Single session interventions (SSIs) for chronic pain are a novel and scalable intervention approach that are far less burdensome than typical 8-session behavioral treatments, and have demonstrated improvements in pain outcomes. Therefore, the current review focuses on systematically summarizing evidence from randomized controlled trials (RCTs) on behavioral SSIs for chronic pain. The review was prospectively registered (PROSPERO CRD42023447224), and the search strategy included seven electronic databases up until 11/2024. Title, abstract, and full text review was conducted with 17 RCTs identified and summarized. Eligible studies were RCTs testing a psychological SSI that targeted pain among adults with chronic pain. Study quality was analyzed using National Institute of Health (NIH)'s Quality Assessment Tool for RCTs. The review focused on synthesizing: 1) the main contents, mode, frequency and duration of interventions for patients with chronic pain; and 2) the effects of SSIs on psychological and physical outcomes. Overall, we found that various SSIs demonstrated efficacy in improving pain outcomes. Specifically, small but significant effects of SSIs were observed for pain intensity (Standardized mean difference [SMD]=0.17) and pain interference (SMD=0.27) compared to control conditions. SSIs also demonstrated significant reductions in pain catastrophizing, anxiety, and depression (SMD = 0.37, 0.29, and 0.25 respectively). Of the 17 RCTs, 13 (76%) had good internal validity, and 4 (24%) had fair internal validity. SSIs can be low burden and improve behavioral pain care access. Finally, we discuss design and methodology recommendations for future research on SSIs for chronic pain. PERSPECTIVE: Findings suggest that SSIs are generally effective in improving pain and other health outcomes across various types of chronic pain conditions. SSIs can be low burden and improve behavioral pain care access, especially in settings where longer-course behavioral treatments are infeasible or not offered.
| Discipline Area | Score |
|---|---|
| Physician |  |
Physician rater
SSI for pain are potentially scalable in primary care, increasing feasibility. However, most trials in this systematic review relied on mental health professionals, effects were small, and used treatment as usual for comparison. Given that the main outcome was subjective and pain is influenced by placebo effects, it is not apparent whether these represented placebo effects.
Physician rater
Not a journal generalists will read. Also, it is not clear what the interventions are. Behavioral referrals are very difficult to get in many areas of the US. So not sure this is going to change clinician behavior.
, McMaster University