Does Teletherapy Work for Pain?

Peter M. Yellowlees, MBBS, MD


May 19, 2017

This is the Medscape Psychiatry Minute. I am Dr Peter Yellowlees.

The effective treatment of chronic pain is a major clinical problem, as is access to care by traditional methods for many patients. Now, a team of investigators[1] from the VA San Diego Healthcare System have undertaken a randomized noninferiority trial to compare videoconferencing versus in-person delivery of an 8-week acceptance and commitment therapy intervention among veterans with chronic pain (N = 128).

Assessments were completed post-treatment and 6 months later. The primary outcome was the pain interference subscale score of the Brief Pain Inventory. Secondary outcomes included measures of pain severity, mental and physical health-related quality of life, pain acceptance, activity level, depression, pain-related anxiety, and sleep quality. The researchers found that, overall, the acceptance and commitment therapy delivered via video was as effective and acceptable as in-person delivery for chronic pain, although they noted that the group of veterans who received therapy via video generally had lower levels of activity throughout the trial.

These results add to the rapidly growing evidence base on the effectiveness of videoconferencing and other telepsychiatry modalities as a service delivery system. It is becoming clear that numerous psychotherapeutic treatments can be delivered as effectively by video as in person, and in some patient groups, such as veterans, sometimes with better results than in-person delivery. We know that more than 1 million mental health patients in the United States have been treated using telemedicine in the past year—many of these in the Veterans Administration, a world leader in the use of these technologies.

If you are not already using telemedicine in some areas of your practice, you should try it. Your patients will thank you. Thank you for listening to this Medscape Psychiatry Minute. Do enjoy your practice.


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