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Emotional awareness and expression therapy vs cognitive behavioural therapy in patients with chronic pain: Systematic review and Meta Analysis

Published online by Cambridge University Press:  26 August 2025

N. Farid ,
S. Reza ,
K. Marvin ,
R. Sabloak ,
N. Belhayne ,
R. Jabbar  and
I. Teohar
N. Farid*
Affiliation:
Medicine, Mohiuddin Islamic medical College, Mirpur, Pakistan
S. Reza
Affiliation:
Upszilla health complax, Sitakundo, Bangladesh
K. Marvin
Affiliation:
Azerbaijan Medical University, Baku, Azerbaijan
R. Sabloak
Affiliation:
Faculty of medicine, Sriwijaya University, Palembang, Indonesia
N. Belhayne
Affiliation:
Faculty of rehabilitationsciences and health techniques, Universiapolis University, Agadir, Morocco
R. Jabbar
Affiliation:
Fatima Memorial Hospital, FMHCMD, Lahore, Pakistan
I. Teohar
Affiliation:
Department of Physical and Rehabilitation Medicine, The Clinical Rehabilitation Hospital of Cluj-Napoca, Cluj Napoca, Romania
*
*Corresponding author.

Abstract

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Introduction

Emotional awareness and expression therapy (EAET) is a newer approach that focuses on identifying and expressing repressed emotions.While cognitive behavioural therapy (CBT) has ample evidence supporting its efficacy, the benefits provided by EAET are still unknown.

Objectives

We aimed to compare the efficacy of EAET versus CBT in treating chronic pain and stress-related conditions.

Methods

We systematically searched PubMed, Embase, Cochrane and Web of Science databases for randomized controlled trials (RCTs) comparing EAET with CBT in patients with chronic pain. Statistical analysis was performed using Review Manager 8.1.1 (Cochrane Collaboration). Heterogeneity was assessed by I². We pooled mean differences (MD) with 95% confidence intervals (CI). Reduction in pain severity was assessed using brief pain inventory (BPI), anxiety by PROMIS anxiety short form 7a, sleep disturbances by PROMIS sleep disturbances short form 8a and satisfaction with life by NIH toolbox general life satisfaction fixed form B.

Results

Three RCTs reporting data on 333 patients were included.Among them, 173 (52%) received EAET and 160 (48%) received CBT. Follow-up ranged from 3 to 6 months. The mean age of patients between studies ranged from 48 to 75 years. EAET significantly reduced pain severity (MD -0.93 points; 95% CI -1.63 to -0.23 ; p=0.009; I² = 81%) compared with CBT. There were no differences in anxiety (MD -1.62 points; 95% CI -4.30 to 1.05; p=0.23; I² = 91%), Sleep disturbance (MD -0.21 points; 95% CI -0.55 to 0.12; p=0.22; I² = 55%) and satisfaction with life (MD 0.71 points; 95% CI -0.24 to 1.65; p=0.14; I²=94%).

Conclusions

In patients with chronic pain, EAET was associated with a greater reduction in pain severity compared with CBT.

Disclosure of Interest

None Declared

Information

Type
Abstract
Information
European Psychiatry , Volume 68 , Special Issue S1: Abstracts of the 33rd European Congress of Psychiatry , April 2025 , pp. S499
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of European Psychiatric Association
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