Now that we’ve learned about CBT for Chronic Pain treatment, let’s see what it is like to go through treatment!

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Click on this video to see what treatment looks like up close.

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Let’s view the Treatment Process Up Close

What Will Treatment Be Like?

In Cognitive Behavioral Therapy for Chronic Pain (CBT-CP), a trained therapist will work with you to help you to take control of your pain and its impact on your life. You will learn proven skills for changing thoughts and behaviors that affect pain and how you experience pain.

At the start of treatment, you’ll create treatment goals that are specific to you. Then, you and your therapist will work together as a team to help you achieve your goals. Throughout treatment, your therapist will ask you for feedback to make sure things are headed in the right direction. Treatment lasts about 12 sessions. CBT-CP can be provided alone or together with other pain management approaches, like physical therapy, massage, and medication.

Treatment Up Close: Tom’s Journey

Click on this video to see how CBT-CP treatment turned out for Tom.

Treatment Success: Julie's Story

Read about what treatment looked like for Julie by clicking on the pages of this e-book. Julie’s story is based on the experiences of Veterans with chronic pain who have decided to give CBT-CP a try. See if you can spot the treatment steps in Julie’s story!

Introduction

Julie is a 28-year-old Veteran who started having neck pain about 5 years ago. She was in a car accident during active duty, though the pain was not bad at that time. Over the last few years, it’s slowly gotten worse and affects her day-today life. She’s no longer as active as she used to be and her sleep has been getting worse. The pain has also affected her mood—she’s often on edge, which has hurt her relationship with her boyfriend. Julie’s doctor recommended an effective treatment (CBT for Chronic Pain) that he said could help improve her responses to pain and decrease the negative impact it has on her life. Although skeptical, Julie was eager to regain control of her life, so she agreed to see a therapist to learn more.

Sessions 1-2 (Interview, Assessment, & Orientation to Treatment)

In looking at her life with her therapist, Julie saw that pain was affecting the choices that she made every day. Instead of doing what she wanted, she was letting pain call the shots and suffering in many ways. Her therapist explained that there were many things that she could do differently to give her back more control over her pain and her life. Julie learned that pain is more than just physical, but is affected by our thoughts, emotions, and behaviors, which “turn up the volume” on chronic pain. Julie liked the idea of learning how to take control of the dial.

Sessions 3-4 (Goals, Movement and Pacing)

Julie and her therapist discussed how avoiding activities to reduce her pain was understandable but actually was working against her. Julie learned that avoiding activities and movement was weakening her muscles and lowering her energy level. Julie and her therapist developed a plan for Julie to be more physically active, in a safe way. As part of this plan, Julie would not do too much that would create a pain flare, but would do enough every day to stay engaged and productive. Julie noticed that by pacing her life, she was able to do more and have less pain.

Sessions 5-7 (Relaxation & Pleasant Activities)

Now that Julie was having less physical ups and downs, her therapist introduced ways for her to better control her body’s physical responses to pain. Julie learned effective relaxation strategies to turn down her body’s harm alarm. This helped to calm her nervous system and reduce her muscle tension. As a result, Julie’s neck pain and headaches felt better!

Next, Julie and her therapist focused on finding more activities that she enjoyed to improve her mood. Since Julie loved animals, she decided to volunteer at the local shelter. She helped all of the dogs and cats as much as they helped her! And she even became good friends with a few of the other shelter volunteers.

Sessions 8-9 (Re-Thinking Pain)

Despite her progress, some days Julie still had thoughts like, “My life is never going to be good with this pain.” During the next couple of weeks, Julie’s therapist helped her catch these unhelpful pain-related thoughts and see the impact they had on her mood (e.g., feeling down) and behaviors (e.g., staying at home alone). Julie used tools her therapist gave her to change these thoughts and take away their negative power. Yes, the pain would be there, but she would decide the effect it would have on her day.

Sessions 10-11 (Sleep & Discharge)

Julie was now feeling like she had more control over her life, but she was still struggling with sleep. Most nights she tossed and turned awake and frustrated in bed, sleeping only about 4-5 hours per night. Julie came to see that being sleepy during the day made her more sensitive to pain. Working with her therapist, Julie learned proven sleep skills that helped her sleep longer and better.

After 11 weeks in treatment, Julie had made great progress. Although she still had pain, it no longer controlled her life. Julie was more active, less irritable, sleeping better, and feeling less overwhelmed. Together with her therapist, Julie made a plan for how to use all of her new skills to minimize and manage setbacks in the future.

Session 12 (Booster Session)

Five weeks after treatment ended, Julie checked back in with her therapist. She reported that she was doing much better than when she started treatment. She was exercising again, using relaxation as a way to calm her nervous system, and was still volunteering at the animal shelter. Sometimes old fears like, “My life will never be good,” crept into her mind. Her therapist reminded her of other ways to look at pain. Julie also reported having some pain flares when she “pushed through” to get her chores done. She and her therapist revisited how pacing activities allowed her to do more in the long run, and they made a plan for how to pace more often. Julie felt like she had come a long way and like she was in charge now, instead of the pain.

Now that we’ve learned about CBT for Chronic Pain, let’s explore what goals you may have for treatment.

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