A Review of Outcome Studies on Cognitive-Behavioral Therapy for Reducing Fear-Avoidance Beliefs Among Individuals With Chronic Pain

In the last two decades, emerging research has focused on advancing the explanations of how chronic pain becomes disabling. The fear-avoidance model of pain suggests that fear of reinjury in chronic pain patients leads to avoidance of certain movements that subsequently results in more pain and disability from that lack of movement. The literature supporting this model of pain and disability has allowed specific therapeutic interventions to be developed aimed at reducing pain-related fears in an attempt to reduce the physical symptoms and disability of chronic pain. Studies using cognitive-behavioral interventions to reduce fear-avoidance beliefs are reviewed and the treatments are evaluated based on the studies’ effectiveness. The author concludes that graded exposure in vivo appears to be the most effective treatment for chronic pain in individuals with increased fear and avoidance.