CBT for Chronic Pain Online
Living with pain day after day wears on more than your body. It can disrupt sleep, shrink your world, and leave you anxious or discouraged. Your pain is real, and it isn’t “all in your head.” Cognitive Behavioral Therapy (CBT) for chronic pain is a well-studied treatment that helps reduce pain’s grip on your life and, for many people, the intensity of pain itself. Our clinicians offer it by secure video in 44 states.
Why See a Therapist for Physical Pain?
Pain is produced by the nervous system, which weighs body signals alongside stress, sleep, mood, attention, and past experience. When pain persists for months, the nervous system can become more sensitive, amplifying pain even after tissues heal. Stress, poor sleep, fear of movement, and low mood turn up the volume, and pain worsens them in turn. Psychological treatment works on this cycle and complements medical care rather than replacing it.
Major guidelines support this approach. The National Institute for Health and Care Excellence (NICE) recommends CBT and Acceptance and Commitment Therapy (ACT) for chronic primary pain, and the Centers for Disease Control and Prevention (CDC) recommends nonmedication treatments, including CBT, as part of managing chronic pain.
Conditions We Help With
- Chronic low back and neck pain
- Fibromyalgia
- Migraine and chronic headaches
- Arthritis pain
- Irritable bowel syndrome and pelvic pain
- Nerve pain and pain after injury or surgery
- Pain alongside anxiety, depression, or posttraumatic stress disorder (PTSD)
What CBT for Chronic Pain Involves
CBT for chronic pain is structured and skills-based, and usually takes about 8 to 12 sessions. Common components include:
- Pain education. How pain works in the nervous system, and why hurt doesn’t always mean harm.
- Activity pacing. Breaking the “boom and bust” cycle and gradually rebuilding activity.
- Relaxation and attention skills. Breathing, muscle relaxation, and imagery to calm the nervous system.
- Working with thoughts. Shifting patterns like catastrophizing (“This will never get better”).
- Improving sleep. Skills from CBT for insomnia often help, since pain and insomnia feed each other.
- Returning to valued activities. Goals around work, family, or hobbies.
- Flare-up planning. Preparing for setbacks so they don’t derail progress.
The Fear-Avoidance Cycle
After an injury, avoiding movement makes sense short term. Over time, fear of pain or reinjury can lead to avoiding more and more activity, so muscles weaken, stiffness increases, and life gets smaller. CBT helps you break this cycle by gradually reintroducing avoided activities, in coordination with your medical providers.
Acceptance and Commitment Therapy for Pain
ACT takes a complementary approach: instead of fighting pain, you make room for it while moving toward what matters. Research shows ACT improves functioning and quality of life in chronic pain, and many clinicians blend ACT and CBT skills. Learn more about our Cognitive Behavioral Therapy approach.
What the Research Shows
Large reviews show CBT for chronic pain produces modest but meaningful improvements in pain, disability, and mood. The biggest gains are often in how much pain interferes with life.
Pain, Mood, and Trauma
Depression and anxiety are common with long-term pain, and treating them can improve how pain feels and how you cope. Pain that began with an accident may also come with trauma symptoms. See our pages on therapy after a car accident, depression therapy, and anxiety therapy.
What to Expect
Your first session focuses on understanding your pain: when it started, what changes it, how it affects daily life, and what you’ve tried. With your permission, we can coordinate with your physician, physical therapist, or pain specialist. Between sessions, you’ll practice skills and track activity, pain, and sleep.
Not every clinician focuses on chronic pain, so mention it when you book and we’ll match you.
Online Therapy for Chronic Pain
Telehealth makes pain care more accessible: no driving, no waiting-room chairs, and you can attend from wherever you’re most comfortable, even lying down. Research suggests remote CBT for chronic pain can be effective. Learn how our teletherapy works.
Small Steps You Can Start Today
- Pace yourself. Find a level of activity you can do on good and bad days, and build slowly.
- Protect your sleep with a consistent wake time.
- Notice “always” and “never” thoughts, and try a more balanced version.
- Schedule one valued activity each day, even briefly.
Insurance Coverage
We’re in-network with:
- Aetna. See our Aetna page.
- Optum and UnitedHealthcare, in the states listed on our Optum and UnitedHealthcare page.
- Oscar, through the UnitedHealthcare network
- Anthem, accepted depending on the clinician and state
- Blue Cross Blue Shield, Ambetter (in Washington only), and others
We do not accept Medicare or Medicare Advantage plans.
Psychological Healing has 40 clinicians, offering in-person sessions in 20 states and video sessions in 44 states.
Frequently Asked Questions
Does CBT really help chronic pain? Yes. Research shows CBT reduces pain’s interference with daily life and improves mood and functioning, and many people also notice less pain.
Does seeing a therapist mean my pain is in my head? No. Your pain is real. Psychological treatment works because the brain and nervous system process all pain, and stress, sleep, and mood affect it.
What is the difference between CBT and ACT for pain? CBT focuses on changing unhelpful thoughts and behaviors. ACT focuses on accepting pain while moving toward your values. Both have research support, and many clinicians combine them.
Is CBT for chronic pain covered by insurance? Often, yes, as outpatient psychotherapy, especially when pain affects mood or functioning. We’ll check your benefits.
If you are in crisis or thinking about harming yourself, call or text 988 (Suicide & Crisis Lifeline) or call 911.
Clinically reviewed by Karan Singh, Ph.D.
Last reviewed October 16, 2026