Psychological therapy results vary by intervention in acute pain care, review shows

Editor's Note

Psychological interventions such as hypnosis, music therapy, and cognitive behavioral therapy (CBT) may reduce acute pain in clinical settings, though statistically significant effects were found only in some studies, according to a July 16 scoping review published in The Journal of PeriAnesthesia Nursing.

Hypnosis was the most adaptable in terms of delivery media, while music therapy was easiest to implement across settings. However, not all interventions demonstrated statistically significant effects. The review recommends integrating these techniques alongside standard care and ensuring that healthcare staff—particularly nurses—receive adequate training and institutional support to deliver them effectively.

These findings were gleaned from an examination of 20 randomized controlled trials published between 2013 and 2022, focusing on adult patients receiving psychological interventions for acute pain relief. The review excluded pediatric studies, chronic pain conditions, and non-experimental or pharmacologic interventions. Researchers searched five databases and evaluated risk of bias using Cochrane guidelines. Of the 20 studies included, 9 had low risk of bias, 6 had some concerns, and 5 were high risk—primarily due to deviations from the intended interventions and missing data.

Specific interventions detailed in the review include the following:

• Hypnosis, which was used across various surgical and procedural settings. Most studies using hypnosis showed statistically significant pain reduction. The method was noted for its delivery flexibility, with formats including face-to-face, mobile apps, CDs, brochures, and scripts, and was implemented by a wide range of providers.
• Music therapy, cited as the most practical intervention, showed statistically significant pain reduction in most studies. It was delivered by nurses, anesthetists, therapists, or caregivers using MP3 players, phones, or CDs in perioperative units and emergency departments.
• CBT was applied in surgical settings such as mastectomy and joint replacement and delivered by psychologists, nurses, and midwives using in-person, telephone, and online formats. Some studies demonstrated statistically significant reductions in acute pain.
• Emotion regulation techniques—including mindfulness and relaxation—showed positive outcomes in studies involving both surgical and nonsurgical populations. Delivery methods included face-to-face sessions, telephone counseling, and prerecorded content.
• Psychoeducation produced mixed findings; several studies reported statistically significant reductions in acute pain, while others showed only mean score decreases. Delivery formats ranged from in-person consultations to brochures and phone calls.
• Humanistic approaches consistently yielded statistically significant results across the reviewed trials. These interventions were implemented in both inpatient and outpatient settings and often emphasized patient-centered communication and engagement.