Critical Analysis of Research 1: CBT and Chronic Pain

This report presents a critical analysis of a research study titled "Cognitive Behavioural Therapy for Depression and Anxiety in an Interdisciplinary Rehabilitation Program for Chronic Pain: A Randomized Controlled Trial with a 3-Year Follow-up." The analysis examines the study's methodology, including the use of a randomized controlled trial design and systematic random sampling, and its focus on evaluating the effects of Cognitive Behavioral Therapy (CBT) in conjunction with an interdisciplinary pain management program. The report discusses the study's objectives, which include assessing the impact of CBT on depression and anxiety among patients with chronic musculoskeletal pain, as well as its ethical considerations and findings. The research utilized the Critical Appraisal Skills Programme tool to evaluate the paper. The analysis also delves into the study's strengths, weaknesses, and implications, focusing on the long-term outcomes of the treatment and the significance of addressing comorbid conditions like depression and anxiety in chronic pain management. The report also covers the statistical analysis and the instruments used to measure pain, fear, and depression. The study's design, which involved a 3-year follow-up, provided valuable insights into the sustained benefits of CBT within an interdisciplinary setting.

Critical Analysis of
Research
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Contents
INTRODUCTION...........................................................................................................................3
MAIN BODY..................................................................................................................................3
Cognitive Behavioural Therapy for Depression and Anxiety in an Interdisciplinary
Rehabilitation Program for Chronic Pain: A Randomized Controlled Trial with a 3-Year
Follow-up.....................................................................................................................................3
CONCLUSION................................................................................................................................8
REFERENCES................................................................................................................................9
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INTRODUCTION
Critical analysis is defined as an approach to research which investigates the link between
language and power through examining the way everyday texts develop and reinforce hierarchy.
The main purpose of writing a critique is to analyse evaluate the work done by somebody else to
enhance the understanding of reader about the paper. It is a subjective writing as it expresses the
opinions of writer or evaluation of a text. The selected paper to critically analyse in this project is
“Cognitive Behavioural Therapy for Depression and Anxiety in an Interdisciplinary
Rehabilitation Program for Chronic Pain: A Randomized Controlled Trial with a 3-Year Follow-
up”. This project helps in demonstrating an understanding of different research methodologies
and philosophies covered throughout the paper and provide in-depth discussion and justification
of methodologies and methods used. In order to provide critical review of the paper, Critical
Appraisal Skills Programme tool is used.
MAIN BODY
Cognitive Behavioural Therapy for Depression and Anxiety in an Interdisciplinary Rehabilitation
Program for Chronic Pain: A Randomized Controlled Trial with a 3-Year Follow-up
The selected study is based on evaluating the effects of Cognitive Behavioural Therapy
provided in relation to interdisciplinary pain management program which three years follow up.
In the research different methods and studies of researchers has been utilised and it was
undertaken under the consideration of chronic pain. 115 patients suffering from chronic
musculoskeletal pain were observed and their conditions were analysed, these patients were seen
engaged in Interdisciplinary pain management program. Amongst these patients, 80 patients in
the criteria of cognitive behavioural therapy treatment analysed that whether they shall be getting
cognitive behavioural therapy treatment of anxiety and depressions or not along with the pain
management program. The remaining 35 individuals constituted second comparison groups in
the study and follow-up data were gathered one and three years post treatment with around 19%
of individuals dropping out after 1 year and 34 percent after 3 years. In context of this particular
research study, the researchers were considering three research papers and out of those two
papers were determined that helped evaluating effects of cognitive behavioural treatment with
the emphasis over depression and anxiety relating to standard pain rehabilitation.
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Under this study, the advantages that could be derived from intensive and interdisciplinary
pain rehabilitation programs, that are also incorporating cognitive behavioural therapy treatment
having its focus over pain management as well, are developed. However, few investigations have
evaluated long-term outcomes of either cognitive behavioural therapy or interdisciplinary pain
treatment. It is a randomised controlled trial study and in the study design, every fifth patient
referred to the clinic was randomised to participate in study. For selecting the sample in relation
to this study, systematic random sampling method is used where the participants were selected
randomly one out of every five over 4 years of course.
The results that were gathered from this research were seen in consistence with the past
findings and researches. Main objective of this study is the evaluation of effects of cognitive
behavioural therapy in relation to interdisciplinary pain management program for the three year
consideration. The motives were also in the direction that study must be going in the systematic
manner. The study was thought important as depression is frequent comorbid condition among
people with chronic pain. Apart from this, it is also related to high level of disability and pain
intensity in people with chronic pain. From the reviews, it has been found that anxiety and
depression are the risk forces for poor results in chronic pain - especially pain at multiple
locations is related to maximised risk for developing depression and anxiety. The cognitive
behavioural therapy is effective in treating variety of disorders involving chronic pain, anxiety
and depression. It is the common psychological treatment for chronic pain in patients. However,
the cognitive behavioural therapy treatment emphasizing on declining depression and anxiety has
rarely been evaluated in individuals with depression and comorbid pain. Thus, performing this
study was significant for researches as it helped in effectively evaluating effects of cognitive
behavioural therapy administered in relation to interdisciplinary pain management program with
3-year follow-up.
On the other hand, the research design chosen for the study was randomised control trial. It
was performed in chronic pain clinic and annually around 160 patients are treated in clinic.
Systematic random sampling method was utilised in the study to select the participants. It is the
type of probability sampling method where the participants are selected from large population as
per the random initial point but with periodic, fixed interval. In this, the sampling intervals were
calculated by researcher through dividing the overall population size through desired size of
sample. It is a symmetrical process where the investigator selects samples after particularly
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defined intervals. The main benefits of using a systematic random sampling method in this study
is that this method easy to use and understand and also administer researcher and statisticians
with an extent of control as well as sense of process. Perhaps big strength of this approach is its
low risk factor. The prime potential disadvantage of system carries differently low probability of
data contamination. However, there are some disadvantages also using systematic random
sampling procedure in the study. In this, the population required to exhibit natural extent of
randomness along the selected metric. If the chosen population has standardized pattern type, the
risk of accidentally selecting common cases is more apparent. The aim of the research study was
appropriately addressed by the research design selected in the study.
Data collected in the research is in strong consistence with the objective of research, it had
been kept in mind that relevance of data should not be undermined and meaningful results shall
be derived. The screening and outcome measures involves measures that used commonly in the
research of chronic pain which assisted in supporting the validity and reliability of study. 0 to 10
numeric rating scale was utilised by researcher in order to assess the intensity of current pain.
Apart from this, Fear Avoidance Beliefs Questionnaire were made in use to evaluate fear
avoidance beliefs. Two sub-scales are consisted in the questionnaire - fear avoidance beliefs for
physical activities and fear avoidance beliefs for work. The depression was measured by utilising
Back depression inventory 2nd edition that ask respondents to depict severity of 21 symptoms
during past two weeks. Apart from this, for statistical analysis of data, SPSS version 19.0
software was utilised in the groups were compared on clinical characteristics and
sociodemographic basis.
The study had considered ethical issues like taking informed consent from the participants.
In relation to this particular study, also consent of the people who participated in the research
was taken, before final results were published. In addition to this, the approval of Institutional
Review Board was also obtained from Icelandic National Bioethics Committee. Moreover, there
is a clear statement of findings provided in the paper according to which administering cognitive
behavioural therapy for anxiety and depression, this will improve long term benefits of treatment
as an integral part of interdisciplinary pain management and rehabilitation program. There can be
significant and severe economic and clinical implications if these findings get replicated in
additional studies.
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This literature review has been conducted on the chronic behavioural therapy for depression
and anxiety within an indiscipline rehabilitation program for chronic patient. It has been
evaluated that cognitive-behavioural therapy is mainly defined as effective in order to treat
anxiety and depression within patient with chronic pain. In order to conduct this research
evaluation investigator, undertake effect of qualitative methodology, in which researcher
effectively interpret experience of research participants. Furthermore, it has been evaluated that
this study was mainly design in order to effectively determine CBT treatment for anxiety and
depression within individual. Viewpoint of all the engage participants is being analysed by
researcher those who have suffered from depression and anxiety symptoms from long term. This
research analysis is being effectively conducted with effective measures which is further
supported with reliable and validate information and data. Furthermore, it has been underlined
that the entire patient was effectively screened for randomization using their scores on the Beck
Inventories assessing anxiety and depressive symptoms. In addition to this, it has been identified
that qualitative research is the right methodology in order to address their viewpoint. In this
research effective determination of viewpoint and aspects of those patients who have suffered
from the disease is being duly undertaken. This enhances effectiveness of research as it allows a
investigator to undertake use of accurate data and information through which research is
completed in effective manner.
The recruitment strategy is effectively appropriate to the aim of the research in which
effective explanation of the manner in which participant has been selected is given. According to
the researcher screening and randomisation process effectively help in ensuring equal number of
participants in each group. It has been underline that into ANOVA measures was used in order to
evaluate the significant changes in variable outcomes. In addition to this all the participants in all
three groups actually received the standard rehabilitation plan management treatment that was
offered at the time of study. Along with this according to the evaluation of this research it has
been identified that total number of 136 patients with different chronic pain problems were
identified for study participation. In this it has been evaluated that almost 50% patient have issue
from chronic low back pain. While on the other hand 25% patients had post injury pain.
According to the analysis it has been identified that patient that has been selected in this research
was most appropriate in order to provide access to the type of knowledge sought by the study, as
the participants that were involved have suffered from the injury and faced the problem
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associated to the selected topics. It effectively helps in analysing their viewpoint that enhance the
effectiveness of research in a well define manner. However, it has been identified that there was
no discussion around recruitment in which some people choose not to take part.
According to this tool of critical appraisal skill program it has been identified that the setting
for the data collection was effectively justified that addressed the research issue in a well define
an effective manner. The data has been collected by researcher by involving patients those who
had suffered from the disease who are still suffering helps in enhancing research effectiveness, as
it allowed investigator to implement effective, authenticated and validate information in this
research. In addition to this the study design in order to accomplish this research was conducted
in the chronic clinic pain, at this has been evaluated that in this all 136 patients get treated at
clinic. Furthermore, in order to conduct this research data has been collected with the help of
randomly selecting one out of every five patients to participate. In addition to this participant
were effectively administered with the help of questionnaire that involve anxiety and depression
questions. Along with this patient meeting criterion for CBDT treatment is also undertaken in
which individuals receive CBDT therapy. This method is being effectively implemented by
research through which effective outcome of research assured. In addition to this it has been
identified that the researcher has justified the methods choosing in appropriate way that enhance
research effectiveness. Furthermore, according to the analysis of this research it has been
identified that investigator have undertaken the use of interview method in which proper
screening of patience is being undertaken. All that total 136 patients those who have faced
problems with chronic plain effectively screened. According to the analysis it has been identified
that the form of data that has been collected in context with notes, while researcher does not
discussed saturation of data.
According to the evaluation of this research, it has been identified that a data analysis is
sufficiently rigours as in this in-depth description of the analysis process is being conducted by
researcher. Furthermore, it has been identified by the researcher the manner in which data
present is selected from original sample to demonstrate the analysis process. In this investigator
scripture explains that data has been collected with the help of questionnaire method from
patience that effectively support in conducting research in effective manner. Furthermore, it has
been underlined that the sufficient data was presented to support the findings, as researcher
effectively undertakes use of various methods to acquire data and information. However, it has
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been evaluated that contradictory data that has been taken into amount is comparatively low, in
this researcher can undertake use of effective contradictory data to conduct the search.
Furthermore, the researcher critically examines their own role in fluid during analysis and
potential biases with the help of data for protection.
This research analysis has been conducted on the topic of, Cognitive Behavioural Therapy
for Depression and Anxiety in an Interdisciplinary Rehabilitation Program for Chronic Pain.
Cognitive behavioural therapy (CBT) is mainly defined as effective for treating depression and
anxiety within patients with chronic pain. It has been identified that there is an effectively
discuss the contribution of study in context with existing understanding. Furthermore, it has
been evaluated that researcher did not identify new areas with the help of taking consideration of
respondents’ point of views. Researcher also discussed the manner in which findings can be
transferred to population.
CONCLUSION
According to the above mentioned analysis, it has been identified that the present research
study is been conducted Cognitive Behavioural Therapy for Depression and Anxiety in an
Interdisciplinary Rehabilitation Program for Chronic Pain. Cognitive behavioural therapy
method are methods that are effective in providing treatment for depression and anxiety related
mental and cognitive problems, within patients with chronic pain. This evaluation of patient’s
outcomes with chronic pain effectively enhances research effectiveness, as in this sufficient
amount of data and information has been implemented by investigating. With the help of
effective methods research analyses patient viewpoint that helps in depth analysis of the
research. It has been identified that by offering CBDT for depression and anxiety as a part of
rehabilitation trade management program are helpful in offering effective long term benefits of
the treatment.
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REFERENCES
Books and Journals
Ólason, M., Andrason, R. H., Jónsdóttir, I. H., Kristbergsdóttir, H., & Jensen, M. P. (2018).
Cognitive behavioral therapy for depression and anxiety in an interdisciplinary
rehabilitation program for chronic pain: a randomized controlled trial with a 3-year
follow-up. International journal of behavioral medicine, 25(1), 55-66.
Long, H. A., French, D. P., & Brooks, J. M. (2020). Optimising the value of the critical appraisal
skills programme (CASP) tool for quality appraisal in qualitative evidence
synthesis. Research Methods in Medicine & Health Sciences, 1(1), 31-42.
Pérez-Rojo, G., Martín, N., Noriega, C., & López, J. (2018). Psychometric properties of the
CASP-12 in a Spanish older community dwelling sample. Aging & mental health, 22(5),
700-708.
Kim, G. R., Netuveli, G., Blane, D., Peasey, A., Malyutina, S., Simonova, G., ... & Pikhart, H.
(2015). Psychometric properties and confirmatory factor analysis of the CASP-19, a
measure of quality of life in early old age: the HAPIEE study. Aging & Mental
Health, 19(7), 595-609.
Rinaldo, U., & Selander, J. (2016). Return to work after vocational rehabilitation for sick-listed
workers with long-term back, neck and shoulder problems: a follow-up study of factors
involved. Work, 55(1), 115-131.
Bérubé, M. (2019). Evidence-Based Strategies for the Prevention of Chronic Post–Intensive Care
and Acute Care–Related Pain. AACN advanced critical care, 30(4), 320-334.
Shukla, A. W., & Okun, M. S. (2016). State of the art for deep brain stimulation therapy in
movement disorders: a clinical and technological perspective. IEEE reviews in
biomedical engineering, 9, 219-233.
Barrett, K., & Stewart, I. (2021). A preliminary comparison of the efficacy of online Acceptance
and Commitment Therapy (ACT) and Cognitive Behavioural Therapy (CBT) stress
management interventions for social and healthcare workers. Health & Social Care in the
Community. 29(1). 113-126.
Pipkin, A., Hogg, L., & Armitage, S. (2021). ‘Someone on my level’: A Meta‐Ethnographic
Review of Therapeutic Relationships in Cognitive Behavioural Therapy for
Psychosis. Clinical Psychology & Psychotherapy.
Jansson-Fröjmark, M., & Jacobson, K. (2021). Cognitive behavioural therapy for insomnia for
patients with co-morbid generalized anxiety disorder: an open trial on clinical outcomes
and putative mechanisms. Behavioural and Cognitive Psychotherapy, 1-16.
Giannaki, R., & Hewitt, O. (2021). A multiple methods evaluation of a cognitive behavioural
therapy group for people with learning disabilities and anxiety. British Journal of
Learning Disabilities. 49(1). 87-99.
Swartzman, S., Kerr, J., & McElhinney, R. (2021). An evaluation of a group-based cognitive
behavioural therapy intervention for low self-esteem. Behavioural and Cognitive
Psychotherapy, 1-10.
Online
Cognitive Behavioral Therapy for Depression and Anxietyin an Interdisciplinary Rehabilitation
Program for Chronic Pain:a Randomized Controlled Trial with a 3-Year Follow-up,
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2018. [Online]. Available through:
<https://www.researchgate.net/publication/320791484_Cognitive_Behavioral_Therapy_f
or_Depression_and_Anxiety_in_an_Interdisciplinary_Rehabilitation_Program_for_Chro
nic_Pain_a_Randomized_Controlled_Trial_with_a_3-Year_Follow-up>
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