• Miriam C Böhmer, Peter la Cour, and Tatjana Schnell.
• Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Munich, Germany.
• Pain Med. 2022 Feb 1; 23 (2): 314-325.

ObjectiveAlthough considered the first-line psychological treatment for chronic pain, cognitive behavioral therapy has recently been criticized as being too limited, insufficient, and sometimes ineffective in the treatment of patients with chronic pain. Moreover, important existential perspectives are sparsely or not at all integrated into cognitive behavioral therapy. We therefore propose to complement chronic pain treatment with a meaning-based intervention, the Sources of Meaning Card Method (SoMeCaM). This study tested its efficacy.DesignA randomized controlled trial was conducted with 42 patients with chronic pain. The trial compared an intervention group (standard care and participation in the SoMeCaM, a meaning-oriented approach) with a control group (standard care). We evaluated both groups at baseline and at 1 (t1) and 2 months (t2) after the intervention. The primary outcome assessed was pain acceptance, while depression, anxiety, pain intensity, pain medication, satisfaction with life, meaningfulness, and crisis of meaning were examined as secondary outcomes.ResultsComparisons within and between groups showed significant treatment effects at t1. Higher increases in pain acceptance and decreases in anxiety, depression, and crisis of meaning were observed in the intervention group. Improvements in pain acceptance and anxiety persisted until t2, when pain intensity was also lower. Effect sizes at t2 were medium to large.ConclusionOur preliminary work demonstrates the importance of the existential perspective in chronic pain therapy.© The Author(s) 2021. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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