Pain relief through self help is highly effective
Self-directed cognitive behavioral therapy for pain can be just as effective as therapy delivered by a professional, according to recent research. Cognitive behavioral therapy for pain has been shown to reduce pain inventory scores in people living with chronic pain. Now, studies are indicating that self-directed therapy for pain is just as good as, if not better than, clinician-delivered therapy.
A research study published in JAMA in June 2026 found that self-directed therapy for pain reduced pain interference scores by a point more than clinician-delivered therapy. The study also found that patients who used self-directed therapy were more likely to complete the full course of sessions and reported greater improvements in pain interference and pain intensity.
Self-directed cognitive behavioral therapy for pain involves using instructional booklets and phone calls to guide patients through a course of cognitive behavioral therapy. The COPES program, developed by researchers at the American Veterans Health Administration, is an example of a self-directed program for chronic pain. The program involves an eleven-week course of therapy sessions, with participants calling an automated line every day to report on their pain, sleep, and skill use.
A qualified coach then leaves a weekly personalized message for each participant based on their reports. The therapy program itself is the same as the in-person program, but participants can choose when and where they complete each session, and they don’t need to see a therapist face-to-face.
The study found that patients themselves consistently said that they found self-directed CBT for pain more effective than the participants who met with a clinician a year after starting therapy.
Both self-directed and clinician-directed therapy for pain can be helpful, with small improvements in pain intensity, sleep quality, depression scores, and other measures of pain. Of the self-directed CBT group, 38% of participants said they felt they had an improvement in pain interference of 30% or more and 26% said their pain intensity improved by 30% or more.
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The study’s results have significant implications for the treatment of chronic pain. They suggest that self-directed programs like COPES could be a useful alternative to traditional clinician-delivered therapy. This could be especially helpful for people who have difficulty accessing in-person therapy or who prefer to work on their own.
Researchers note that the key to self-directed therapy is that it allows participants to work at their own pace and on their own schedule. This can be especially helpful for people who are busy or who have difficulty committing to regular therapy sessions.
It is likely that we will see more research on self-directed therapy programs for chronic pain. This could involve larger studies or studies that compare different types of self-directed programs. More self-directed programs may be developed and made available to the public.
The COPES program is already being used by the US Department of Veterans Affairs to help veterans manage their chronic pain. Other organizations could also start using similar programs to help people with chronic pain.
The study’s findings suggest that self-directed therapy for chronic pain is a promising approach that could help many people. With more research and development, self-directed programs could become a standard part of chronic pain treatment.
According to the US Department of Veterans Affairs, the COPES program has already shown promising results in helping veterans manage their chronic pain. The program is currently being expanded to reach more veterans, and it could be used to help people with chronic pain in other settings as well, including those seeking chronic pain management options.
