Feasibility Outcomes from a Pilot Randomized Controlled Trial of Brief Cognitive Behavioral Therapy for Chronic Pain Among Military Veterans

Brief Cognitive Behavioral Therapy for Chronic Pain is an abbreviated treatment designed for use in integrated primary care. This pilot study aimed to assess the feasibility of treatment delivery and study procedures in preparation for conducting a future effectiveness trial. Thirty patients with chronic musculoskeletal pain were recruited from a Veterans Health Administration medical center. Following baseline assessment, patients were randomized to either Brief Cognitive Behavioral Therapy for Chronic Pain plus primary care treatment as usual or primary care treatment as usual alone. Recruitment was completed on time averaging 2.5 patients enrolled per month. Completion of study assessments was high (i.e., 13% missing at 6-week assessment; 10% missing at 12-week assessment). Patients assigned to Brief Cognitive Behavioral Therapy for Chronic Pain averaged 5.6 of 6 possible sessions and reported strong therapeutic relationships with their therapists. Descriptive analyses indicated that clinically significant improvement in pain-related activity interference, pain intensity, and depression symptoms was demonstrated in the treatment group only. This treatment is feasible to deliver in the context of a clinical trial and shows potential as a time-limited approach to impart pain self-management skills among primary care patients. A powered effectiveness trial is warranted. This trial was registered at ClinicalTrials.gov (NCT03490981) on 10/1/2018.