Clinical Edge

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Positive Psychology Interventions for Pain Management

Clin J Pain; 2017 Nov; Peters, Smeets, et al

An internet-based positive and cognitive-behavioral self-help intervention for the management of chronic pain led to increases in happiness and decreases in depression, but not physical impairments, a recent study found. The randomized controlled trial of an 8-week internet-delivered positive psychology intervention was carried out with 3 conditions: 1) an internet-delivered positive psychology program, 2) an internet-delivered cognitive-behavioral program, and 3) waitlist control. 276 patients were randomized to 1 of the 3 conditions with post-treatment data obtained from 206 patients. Primary outcomes were happiness, depression, and physical impairments at post-treatment and at 6-month follow-up. Researchers found:

  • Both treatments led to significant increases in happiness and decreases in depression and were maintained until 6-month follow-up.
  • Physical impairments did not significantly decrease compared with waitlist.
  • Patients with a higher education level profited slightly more from the positive psychology intervention than from the cognitive-behavioral program.

Peters ML, Smeets E, Feijge M, et al. Happy despite pain: A randomized controlled trial of an 8-week internet-delivered positive psychology intervention for enhancing well-being in patients with chronic pain. Clin J Pain. 2017;33(11):962-975. doi:10.1097/AJP.0000000000000494.


Chronic pain is a common and difficult problem that is not sufficiently handled by current pain medications. For this reason, psychological interventions, physical therapy, acupuncture, and other complementary approaches are being explored to see how they may benefit patients suffering from chronic pain. Previous studies have shown that cognitive behavioral therapy (CBT), as well as internet-delivered CBT, can have positive effects on patients with chronic pain.1 This study looked at internet delivery of a different type of psychotherapy, positive psychology, that teaches people exercises aimed at improving positive behaviors, emotions, and cognitions to help with chronic pain. The exercises emphasize self-compassion, positive affect, and optimism. In other studies, positive psychology has been shown to help patients better cope with chronic pain.2 This study showed an increase in happiness and decrease in depression, both worthwhile outcomes. —Neil Skolnik, MD

  1. Ehde DM, Dillworth TM, Turner JA. Cognitive-behavioral therapy for individuals with chronic pain: Efficacy, innovations, and directions for research. Am Psychol. 2014;69: 153–166.  doi:10.1037/a0035747.
  2. Eccleston C, Fisher E, Craig L, et al. Psychological therapies (internet-delivered) for the management of chronic pain in adults. Cochrane Database Syst Rev. 2014;26:CD010152.

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