Differential efficacy between cognitive-behavioral therapy and mindfulness-based therapies for chronic pain: Systematic review

Abstract

Background/Objective: To assess the differential efficacy between mindfulness-based interventions and cognitive-behavioral Therapy (CBT) on chronic pain across medical conditions involving pain. Method: ProQuest, Science Direct, Google Scholar, Pubmed, and Embase databases were searched to identify randomized clinical trials. Measurements of mindfulness, pain, mood, and further miscellaneous measurements were included. Results: 18 studies met the inclusion criteria (fibromyalgia, n = 5; low back pain, n = 5; headache/migraine, n = 4; non-specific chronic pain, n = 4). In fibromyalgia, mindfulness based stress reduction (MBSR) was superior to the usual care and Fibroqol, in impact and symptoms. In low back pain, MBSR was superior to the usual care, but not to CBT, in physical functionality and pain intensity. There were no studies on differential efficacy between mindfulness and CBT for headache and non-specific chronic pain, but Mindfulness interventions were superior to the usual care in these syndromes. Conclusions: Mindfulness interventions are superior to usual cares in all diagnoses, but it is not possible to conclude their superiority over CBT. Comparisons between mindfulness interventions are scarce, with MBSR being the most studied. In central sensitization syndromes, variables associated with pain tend to improve with treatment. More research is needed to differentiate diagnosis and intervention.

Psychological Therapy in Chronic Pain: Differential Efficacy between Mindfulness-Based Cognitive Therapy and Cognitive Behavioral Therapy

“…The present study was conducted to compare two therapies which had obtained good results for chronic pain according to previous literature. The differences found in the pre-treatment phase between both groups were mostly equalized by the post-treatment stage, coinciding with previous literature that described similar efficacies between the two treatments [11,12]. The authors of the present study hypothesized that the mutual improvements observed in both treatments were perhaps due to content that was common to both therapies.…”

“…In parallel, treatments for chronic pain based on Mindfulness have also been developed, such as Mindfulness-Based Stress Reduction (MBSR) [7] and Mindfulness-Based Cognitive Therapy for Chronic Pain (MBCT-CP) [8]. A recent transdiagnostic study [9] and several meta-analyses [10][11][12] have indicated that although MBCT-CT is superior to CBT, in general, it has a similar efficacy in variables related to pain intensity and interference, as well as psychological variables, in all diagnostic groups (fibromyalgia, low back pain, unspecified chronic pain and headache) [10][11][12]. However, studies on the subject are scarce and highly heterogeneous concerning the variables studied, the types of samples, and the measurement instruments used.…”

Impact of mindfulness and self-compassion on anxiety and depression: The mediating role of resilience

“…These represent an innovation within cognitive-behavior therapy, as they do not aim at symptom improvement as their only objective and underline themes such as mindfulness, compassion, cognitive fusion, acceptance, and spirituality ( Jahoda et al, 2017 , Pérez-Aranda et al, 2019 ). Mindfulness-based interventions, Compassion-Focused Therapy, and Acceptance and Commitment Therapy are some examples of ‘third-wave’ psychotherapies that have proven efficacy for treating different conditions, mainly depressive and anxiety disorders ( O’Connor et al, 2018 , Pardos-Gascón et al, 2021 , Wilson et al, 2019 ).…”

Effects of Mindfulness-Based Cognitive Therapy for Chronic Pain: A Multicenter Study

“…These treatments are based on the acceptance of pain, the decrease in avoidance, the de-identification with mental processes, and the reduction of the hyper-alert state towards the feelings of pain [ 14 ]. The meta-analyses generally agree on their effectiveness [ 15 , 16 , 17 , 18 , 19 , 20 ] and some authors believe these treatments may even last longer than CBT in the medium term [ 21 ].…”