The article of the month for December: new ways to assess the effectiveness of psychological therapies in chronic pain
The Research and Communication Committee of the Department of Clinical and Health Psychology has selected “An ecological momentary assessment study examining the efficacy of third-wave cognitive behavioral therapies on different indices of pain-related outcomes” as the article of the month for December.
This research examines the effectiveness of third-wave cognitive behavioral therapies compared with treatment as usual in individuals with chronic low back pain and depressive symptoms, using ecological momentary assessment (EMA). This approach makes it possible to record patients’ daily experiences in their natural environments, overcoming some of the limitations of traditional retrospective assessments, which are often based on limited time points and may be affected by recall bias.
The study is based on data collected in a randomized controlled trial involving adults with chronic low back pain and depressive symptoms. Over a ten-week period, participants completed two brief assessments per day via a mobile application, reporting on pain intensity, pain interference in daily life, sleep disturbances, and depressed mood. Unlike most clinical trials, which tend to focus on average symptom levels, this study compared six different indicators derived from daily data: mean level, variability, maximum level, minimum level, frequency of high values, and frequency of low values. The aim was to determine which indicators are most sensitive to detecting changes associated with psychological treatment.
The results show that third-wave cognitive behavioral therapies were generally associated with better outcomes than treatment as usual, particularly for variables such as pain interference, sleep disturbances, and depressed mood. Notably, the frequency of low values (that is, the number of times patients reported low symptom levels) emerged as one of the most sensitive indicators for capturing treatment effects, whereas mean level showed a more limited capacity to detect change.
According to the authors, these findings highlight the importance of using multiple indicators and repeated measurements over time to better understand how and when clinical change occurs. This approach allows for a more accurate representation of the real dynamics of the therapeutic process and provides a more precise view of the progression of patients with chronic pain.
The study highlights the value of intensive assessments in everyday life as a promising tool for both research and clinical practice, as they facilitate more precise monitoring of outcomes and support the development of psychological interventions better tailored to the needs of individuals with chronic pain and emotional comorbidity.