• Robert D Kerns, John W Burns, Marc Shulman, Mark P Jensen, Warren R Nielson, Rebecca Czlapinski, Mary I Dallas, David Chatkoff, John Sellinger, Alicia Heapy, and Patricia Rosenberger.
• Pain Research, Informatics, Multimorbidities and Education (PRIME) Center/Research Service, VA Connecticut Healthcare System.
• Health Psychol. 2014 Sep 1;33(9):938-47.

ObjectiveThis study evaluated whether tailored cognitive-behavioral therapy (TCBT) that incorporated preferences for learning specific cognitive and/or behavioral skills and used motivational enhancement strategies would improve treatment engagement and participation compared with standard CBT (SCBT). We hypothesized that participants receiving TCBT would show a lower dropout rate, attend more sessions, and report more frequent intersession pain coping skill practice than those receiving SCBT. We also hypothesized that indices of engagement and adherence would correlate with pre- to posttreatment changes in outcome factors.MethodOne hundred twenty-eight of 161 consenting persons with chronic back pain who completed baseline measures were allocated to either TCBT or SCBT using a modified randomization procedure. Participants completed daily ratings of pain coping skill practice and goal accomplishment during treatment, as well as measures of pain severity, disability, and other key outcomes at the end of treatment.ResultsNo significant differences between treatment groups were noted on measures of treatment engagement or adherence. However, these factors were significantly related to some pre- to posttreatment improvements in outcomes, regardless of treatment condition.ConclusionsParticipants in this study evidenced a high degree of participation and adherence, but treatment tailored to take into account participant preferences, and that employed motivational enhancement strategies, failed to increase treatment participation over and above SCBT for chronic back pain. Evidence that participation and adherence were associated with positive outcomes supports continued clinical and research efforts focusing on these therapeutic processes.(PsycINFO Database Record (c) 2014 APA, all rights reserved).

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