Department of Rehabilitation Medicine, University of Washington.
Department of Psychiatry and Behavioral Sciences, University of Washington.
Am Psychol. 2014 Feb-Mar;69(2):153-66. doi: 10.1037/a0035747.
Over the past three decades, cognitive-behavioral therapy (CBT) has become a first-line psychosocial treatment for individuals with chronic pain. Evidence for efficacy in improving pain and pain-related problems across a wide spectrum of chronic pain syndromes has come from multiple randomized controlled trials. CBT has been tailored to, and found beneficial for, special populations with chronic pain, including children and older adults. Innovations in CBT delivery formats (e.g., Web-based, telephone-delivered) and treatments based on CBT principles that are delivered by health professionals other than psychologists show promise for chronic pain problems. This article reviews (a) the evidence base for CBT as applied to chronic pain, (b) recent innovations in target populations and delivery methods that expand the application of CBT to underserved populations, (c) current limitations and knowledge gaps, and (d) promising directions for improving CBT efficacy and access for people living with chronic pain.
在过去的三十年中，认知行为疗法（CBT）已成为治疗慢性疼痛患者的一线心理社会治疗方法。多项随机对照试验的证据表明，CBT 在改善各种慢性疼痛综合征的疼痛和相关问题方面具有疗效。CBT 已经针对慢性疼痛的特殊人群（包括儿童和老年人）进行了调整，并发现对他们有益。CBT 交付格式的创新（例如，基于网络的、通过电话提供的）以及由心理学家以外的健康专业人员提供的基于 CBT 原则的治疗方法，为慢性疼痛问题的治疗带来了希望。本文综述了（a）CBT 在慢性疼痛中的应用的证据基础，（b）针对目标人群和交付方法的最新创新，这些创新将 CBT 应用扩展到服务不足的人群，（c）当前的局限性和知识空白，以及（d）提高慢性疼痛患者的 CBT 疗效和可及性的有前景的方向。
