Tailoring cognitive-behavioral treatment for cancer pain.

Journal Article (Clinical Trial;Journal Article;Multicenter Study)

Though it has been shown that cancer patients report cognitive, behavioral, and physiologic responses to pain, little attention has been paid to the benefits of cognitive-behavioral therapy (CBT) protocols tailored to patient characteristics. To determine whether a profile-tailored CBT treatment program was more effective than either standard CBT or usual care in changing outcomes for patients with cancer-related pain, 131 patients receiving treatment at four sites were randomly assigned to standard CBT, profile-tailored CBT, or usual care. CBT patients attended five 50-minute treatment sessions. When compared to standard CBT patients, profile-tailored CBT patients experienced substantial improvement from baseline to immediately post-intervention in worst pain, least pain, less interference of pain with sleep, and less confusion. From baseline to one-month post-intervention, profile-tailored patients saw greater improvement in less interference of pain with activities, walking, relationships, and sleep; less composite pain interference; and less mobility and confusion symptom distress. Standard CBT and usual care patients experienced little change. Compared to profile-tailored CBT patients, standard CBT patients showed greater improvement at six-months post-intervention with less average pain, less pain now, better bowel patterns, lower summary symptom distress, better mental quality of life, and greater improvement in Karnofsky performance status; usual care patients showed little change. More research is needed to refine the matching of cognitive-behavioral treatments to psychophysiologic patient profiles, and to determine a treatment period that does not burden those patients too fatigued to participate in a five-week program. Delivery of CBT by home visits, phone, or Internet needs to be explored further.

Full Text

Duke Authors

Cited Authors

  • Dalton, JA; Keefe, FJ; Carlson, J; Youngblood, R

Published Date

  • March 2004

Published In

Volume / Issue

  • 5 / 1

Start / End Page

  • 3 - 18

PubMed ID

  • 14999649

International Standard Serial Number (ISSN)

  • 1524-9042

Digital Object Identifier (DOI)

  • 10.1016/s1524-9042(03)00027-4


  • eng

Conference Location

  • United States