Mechanisms of Mindfulness Meditation, Cognitive Therapy, and Mindfulness-based Cognitive Therapy for Chronic Low Back Pain
The Clinical Journal of Pain October 1, 2020 Melissa A. Day, L. Charles Ward, Beverly E. Thorn et al.
In a pilot randomized controlled trial, cognitive therapy, mindfulness meditation, and mindfulness-based cognitive therapy for chronic low back pain all produced large changes in pain control beliefs, mindful observing, and pain catastrophizing. Changes in pain control beliefs and pain catastrophizing were significantly associated with reduced pain interference but not pain intensity across all three treatments. Therapeutic alliance was significantly associated with pain intensity improvement and with changes in the therapy-specific mechanisms. Mindful observing, group cohesion, and at-home practice were not significantly associated with outcome changes. The authors propose that change in perceived pain control and pain catastrophizing may be shared "meta-mechanisms" across treatments, and that strong working alliance may be a critical therapeutic process.