The effectiveness of exposure treatments for chronic pain

Traditional Cognitive Behavioural Therapy for chronic pain, including activity pacing, cognitive restructuring and relaxation or biofeedback is effective, but there is room for improvement especially concerning the reduction of pain related disability. There has been a call for more focused, tailored chronic pain treatments specifically addressing subgroups of pain patients in hope of achieving better results. To date, however, there is no empirical evidence as to whether pain interventions specifically tailored for particular subgroups or specific problems  are in fact more effective than traditional, broad-spectrum cognitive behavioral treatments.

Sixteen years ago, a new treatment, graded in vivo exposure for chronic low back pain (“Exposure”) was developed, focusing on a subgroup of individuals with chronic back pain who avoid activity due to fear of harm. In a series of studies using different designs and methods (RCTs, multicenter trials, singe case designs, systematic reviews, metaanlyses) we investigate the effectiveness of Exposure Treatment for chronic low back pain. We are also interested in underlying treatment process, more and less effective treatment components, different setting and the optimal treatment dosage.

• Winfried Rief, University of Marburg
• Johan Vlaeyen, Leuven & Maastricht Universities
• Jeroen De Jong, Maastricht University Hospital
• Steven Linton, Örebro University
• Ulrike Bingel, Essen University Hospital