxiety. To threat this anxiety, the therapist can use a variety of techniques such as biofeedback and relaxation training. The goal of these techniques is to reduce anxiety because of pain. Some persons with CLBP who are in depression have negative cognitions about the present and the future. Pain will never go away in their opinion and others don’t understand their condition. In this situation, therapist must change these negative cognitions and help patients to reframe their present and future actively.
The ideal CLBP patient for CBT is the one who with average intelligence and who can be motivated to learn coping strategies to manage his pain. The other important thing is that willing to do homeworks and exercises. Patients with major cognitive deficit would not likely be good candidate for CBT.
Finally, results of many published studies in the scientific literature showed that CBT and behavioral treatments for chronic pain reduces patients’ pain, distress and pain behavior; so, CBT is effective way in the all treatment of CLBP.
Gatchel, R., Rollings, K.H., (2008). Evidence-Informed Management of Chronic Low Back Pain with Cognitive Behavioral Therapy, The Spine Journal 8, 40–44.
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