The efficacy, safety, and satisfaction of telehealth-delivered hypnotic cognitive therapy for chronic pain in spinal cord injury: A pilot study with historical controls.

Abstract

Context/objective: In-person hypnotic cognitive therapy (HYP-CT) is a promising treatment for chronic spinal cord injury-related pain. We describe the effects of HYP-CT delivered via Zoom (Z-HYP-CT) and compare the effects to historical controls who received hypnosis, cognitive therapy, or HYP-CT in-person.

Design: Open pilot trial of HYP-CT versus historical controls.

Setting: Telehealth study that recruited people with chronic SCI.

Participants: Adults with moderate to severe chronic SCI-related pain.

Interventions: Four weekly sessions of HYP-CT delivered via Zoom.

Outcome measures: The primary outcome was average pain intensity on a 0-10 numerical rating scale measured at end of treatment (4 weeks) and 12 weeks. Secondary outcomes included pain interference, depression, sleep, pain catastrophizing, and pain self-efficacy.

Results: 23 individuals with SCI-related pain participated in the open trial and were compared to 21 historical controls. Average age was 54 years, 70% were male, and the majority were White. The participants were 11.6-13.1 years post-SCI and average pain intensity was 4.8-5.4/10. After Z-HYP-CT mixed-effects linear regressions showed that pain intensity was significantly less at 4 weeks (-1.28, P < .0001) and 12 weeks (-1.50, P < .0001) relative to baseline. Pain interference, depression, and pain catastrophizing also decreased significantly at both time points. There were no significant differences between the effects of Z-HYP-CT versus historical controls on any outcome variable.

Conclusion: HYP-CT delivered via telehealth was associated with reduced pain intensity and other benefits that were comparable to the effect achieved by in-person historical controls. The effects of Z-HYP-CT should be evaluated using a randomized controlled design.