Group Cognitive Behavioral Interventions for Low Back Pain among Primary Care Patients

According to a recent study published in PAIN, group cognitive behavioral intervention (CBI) is effective in reducing low back pain (LBI) and disability over a 12-month period. The results indicate that the effects of CBI are maintained for up to an average of 34 months.

Participants (701, ages 18 and older), recruited from primary care settings in England who were experiencing at least moderately troublesome lower back pain for at least six weeks, participated in a randomized control trial. They received either 10-15 minute sessions of best-practice advice from a trained health professional or a cognitive behavioral intervention (one-hour individual assessment and six 90-minutes sessions of group therapy.)  At 20-50 month follow ups, returning participants (395 participants) noted less disability and pain than the original sample. The effects of CBI are reported to reduce lower back pain and sustain reductions over a length of time ranging from an average of 34 months up to 50 months.  Improvements do occur when using best-practice advice, however they are slower and often less substantial, leading to minimal impact on disability. The sustainability of CBI may be attributed to the acquisition of skills needed to challenge negative thoughts and beliefs and become more physically active.

Lamb, S. E., Mistry, D., Lall, R., Hansen, Z., Evans, D., Withers, E. J., & Underwood, M. R. (February 01, 2012). Group cognitive behavioural interventions for low back pain in primary care: Extended follow-up of the Back Skills Training Trial (ISRCTN54717854). Pain, 153, 2, 494-501.

November 14 – 16, 2011, Cognitive Behavior Therapy Workshop Level ll: Personality Disorders and Challenging Problems

Dr. Judith Beck demonstrates a how to conceptualize a challenging case.

Last week at Beck Institute we held our Level 2 CBT Workshop on Personality Disorders and Challenging Problems. Psychologists, psychiatrists, social workers, counselors, and other health and mental health professionals traveled from all over the world, including Canada, India, Peru and nine U.S. states, to receive training in Cognitive Behavior Therapy.

Participants received professional training from Judith S. Beck, Ph.D., Leslie Sokol, Ph.D., and Norman Cotterell, Ph.D.  Lectures and role-plays emphasized the need for the therapeutic alliance in order to establish rapport.  Dr. Sokol

Level 2 participants watched multiple live patient sessions while at Beck Institute

discussed patient collaboration and made it clear that a therapist should always be there for the client.  The use of mood checks was discussed and participants were told that a patient will often start with negative emotions and it is critical to probe them for positives to counter the negatives.

CBT Worksheet Demonstration

Dr. Judith Beck (above) demonstrated how to use a variety of CBT worksheets for therapists to use, such as the Cognitive Conceptualization Diagram. Dr. Beck encouraged workshop participants to roleplay (left and below) with one another to practice cognitive therapy techniques for personality disorders and challenging problems. Click here to learn more about our CBT workshops and how to register for our next Level 2 in February 2012. See below for more workshop highlights:


CBT Relieves Chronic Back Pain

NewStudy-Graphic-72x72_edited-3In a recent study, published in the February 26, 2010 issue of The Lancet, 701 patients with chronic back pain were treated with either standard treatment alone or standard treatment supplemented with Cognitive Behavior Therapy (CBT). The intervention helped participants identify cycles of negative thinking that lead to their inactivity and thus perpetuated their pain. Specifically, CBT played an important role in helping patients to resume activities they had been avoiding based on distorted thoughts and beliefs about the pain they experienced (e.g., “I should avoid all activities that cause me pain.”). At one year follow-up, the participants who received CBT showed greater improvement on disability tests than their non-CBT counterparts.

Because CBT is cost-effective and does not expose patients to additional risks like so many other treatment options, the researchers hope that this study will raise awareness, among health insurance providers and physicians, of the important role CBT may play in clinical practice.



Lamb, S.E., Hansen, Z., Lall, R., Castelnuovo, E., Withers, E.J., Nichols, V., et al. (2010). Group cognitive behavioural treatment for low-back pain in primary care: A randomised controlled trial and cost-effectiveness analysis. The Lancet, 375(9718), 916-923.

Cognitive Behavior Therapy for Back Pain

A lot of people know that Cognitive Behavior Therapy (CBT) is effective for anxiety, depression, and many other psychiatric problems… But we’re guessing that not as many people know that CBT also reduces physical pain associated with many medical disorders and problems.

Check out this NY Times article — it talks about a review of 22 different studies, which show that psychological treatments reduce lower back pain. The two treatments that were most effective were Cognitive Behavior Therapy (CBT) and Self-Regulatory Therapy. For a full list of disorders that CBT can treat, including MANY medical problems, see Cognitive Behavior Therapy Outcome Studies (sources are at bottom of disorder list).