Pain medicine, pain management, fibromyalgia, Arizona pain, back pain, pain treatment, discography, back pain, neck pain, migraine., headaches, sciatica, muscle pain, Arizona pain center, acupuncture, arthritis, Arizona, Scottsdale,
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Many different disorders are treated successfully by CBT, including mood disorders, anxiety disorders, and chronic pain.  
The specific CBT methods used varies with each type of disorder so it is important for the CBT therapist to be familiar with
the patient and goals of therapy.


Some of the commonly used tools used in CBT are:  

Journal writing - Patients are asked to keep a daily journal of the day’s events and associated feeling, emotions, and
actions.  They are asked to record the most stressful parts of their day and their associated pain scores.

Conditioning - The CBT therapist uses positive or negative reinforcement to encourage helpful behaviors.

Systematic desensitization - Frequently used in patients with anxiety disorders.  Patients imagine an uncomfortable or
fearful situation and the CBT therapist helps the patient to relax through it. Gradually the patient becomes desensitized to
the fear producing stimuli and instead associates relaxation with the stimuli.

Cognitive rehearsal - The patient imagines a problematic circumstance and the therapist helps them through the process.  
Fears and negative emotions are identified and the circumstance is thought about with a healthy frame of mind.


CBT in chronic pain:

Cognitive-behavioral therapy is frequently used as a technique to cope with pain that is chronic for patients with illnesses
such as rheumatoid arthritis, fibromyalgia, back pain, and cancer.  CBT focuses on factors that exacerbate or prolong
chronic pain, and should be considered as part of a multidisciplinary treatment paradigm (Molton 2007).   Patients who
suffer from chronic pain commonly develop co-existing depression.  Many recent studies focus on a patients’ state of mind
and the ability to control their pain level.  Many of these studies show an improved quality of life and overall reduction in
average pain scores.


CBT in Depression:

Cognitive behavioral therapy has shown to be as useful as antidepressant medication for individuals with depression.  In a
large research study there were substantially higher results of response and remission from depression when a form of
cognitive behavior therapy was used in addition to anti-depressant drugs than when either method was used alone (Keller
2000).  With CBT, patients suffering from depression learn how to rearrange negative thought patterns in order to
influence their daily life activities.  CBT for depression involves changing two main contributing factors to depression:  
negative emotions and social withdraw (tendency to stop enjoyable activities).  

Patients suffering from depression typically have a downward spiral.  The onset of depression comes on slowly with
negative feelings present.  Then, the person tends to stop doing pleasurable activities.  Finally depression sufferers can
become unable to function in their daily life.  

Changing negative thought associations with depression along with helping patients to participate in gratifying activities
are the goals of CBT.  When these goals are accomplished, they have proven to be extremely successful in treating
depression.


CBT in Anxiety:

CBT is also a useful treatment for anxiety disorders, including phobias, panic attacks, and obsessive-compulsive
behaviors.  In CBT, patients learn to be aware of and change maladaptive thinking patterns.  CBT is not just “thinking
happy thoughts and all of your problems go away”; it is a way to gain conscious control over unwanted thoughts or
feelings which are typically associated with anxiety.

Patients who have certain phobias benefit from a CBT method that uses exposure to what they fear and gradual
improvement of their reactions to the object or situation.  Those who suffer from panic attacks are made aware of their
bodies’ negative responses and actions during these attacks.  During CBT they develop methods to counteract the
reason for their panic attacks.  Additionally, people who have obsessive-compulsive tendencies are encouraged to
expose themselves to what they fear and identify what they truly fear.


Other uses for CBT:

Cognitive behavioral therapy has been used in numerous disorders including mental disorders, personality disorders,
phobias, eating disorders, substance abuse, post-traumatic stress disorder (PTSD), and attention-deficit/hyperactivity
disorder (ADHD Patients with sleep disorders may also find cognitive-behavioral therapy a useful treatment for insomnia.  
CBT for insomnia can improve sleep quality, reduce hypnotic drug use, and improve quality of life in patients with chronic
sleep difficulties (Morgan 2004).


Journal Outcome:

Many patients who undergo cognitive-behavioral therapy successfully learn how to replace their negative or unwanted
thoughts and behaviors with healthier more positive ones.  Often times these changes can improve quality of life and
decrease pain for chronic sufferers.  CBT is especially useful in conjunction with other therapies and modalities to relieve
chronic pain.


Journal Articles:

Keller, M. et al. A Comparison of Nefazodone, the Cognitive Behavioral-Analysis System of Psychotherapy, and Their
Combination for the Treatment of Chronic Depression. New England Journal of Medicine Volume 342:1462-1470 May 18,
2000

Psychological treatment for insomnia in the regulation of long-term hypnotic drug Morgan K, Dixon S, Mathers N,
Thompson J, Tomeny M. Health Technol Assess. 2004 Feb;8(8):iii-iv, 1- PMID: 14960254

Current psychological approaches to the management of chronic pain Molton IR, Graham C, Stoelb BL, Jensen MP. Curr
Opin Anaesthesiol. 2007 Oct;20(5):485
PMID: 17873602

www.NACBT.org

www.wikipedia.org
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Pain medicine, pain management, fibromyalgia, Arizona pain, back pain, pain treatment, discography, back pain, neck pain, migraine., headaches, sciatica, muscle pain, Arizona pain center, acupuncture, arthritis, Arizona, Scottsdale,
Cognitive Behavioral Therapy (CBT)
by Nicole Berardoni M.D, Paul Lynch M.D, and Tory McJunkin M.D


Cognitive Behavioral Therapy is a common psychosocial therapy
used in the treatment of many different chronic pain states.  CBT
theorizes that a maladaptive thought process can cause negative
behaviors and emotions.  In multiple studies, negative emotions
have been shown to increase average pain scores.  The goal of
CBT is to make you aware of negative thoughts and emotions so
that you can consciously change them.  Healthy positive thoughts
and emotions replace the negative ones, causing a powerful
impact on your life and decreasing your pain.
Cognitive behavioral therapy, group therapy, family therapy, pain, pain management, pain, back pain, neck pain, biofeedback, therapy,
At Arizona Pain Specialists you can schedule therapy
sessions alone, with a loved one or even with a group of
people with similar pain conditions - it's your choice.
Book I  -  Pain Syndromes

Chapter 1     Low Back Pain
Chapter 2     Neck Pain
Chapter 3     Cancer Pain
Chapter 4     Headaches
Chapter 5     Spinal Stenosis
Chapter 6     Sciatica
Chapter 7     Arthritis
Chapter 8     Fibromyalgia
Chapter 9     Motor Vehicle Injuries
Chapter 10   Complex Regional Pain
Syndrome
Chapter 11   Vertebral Body
Fractures
Chapter 12   Hip and Leg Pain
Chapter 13   Diabetic Peripheral
Neuropathy

Book II  -  Interventional Procedures

Chapter 14   Epidural Steroid
Injection
Chapter 15   Facet Injections/Medial
Branch Blocks
Chapter 16   Radiofrequency Ablation
Chapter 17   Spinal Cord Stimulator
Implants
Chapter 18   IntraDiscal
Electrothermal Therapy (IDET)
Chapter 19   
Vertebroplasty/Kyphoplasty   
Chapter 20   Discography
Chapter 21   Percutaneous
Discectomy
Chapter 22   Occipital Nerve Block
Chapter 23   Sympathetic Block
Chapter 24   Stellate Ganglion Block
Chapter 25   Intrathecal Pump
Implants
Chapter 26   Caudal Steroid Injection
Chapter 27   Adhesiolysis
Chapter 28   Cervical Steroid
Injection
Chapter 29   Sacroiliac Joint
Injections
Chapter 30   Celiac Plexus Block
Chapter 31   Head and Neck
Procedures
Chapter 32   Joint Injections
Chapter 33   Continuous Catheter
Nerve Blocks
Chapter 34   Peripheral Nerve
Stimulation/Field Stimulation
Chapter 35   Disc Denervation

Book III   Other Treatments

Chapter 36   Medication Management
Chapter 37   Acupuncture
Chapter 38   Prolotherapy
Chapter 39   Botox
Chapter 40   Massage
Chapter 41   Alternative and
Complementary Medicines
Chapter 42   Exercise and Nutrition
Counseling
Chapter 43   Prayer
Chapter 44   Cognitive Behavioral
Therapy
Chapter 45   Group Therapy
Chapter 46   Biofeedback
Chapter 47   Chiropractic
Manipulations
Chapter 48   Vitamin Supplements
Chapter 49   Customized
Pharmaceutical Formulations
Chapter 50   Hormone Therapy

Frequently Asked Questions