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The following is a summary of “Treatment Expectations and Pain-Related Outcomes in Clinical Trials of Digital Cognitive Behavioral Therapy for Youth with Chronic Pain,” published in the January 2025 issue of Pain by Li et al.
Researchers conducted a retrospective study to explore how treatment expectations (TE) influenced outcomes in youth with chronic pain, specifically examining TE’s role in detecting treatment efficacy, predicting pain-related outcomes, and moderating treatment effects in digital cognitive-behavioral therapy (CBT) trials for chronic primary and sickle cell pain.
They analyzed 2 randomized controlled trials: the WebMAP2 Trial (n=273 youth with chronic primary pain) and the iCC-SCD Trial (n=111 youth with sickle cell pain). The study investigated how pretreatment TE influenced treatment outcomes, including detecting efficacy, predicting pain-related outcomes over time, and moderating the effects of digital CBT vs education control.
The results showed that adjusting for pretreatment TE did not enhance the detection of treatment efficacy. In the WebMAP2 Trial (n=273), higher pretreatment TE was linked to greater reductions in anxiety but lower CBT efficacy in improving depressive and anxiety symptoms compared to the education control. In the iCC-SCD Trial (n=111), higher TE were associated with improved mobility and better CBT efficacy for mobility. Overall, higher pretreatment TE predicted better functioning over time, with varying effects on treatment efficacy for youth with primary pain and sickle cell pain.
Investigators concluded the higher pretreatment TE were linked to improved functioning, their impact on treatment efficacy varied across different types of chronic pain in youth, necessitating further research to explore how TE influences treatment responses in population.
Source: jpain.org/article/S1526-5900(25)00017-3/abstract
