Cognitive Behavioral Therapy is helping Veterans with chronic pain


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Living with chronic pain can be challenging. Chronic pain is that which persists for more than three months. Because it is a complex condition that influences behaviors, thoughts, and mood, it can feel like you just need the right medication or treatment to take the pain away. Chronic pain is a complicated condition and approaching it from one angle typically is not enough. It is best addressed with a team of healthcare providers and from a variety of different perspectives.

One treatment option that Veterans are reporting helps to reduce the negative effects of chronic pain is Cognitive Behavioral Therapy for Chronic Pain. Also known as CBT-CP, this treatment changes the way our brains process pain and it equips individuals with a self-directed, problem-solving approach to manage and decrease the challenges associated with chronic pain. While chronic pain is complex, it is possible to change one’s overall pain experience. Instead of feeling overwhelmed by pain, CBT-CP can help you feel empowered and in control.

The goals of CBT-CP are to help Veterans:

  • Increase participation in meaningful activities
  • Manage pain flare-ups more effectively
  • Decrease pain intensity
  • Reduce worries about increased pain or injury
  • Improve overall quality of life

Treatment consists of an assessment session and 10 appointments to acquire helpful pain management skills. VA encourages a follow-up session to review implementation and discuss any areas of difficulty. To maximize benefits, attending sessions regularly is recommended.

How to access CBT-CP

CBT-CP is available to Veterans throughout the VA health care system. Speak to a member of your healthcare team (including your primary care provider, your pain management provider, a member of the Primary Care Mental Health Integration team, your therapist, or your psychiatrist) to learn more about how to access care today. Let CBT-CP help you take back your life from pain and begin doing more of what matters to you.

Watch one Veteran’s inspiring story of how CBT-CP improved his life:


Jennifer L Murphy, PhD is Pain Psychology Program Manager at James A Haley Veterans Hospital in Tampa. FL and an Associate Professor in the University of Florida’s Morsani College of Medicine, Department of Neurology. She has been Master Trainer and subject matter expert for VA’s CBT-CP since its inception in 2012 and is lead author of the CBT-CP Therapist Manual. Dr Murphy serves as the behavioral pain medicine lead to the VHA pain management program office.

Author

VAntagePoint Contributor

— VAntage Point Contributors provide insight and perspective on a wide range of Veterans issues. If you’d like to contribute a story to VAntage Point, learn how you can submit a guest blog at http://www.blogs.va.gov/VAntage/how-to-submit-a-guest-post/

Comments

  1. Rekar Buchi    

    … CBT or being mindful is a great mindset. Most can’t get there due to pain. Still the underlying issue

  2. Virginia N. Garcia    

    I agree with all the comments. I too have spent my life suffering with chronic pain. The VA used to send my pain meds monthly years ago. Then I was treated like an addict for wanting help with my pain these days the Drs act like I’m crazy. The MRI shows a herniated disc with the sciatic nerve pinched. Come to find out that pinched nerve was on older Mary’s the untreated nerve is damaged to the extent that it has caused inability to shit, sexual dysfunction, & worst of all I piss myself. Some days I have to use a cane and can barely bath myself because I’m swelled up and in so much pain. One maybe two pain killers a day to have a break from the constant pain is not an addiction. The VA system is sad… im 36 years old & this all stems from injury from when i was in the service.

  3. Hap DeSimone    

    Have had sinus pain IN Viet Nam, from being soaked by some spray while sleeping (yes, Outdoors). Sinus infection within two weeks of DEROS. Sinus pain leads to daily migraines, helped by broken back pain from PTSD-caused daily 2-hours of motorcycle road racing.
    Non-narcotic meds won’t “reset” a real migraine. You can have a headache for over five WEEKS without a reset. Try that! I have, more than once. Sinus Dr. claimed “There’s nothing wrong with you…and besides, we didn’t do it!” His entire exam had been to shine a flashlight into my nose. Should he be waiting tables somewhere, or pulling down big bucks as a non-functional physician? He tried to redefine my Real pain as the hogwash in the room.
    I implore the VA to rid themselves of the few power-hungry liars and con artists in their midst. I applaud trying new approaches, but when they fall flat for SO MANY of us, man up and do no further harm by mandating them.
    I have great respect and thanks for each and every one of my cherished VA caregivers. The VA in California has indeed turned itself around here. I haven’t met an Under 100% Performer since that last guy. Please critically peer review the hokum, can’t doers and the popular ScienceDuJour and try to emulate the sterling service that is being provided by those terrific providers who work under you. They SERVE. Do you?

  4. Jeff Radke    

    Gralise and physical therapy helps me. I can generally function well enough that no one notices. I went on a trip for a few days and forgot my medicine. Paid for it for a few days until the gralise got back in my system. With the gralise and PT every day, I manage well.

  5. James Utphall    

    The VA is back to giving you a bullet to bite on as in the Civil War.

  6. James Utphall    

    This is another attempt by the VA to NOT deal with pain effectively. They have used prayer, mindfulness etc because they fo not believe in using medicines to control pain. I was recently hospitalized In a VA Hosp. and had 2 Drs hold my feet down instead of treating me with pain killers prior to the procedure.

  7. Tom Fields    

    Nice try but no… Apparently meant for those with a little pain, not chronic. This is hilarious!

  8. C. Millikin    

    The key here is “opioid addiction” which is a false narrative of a small percentage of those who are unable to “kick” any substance abuse problem (alcohol, tobacco, etc.). Since I have used the VA Health for only 4 years now, I have been able to use this life saving method of treatment for 20 years plus until I started using the VA. Using trumpted up and bogus testing to strip me of needed medication you would think that withdrawal would be an issue, nope, I have been on and off this repeatedly and have no addiction issues. Just has made my life now 90% less able to live a healthy life than a year ago. Suggestions of CBT through Wellness Center have been assessed 2 years ago with 0% help with any of their programs and their high handed harrassment and demeaning treatment of the patient. They make the inquisition look like a just another day at the car wash, sad. But not to be outdone, I cannot get a 6 year old refill of Nitro filled by the doctor because I also might become “addicted” to using this necessary but seldom used protection. Have always carried a vial since my heart attack; just in case. The VA just needs to get back to the reality that “Every Veteran is Unique and Different” than their brothers and sisters, and have Individual needs that far outweighs the generic approach they use for the entire veteran community. This is the same approach they have now implemented for Covaid-19; protect first the employees and paid staff in their centers and place the “veterans” under secondary importance with their “screening” at the door process. As for me, the VA health system is not and has not even cared about this veteran for over 6 months now and they wonder why the have such a high drop out rate from their system!?!

  9. Jerry Wooley    

    I have been living with chronic pain issues since 2004. In this time, I have been through many pain management classes, physical therapy and been prescribed everything under the sun for pain. After many years of this I had a combination that was working very well for me. I have never asked for an increase in these medications but in 2018 the VA cut my medication in half. I don’t have any quality of life anymore. I have begged my primary doctor to get me some help. I have pain so severe that it keeps me in bed at least 2 days a week now. No matter how much I ask for help, it falls on deaf ears. Physical therapy made my pain worse because the therapist hurt me. Why don’t you people take this bullshit and try selling it to people who don’t know that you are full of shit. You people have one objective. This is to take away pain medications from the people who need them. If you would actually do something to help my pain, you could have every pill I take for it. I don’t enjoy having to take them. You people put me on them because you didn’t want to treat my problems. You wanted the easiest and quickest way to get us out the door. If this is the best you can come up with for the veterans who suffer from chronic pain, please quit your job and give someone else a chance to do some real good for us.

  10. Gianna Hibbard    

    I am a 53 year old female with CSS, central sensitivity syndrome, which was caused by complex post traumatic disorder. For anyone unfamiliar, my symptoms are so painful, I can no longer work, most days I can’t leave my home due to the tremendous amount of pain I’m in. A social life, what’s that? In my former, pain free life, I was a counsellor. I not only studied and practiced CBT but was treated by a plethora of counsellors therapists, etc with this exact modality and I have one thing to say in regards to CBT and chronic pain. IT DOES NOT WORK!!! I’ve been living with this for the past 11 years and it was only 2 years ago that I was accurately diagnosed. I waited over 5 years to get into a specialized treatment program for chronic pain, first appointment was 6 days ago and you know what the pain specialists (Dr.’s) told me…I have done more by myself in the years waiting to get into this program than they offer their patients. After reading the chart my Dr. sent to them, they asked if I even wanted to proceed. I’ve seen every specialist in the medical field and no one can help me. And do you know why? Firstly, they don’t have a clue. Secondly, they’re using outdated modalities. Third and most importantly, TRY JUST TRY to find someone in the medical field that actually thinks outside of the box and hasn’t been bought and sold by the pharmaceutical industry. It’s all about money folks, not healing. There is phenomenal research and thank-God, trials in psychedelic psychotherapy that is proving, without a shadow of doubt, that this treatment works; for addictions, mental health, PTSD, CPTSD, chronic pain….the list goes on. There’s a wonderful book called, The Emotion Code by Dr. Bradley Nelson that I highly recommend, as well, for anyone living with CPTSD, I also recommend The Crappy Childhood Fairy on YouTube.The bottom line is CBT absolutely DOES NOT WORK for chronic pain. Further to that, whomever wrote and published this article has not done their proper research nor thinks very critically. Having a platform such as this requires you to do your due dilligence and report on the facts instead of giving false and misleading hope. Shame on you.

  11. Davina George    

    Another PhD, like Andrew Kolodny, who hasn’t experienced pain herself and, most probably, has no patients of her own. An administrator pushing mind over matter instead of giving patients relief that is available behind the pharmacy counter. There is NO opioid epidemic. There is a heroin and illegal fentanyl epidemic. Chronic pain patients have become expendable and unworthy of sympathy. We can only hope the coming plague gives these academics something else to focus on.

  12. Daniel L Kibbee    

    Maybe it works… CBT or being mindful is a great mindset. Most can’t get there due to pain. Still the underlying issue … We want you off opioid pain meds and we don’t have anything to offer you. You can do it. Good luck to all.

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