June 24, 2026 · JAMA · DOI: 10.1001/jama.2026.7861

Self-Directed vs Clinician-Delivered Cognitive Behavioral Therapy for Chronic Pain: A Randomized Clinical Trial

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The authors aimed to compare the effectiveness of self-directed cognitive behavioral therapy for chronic pain (CBT-CP) with asynchronous feedback to clinician-delivered CBT-CP in patients with chronic musculoskeletal pain. The study found that self-directed CBT-CP significantly reduced pain interference and improved secondary outcomes at 4 months, with benefits sustained at 12 months, suggesting it may be a more accessible alternative to traditional clinician-delivered therapy.

Alicia A Heapy, Mary A Driscoll, Sara Edmond, Kathryn M LaChappelle, Eugenia Buta, Allison Halat, Sarah L Krein, Steve Martino, Lynn DeBar, Jennifer L Murphy, Kristin Mattocks, Brian C Coleman, Christopher Ruser, John D Piette, R Ross MacLean, Brett Ankawi, Dana Cervone, Todd H Wagner, Diana M Higgins

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