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Comment & Response
October 2018

Psychotherapeutics for Chronic Pain Extends Beyond Cognitive Behavioral Therapy—Reply

Author Affiliations
  • 1Division of Geriatrics and Palliative Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York
  • 2Department of Human Development, Cornell University, Ithaca, New York
  • 3Department of Medicine, Eastern Virginia Medical School, Norfolk
JAMA Intern Med. 2018;178(10):1432. doi:10.1001/jamainternmed.2018.4866

In Reply Our study1 focused appropriately on cognitive behavioral therapy (CBT) approaches to pain management in older adults because the overwhelming majority of psychologically based intervention studies in the pain field have used this modality. Abbass and colleagues are correct to point out that other psychological therapies, such as short-term dynamic psychotherapy and emotion-focused methods, may have value in the management of later-life pain. However, few studies have examined the efficacy of these modalities in older adults with chronic pain, which contrasts with the growing number of investigations that have evaluated CBT-based approaches. Given that the results of our study showed only modest benefits associated with CBT-based modalities and increasing calls for the use of nonpharmacologic approaches to manage pain,2 it is important to evaluate other psychological therapies, including short-term dynamic psychotherapy and emotion-focused methods, as treatments for later-life pain.

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