• Robin M Masheb, Robert D Kerns, Christine Lozano, Mary Jane Minkin, and Susan Richman.
• Yale University School of Medicine, P.O. Box 208098, New Haven, CT 06520-8098, USA. robin.masheb@yale.edu
• Pain. 2009 Jan 1;141(1-2):31-40.

AbstractMany treatments used for women with vulvodynia are based solely upon expert opinion. This randomized trial aimed to test the relative efficacy of cognitive-behavioral therapy (CBT) and supportive psychotherapy (SPT) in women with vulvodynia. Of the 50 participants, 42 (84%) completed 10-week treatments and 47 (94%) completed one-year follow-up assessments. Mixed effects modeling was used to make use of all available data. Participants had statistically significant decreases in pain severity (p's<0.001) with 42% of the overall sample achieving clinical improvement. CBT, relative to SPT, resulted in significantly greater improvement in pain severity during physician examination (p=0.014), and greater improvement in sexual function (p=0.034), from pre- to post-treatment. Treatment effects were well maintained at one-year follow-up in both groups. Participants in the CBT condition reported significantly greater treatment improvement, satisfaction and credibility than participants in the SPT condition (p's<0.05). Findings from the present study suggest that psychosocial treatments for vulvodynia are effective. CBT, a directed treatment approach that involves learning and practice of specific pain-relevant coping and self-management skills, yielded better outcomes and greater patient satisfaction than a less directive approach.

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