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Clin J Pain. 2010 Sep;26(7):593-601. doi: 10.1097/AJP.0b013e3181e37611.

Attrition in cognitive-behavioral treatment of chronic back pain.

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  • 1Philipps-University of Marburg, Section for Clinical Psychology and Psychotherapy, Gutenbergstr., Marburg, Germany.



The aim of this study was to identify pretreatment factors associated with dropout from outpatient individualized cognitive-behavioral treatment for chronic back pain. Despite the importance of this issue, little is known about determinants of dropout from cognitive-behavioral treatment for chronic pain. The presented study is a subanalysis of a larger study on cognitive-behavioral treatment for chronic back pain.


The study included 128 patients, who began a 25 session treatment. Three pretreatment domains (demographic variables, psychologic and pain-related symptom severity, and attitude toward treatment) and satisfaction with treatment within the first 3 sessions were considered as potential predictors of attrition.


Twenty-three patients (18%) were classified as dropouts. Low psychologic distress, low medication intake, and low treatment satisfaction were significantly associated with dropout. Other demographic variables, pain-related variables, attributions, and attitude toward treatment were not associated with treatment attrition. The associations were only valid for early dropouts.


It is concluded that cognitive-behavioral treatment of chronic pain should be adapted for less psychologically distressed patients to avoid treatment dropout.

[PubMed - indexed for MEDLINE]
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