{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T04:17:07Z","timestamp":1788668227808,"version":"build-2803163510"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2023,12,30]],"date-time":"2023-12-30T00:00:00Z","timestamp":1703894400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Cognitive-behavioral therapy for chronic pain (CBT-CP) is an important evidence-based non-pharmacologic treatment for chronic back and neck pain that is frequently recommended as a component of multidisciplinary treatment. However, the success of CBP-CP\u2019s implementation in clinical settings is affected by a variety of poorly understood obstacles to patient engagement with CBT-CP. Expanding upon the limited prior research conducted in heterogeneous practice settings, this study examines patterns of treatment initiation for CBT-CP at an interdisciplinary, hospital-based chronic pain practice and conducts exploratory comparisons between groups of patients who did and did not engage in CBT-CP after receiving a referral. Patients\u2019 descriptive data, including pain severity, work status, prior therapy, and behavioral health questionnaire scores at intake visit, were obtained through a retrospective chart review of electronic medical records. Data were then analyzed using inter-group comparisons and logistic regression modeling to determine factors that predicted treatment initiation for CBT-CP. On multivariate analysis, we found that patient\u2019s depression level as measured by their Patient Health Questionnaire 9 (PHQ-9) score was solely predictive of treatment initiation, as chronic pain patients with a higher level of depression were found to be more likely to attend their recommended appointments of CBT-CP. Anxiety score as measured by GAD-7, work status, pain scores, and prior therapy engagement were not independently predictive. No single \u201cprofile\u201d of patient-level factors was found to delineate patients who did and did not initiate CBT-CP, demonstrating the limitations of clinical variables as predictors of uptake.<\/jats:p>","DOI":"10.1093\/tbm\/ibad079","type":"journal-article","created":{"date-parts":[[2023,12,30]],"date-time":"2023-12-30T16:37:09Z","timestamp":1703954229000},"page":"179-186","source":"Crossref","is-referenced-by-count":6,"title":["Trends in engagement with cognitive-behavioral therapy for chronic pain conditions after referral"],"prefix":"10.1093","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8283-4532","authenticated-orcid":false,"given":"Giovanni","family":"Kozel","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Warren Alpert Medical School, Brown University , Providence, RI , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Owen P","family":"Leary","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Warren Alpert Medical School, Brown University , Providence, RI , USA"},{"name":"Norman Prince Spine Institute, Department of Neurosurgery, Rhode Island Hospital , Providence, RI , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasemin","family":"Losee","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Warren Alpert Medical School, Brown University , Providence, RI , USA"},{"name":"Norman Prince Spine Institute, Department of Neurosurgery, Rhode Island Hospital , Providence, RI , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin L","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Warren Alpert Medical School, Brown University , Providence, RI , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5753-4810","authenticated-orcid":false,"given":"Alexios G","family":"Carayannopoulos","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Warren Alpert Medical School, Brown University , Providence, RI , USA"},{"name":"Norman Prince Spine Institute, Department of Neurosurgery, Rhode Island Hospital , Providence, RI , USA"},{"name":"Department of Physical Medicine & Rehabilitation, Warren Alpert Medical School, Brown University , Providence, RI , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Morris","sequence":"additional","affiliation":[{"name":"Norman Prince Spine Institute, Department of Neurosurgery, Rhode Island Hospital , Providence, RI , USA"},{"name":"Department of Psychiatry & Human Behavior, Warren Alpert Medical School, Brown University , Providence, RI , USA"},{"name":"Private Practice , Providence, RI , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"McLaughlin","sequence":"additional","affiliation":[{"name":"Norman Prince Spine Institute, Department of Neurosurgery, Rhode Island Hospital , Providence, RI , USA"},{"name":"Department of Psychiatry & Human Behavior, Warren Alpert Medical School, Brown University , Providence, RI , USA"},{"name":"Prometheus Federal Services, Department of Health Services Research and Evaluation , Washington, DC , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,12,30]]},"reference":[{"key":"2024022320203486800_CIT0001","first-page":"153","article-title":"Cognitive-behavioral therapy for individuals with chronic pain: efficacy, innovations, and directions for research","volume-title":"Am Psychol","author":"Ehde","year":"2014"},{"key":"2024022320203486800_CIT0002","first-page":"2564","article-title":"Behavioral and cognitive\u2013behavioral treatment for chronic pain: outcome, predictors of outcome, and treatment process","volume-title":"Spine","author":"McCracken","year":"2002"},{"key":"2024022320203486800_CIT0003","first-page":"709","article-title":"Behavioral medicine approaches to pain","volume-title":"Anesthesiol Clin","author":"Okifuji","year":"2007"},{"key":"2024022320203486800_CIT0004","first-page":"742","article-title":"Barriers and facilitators of evidence-based psychotherapies for chronic pain in adults: a systematic review","volume-title":"J Pain","author":"Goldsmith","year":"2023"},{"key":"2024022320203486800_CIT0005","first-page":"1274","article-title":"Predictors of engagement in an internet-based cognitive behavioral therapy program for veterans with chronic low back pain","volume-title":"Transl Behav Med","author":"Solar","year":"2021"},{"key":"2024022320203486800_CIT0006","first-page":"49","article-title":"Predicting responses to self-management treatments for chronic pain: application of the pain stages of change model","volume-title":"Pain","author":"Kerns","year":"2000"},{"key":"2024022320203486800_CIT0007","first-page":"267","article-title":"Pain self-management: easier said than done? Factors associated with early dropout from pain self-management in a rural primary care population","volume-title":"Pain Med","author":"Hardman","year":"2019"},{"key":"2024022320203486800_CIT0008","first-page":"S76","article-title":"Predictors of participation in a nonpharmacological intervention for chronic back pain","volume-title":"Pain Med","author":"Higgins","year":"2018"},{"key":"2024022320203486800_CIT0009","first-page":"938","article-title":"Can we improve cognitive\u2013behavioral therapy for chronic back pain treatment engagement and adherence? A controlled trial of tailored versus standard therapy","volume-title":"Health Psychol","author":"Kerns","year":"2014"},{"key":"2024022320203486800_CIT0010","first-page":"722","article-title":"National dissemination of cognitive-behavioral therapy for chronic pain in veterans","volume-title":"Clin J Pain","author":"Stewart","year":"2015"},{"key":"2024022320203486800_CIT0011","first-page":"S99","article-title":"Efficacy and effectiveness of cognitive behaviour therapy for chronic pain: progress and some challenges","volume-title":"Pain","author":"Morley","year":"2011"},{"key":"2024022320203486800_CIT0012","first-page":"1","article-title":"Enhancing motivation for change in the management of chronic painful conditions: a review of recent literature","volume-title":"Curr Pain Headache Rep","author":"Ankawi","year":"2019"},{"issue":"22","key":"2024022320203486800_CIT0013","doi-asserted-by":"crossref","first-page":"2940","DOI":"10.1097\/00007632-200011150-00017","article-title":"The Oswestry Disability Index","volume":"25","author":"Fairbank","journal-title":"Spine"},{"key":"2024022320203486800_CIT0014","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1016\/j.jmpt.2008.08.006","article-title":"The Neck Disability Index: State-of-the-Art, 1991-2008","volume":"31","author":"Vernon","year":"2008","journal-title":"J Manipulative and Physiol Ther"},{"key":"2024022320203486800_CIT0015","first-page":"365","article-title":"Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis","author":"Levis","journal-title":"BMJ"},{"issue":"8","key":"2024022320203486800_CIT0016","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0182162","article-title":"Psychometric analysis of the Generalized Anxiety Disorder scale (GAD-7) in primary care using modern item response theory","volume":"12","author":"Jordan","journal-title":"PloS one"},{"key":"2024022320203486800_CIT0017","first-page":"41","article-title":"Barriers and facilitators to use of non-pharmacological treatments in chronic pain","volume-title":"BMC Fam Pract","author":"Becker","year":"2017"},{"key":"2024022320203486800_CIT0018","first-page":"542","article-title":"A national survey of patient completion of Cognitive Behavioral Therapy for Chronic Pain: the role of therapist characteristics, attempt rates, and modification","volume-title":"Prof Psychol Res Pr","author":"McGuire","year":"2021"},{"key":"2024022320203486800_CIT0019","first-page":"52","article-title":"Recent developments in group psychotherapy research","volume-title":"Am J Psychother","author":"Rosendahl","year":"2021"},{"key":"2024022320203486800_CIT0020","first-page":"2046","article-title":"Integrating interdisciplinary pain management into primary care: development and implementation of a novel clinical program","volume-title":"Pain Med","author":"Dorflinger","year":"2014"},{"key":"2024022320203486800_CIT0021","first-page":"970","article-title":"Pain care in the Department of Veterans Affairs: understanding how a cultural shift in pain care impacts provider decisions and collaboration","volume-title":"Pain Med","author":"Mattocks","year":"2020"}],"container-title":["Translational Behavioral Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/tbm\/article-pdf\/14\/3\/179\/56749165\/ibad079.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/tbm\/article-pdf\/14\/3\/179\/56749165\/ibad079.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T20:21:02Z","timestamp":1708719662000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/tbm\/article\/14\/3\/179\/7504724"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,30]]},"references-count":21,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,12,30]]},"published-print":{"date-parts":[[2024,2,23]]}},"URL":"https:\/\/doi.org\/10.1093\/tbm\/ibad079","relation":{},"ISSN":["1869-6716","1613-9860"],"issn-type":[{"value":"1869-6716","type":"print"},{"value":"1613-9860","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,3,1]]},"published":{"date-parts":[[2023,12,30]]}}}