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MGH Community News |
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MGH Community News |
| February 2012 | Volume 16 • Issue 2 |
Highlights
Sections
Social Service staff may direct resource questions to the Community Resource Center, Samantha Gallant, x6-8182. Questions, comments about the newsletter? Contact Ellen Forman, x6-5807. |
The RIDE's New Application Heralds Stricter Eligibility Enforcement An earlier version of this article was e-mailed to department staff on February 2nd. The MBTA’s The RIDE program has revised their application. It is significantly different from previous versions. Completing the Application
The biggest change is that instead of providers completing a generic application for all applicants, there are now four provider verification forms to choose from, based on type of impairment. Providers only need to complete one of them, but can complete additional verification forms if they want to provide more information. The Provider Verification Forms are:
The application is self-explanatory, but is longer and more detailed than the previous version. Staff members may want to familiarize themselves with it. Cost-Containment
The MBTA has indicated on their website and in public meetings that continuing the current growth trend for The RIDE is unsustainable (see previous coverage October 2011, September 2011). Several efforts are underway to reign-in costs. Perhaps the main goal of the revision is to ensure that only those who cannot use fixed-route service due to their functional status are approved. A quote from the General Medical form: “Eligibility criteria does not include age, inability to drive or that service would ‘benefit’ the applicant.” The RIDE is required to provide an alternative to those who cannot use fixed-route service, but they are not required to provide door-to-door service as a convenience.
One cost-containment effort is to better determine if some who previously would have been approved for The RIDE might be able to use regular fixed-route MBTA services if certain barriers are addressed. They have included questions about whether the individual has had “travel training” for example. We may see more applications approved temporarily or conditionally (i.e., only for use under certain conditions). For example one might be approved to use The RIDE only for the duration of a specific illness or treatment or only in snowy or icy conditions if those are significant barriers for that individual. |
In-Person Assessment This new application does not alter the plan to begin in-person assessment of applicants on 7/1/12. Rather this form helps pave the way for that effort. Those with certain impairments will be exempt from in-person assessment (those with visual disabilities, mental health disabilities and seizure disorders). The specific provider verification forms for these groups allow the MBTA to make more informed eligibility decisions about them.
-Thanks to Dana Gennett for bringing this to our attention. Utilities: Winter Moratorium Ends March 15, May Be Extended Under Massachusetts law the winter moratorium on heat-related gas and electricity shut-offs for households experiencing “financial hardship” ends March 15 each year. The moratorium does not eliminate the debt, it just delays the shut-off. At the end of the moratorium utilities can start the process to terminate service for those with outstanding bills (“arrearages”). Those facing shut-off should contact the company to explore options such as eligibility for discount rates, eligibility for Arrearage Management/Forgiveness programs, and/or budgeted payments. More information is available on the staff access area of our website under Utility Shut-Off Protections- Managing Arrearages. Advocates may even be able to get discount rates applied retroactively. Learn more about discount rates. The National Consumer Law Center (NCLC) has requested that the Department of Public Utilities (DPU) extend the winter moratorium through April 15. Most years the DPU does request that utilities voluntarily extend the moratorium. If the moratorium is extended we will e-mail staff with details. MA to Administer SSI State Supplement SSI (Supplemental Security Income) is a federal program of the Social Security Administration that makes monthly payments to certain people who are age 65 or older, blind or disabled. Massachusetts adds more money to SSI payments for Massachusetts resident under the SSI State Supplement Program, or SSP. The federal government currently administers both the federal SSI payment and the Massachusetts SSP payment. Through March 2012, monthly payments from the Social Security Administration include both the federal SSI payment and the SSP payment. Starting with the April 2012 payment, as a cost-saving measure, Massachusetts will send state supplemental payments to SSP recipients directly. The federal government will continue to send SSI payments separately. Those who receive both will continue to get the same total amount, but now will receive two monthly checks instead of one; one from SSA and one from the state. Or in the case of direct deposit the state will send a letter in late March saying that the state supplement has been sent to one’s account. The state supplement will be administered by UMass Medical School. See the sample letter from the Commissioners to SSP Recipients that is to be mailed in early March. Here is the Q & A mentioned in the letter. How to Contact the SSP Program
-Cited in/Linked from: February News from MassResources.org, MassResources.org, February 08, 2012. New Federal Poverty Levels/Guidelines March 1 As of March 1, 2012 new Federal Poverty Levels/Federal Poverty Guidelines (FPLs or FPGs) go into effect. See the FPG levels for 3/1/12 – 2/28/13. The FPGs are used in determining eligibility for a wide variety of means-tested public benefits including MassHealth, Commonwealth Care, Health Safety Net, SNAP/Food Stamps, and Emergency Assistance (EA- shelter for homeless families). It is also used by some semi-governmental or non-governmental benefits such as Safelink Wireless and Assurance Wireless.
Increase in SNAP Food Stamp Income Limits for Families with Children The SNAP income limits for Massachusetts families with children and pregnant women increased on 1/26/2012, based on 200% of the revised Federal Poverty Guidelines. For most programs these new levels go into effect on March 1, but SNAP has already adopted them for this population. Keep in mind that for SNAP eligibility different income limits apply to different types of households. Most households have to pass a gross income test, a net income test, or both.
-Adapted from February News from MassResources.org, MassResources.org, February 08, 2012. Nursing Home Quality- Some Problems Slow to Mend USA TODAY analyzed the federal “Nursing Home Compare” ratings for 15,700 nursing homes for the past three years. Among the findings:
-Cited in/Linked from Health Care Weekly Update, Barbara Roop & John Goodson, Health Care for Massachusetts, February 10, 2012. Deal Reached on Treatment of State’s Mentally Ill Inmates Years after a series of suicides in state prison segregation units, the state Department of Correction has reached a landmark agreement with advocate groups to better care for prisoners with severe mental illnesses. The agreement, still under seal in US District Court in Boston and awaiting a judge’s final approval, calls for the Department of Correction to maintain two recently created units at high-level security prisons as alternatives to disciplinary segregation for prisoners with mental illness. A Secure Treatment Program with 19 beds would be maintained at the Souza-Baranowski Correctional Center in Shirley, providing inmates with mental health care while under tight security. A 10-bed Behavior Management Unit at MCI Cedar Junction in Walpole would address needs of mentally ill patients with chronic disciplinary problems. Both programs were started following a lawsuit filed by the Disability Law Center on behalf of prisoners with mental illness, and after a Globe Spotlight series found that inadequate care for mentally ill prisoners often resulted in inmate suicides. The department reported eight suicides in 2010, the highest number in more than 15 years. The department reported one suicide in 2011, after the changes were implemented. -See the full Boston Globe article…
Free GED Program for the Homeless A high school diploma or GED (the General Educational Development or General Equivalency Diploma) can be the key to employment and career advancement. It is also a requirement for certain skills training programs and college acceptance. MA residents who are at least 24 years old and live in a homeless shelter may now be eligible for a free GED program. Classes include basic computer skills and career awareness discussions and staff can even offer college application assistance. Classes are offered by ABCD’s “Learning Works” adult education program and are funded through a grant from DHCD. To register for an orientation session call: 617-348-6721. - From GED Program for Homeless Shelter residents, Christina Knowles, Mass Coalition for the Homeless, February 03, 2012. BenefitsCheckUp Website for Seniors BenefitsCheckUp is free service of the National Council on Aging (NCOA), a nonprofit service and advocacy organization in Washington, DC. Many adults over 55 need help paying for prescription drugs, health care, utilities, and other basic needs. There are over 2,000 federal, state and private benefits programs available to help. But many people don’t know these programs exist or how they can apply. BenefitsCheckUp asks a series of questions to help identify benefits that could save money and cover the costs of everyday expenses. After answering the questions, users will get a personalized report that describes the appropriate programs. Users can apply for many of the programs online. Here are the types of expenses reviewed (primarily aimed at those over 55):
Visit the website: www.benefitscheckup.org/ -Thanks to Barbara Moscowitz, LICSW, Director, Senior HealthWISE, for sharing this resource.
Legal Immigrant Transition to Commonwealth CARE As reported last month (Commonwealth Care- Court Rules in favor of Legal Immigrants, MGH Community News, January 2012), the State Supreme Judicial Court ruled that the state cannot bar legal immigrants from Commonwealth Care, the state’s subsidized health care program. Among other things, this means that current members of the Commonwealth Care Bridge program (Bridge) will be transferred to the Commonwealth Care program The state will implement the reinstatement and accepting of new applications in 2 phases, outlined below. Phase 1: Current CeltiCare Bridge Members – Commonwealth Care Reinstatement by March 1 Timeframe and Process :
What Does This Mean for Our Patients? Since most Partners sites are contracted with CeltiCare, our patients who have been coming to us on the CeltiCare Bridge product can continue to come to us if they do nothing and remain on CeltiCare through Commonwealth Care. However, if they select a Commonwealth Care plan that we don't accept (for most of our sites, that's Network Health and BMC HealthNet), they will need to switch their care out of our system or switch their plan again during this year's open enrollment, beginning June 1.
Phase 2: Legal Immigrants Currently on MassHealth Limited and Health Safety Net (HSN) – May 1 Commonwealth Care Effective Date Timeframe and Process:
What Does This Mean for Our Patients?
New Applicants:
-Adapted from IMPORTANT: legal immigrant transition to Commonwealth Care, e-mail from Kim Simonian, MPH , Associate Director, Patient Access, Partners HealthCare, February 03, 2012.
Medicare Drug Coverage Reminder: Transition Refills Every winter, some people with Medicare discover that their Medicare private drug plans will no longer cover a medicine they need. Perhaps their drug plan dropped the medication from their list of covered drugs for 2012 or imposed new restrictions on a covered drug for the new year. Every Medicare prescription drug plan must have a transition policy. Transition policies ensure that new members have uninterrupted access to medications they were taking before they joined the plan, and that existing plan members do not experience interruptions in drug therapy when their plan imposes new coverage restrictions or changes the list of covered drugs. Transition policies are effective for the first 90 days that you are enrolled in the new plan, or the first 90 days of the calendar year if you are an existing member. Transition policies require that plans cover at least one 30-day supply of drugs that are not on the plan’s list of covered drugs, or that have restrictions on them, such as step therapy or prior authorization. Learn more about the rules for transition fills and your right to appeal a drug coverage denial at www.medicareinteractive.org. -From “Managing Managed Care”, Medicare Watch, Volume 3, Issue 4, Medicare Rights Center, February 02, 2012. Medicare Reminder: Coverage of Second (and Third) Opinions Original Medicare will pay for a second opinion if a doctor has recommended surgery or a “major diagnostic or therapeutic procedure.” Original Medicare will pay for a third opinion if the first and second opinions are different. Even if the surgery or other procedure is determined not to be covered, Medicare will cover the second and third opinions. If the first and second opinions were the same, Medicare may cover a “confirmatory consultation” with a third doctor, as long as that doctor submits a claim using the right code and writes in the medical record that the services provided were reasonable and medically necessary. Different rules about second and third opinions may apply to those enrolled in a Medicare private health plan (Medicare Advantage plan). A private plan may only cover second and third opinions in-network, and may require a primary care physician referral. Members should call their plan to find out the exact rules for getting second and third opinions. Learn more about Medicare coverage of second and third opinions at www.medicareinteractive.org. -From Medicare Watch, Volume 3, Issue 7 , Medicare Rights Center, February 23, 2012. Medicare Reminder: Outpatient Mental Health Coverage Under Original Medicare, Medicare Part B will pay 80 percent of its approved amount for an initial visit to a mental health professional to determine a diagnosis. Medicare will pay 60 percent of its approved amount for subsequent appointments. The patient and his or her supplemental insurance, if any, is responsible for the remainder of the bill. Medicare covers individual and group therapy, occupational therapy, substance abuse treatment, laboratory tests, prescription drugs that must be administered by a doctor, and other outpatient mental health services. Learn more about Medicare coverage of outpatient mental health services at www.medicareinteractive.org. -From Medicare Watch, Volume 3, Issue 6, Medicare Rights Center, February 16, 2012.
Opinion: The Media is an Accomplice in School Shootings- A Call for a "Stephen King" Law By Joseph Grenney, coauthor of Change Anything, Crucial Conversations, Crucial Confrontations, and Influencer. Monday I watched in horror with most of America as the story of the Chardon High School shooting unfolded. But my horror was twofold. The first misery came as I heard the names and numbers of victims and thought about the pain they and their families will endure for the rest of their lives. The second dose came as I held my breath—hoping and praying the media wouldn't amplify the violence. But they did. They did exactly what they needed to do to influence the next perpetrator to lock and load. 1. They named the shooter. School shootings are a contagion. And the media are consistent accomplices in most every one of them. See the full opinion piece on the VitalSmarts website… - From: VitalSmarts, February 29, 2012. Obama Administration Makes Greater Investment in Alzheimer's The Obama administration recently announced a commitment of $156 million over the course of the next 2 years to combat Alzheimer's disease, including making $50 million immediately available to the National Institutes of Health (NIH) for research to identify effective treatments, delay disease progression, and ultimately prevent Alzheimer's altogether. The initiative also includes an additional $26 million in caregiver support, provider education, public awareness, and improvements in data infrastructure. Altogether this represents “more than a 25% increase over the current annual Alzheimer's research investment," said US Department of Health and Human Services Secretary Kathleen Sebelius during a media briefing at the National Press Club. -See the full article on Medscape.com… Alzheimer’s Disease and Related Disorders State Plan Recommendations The Massachusetts Executive Office of Health and Human Services (EOHHS) and the Executive Office of Elder Affairs (EOEA), recently released Massachusetts Alzheimer's Disease and Related Disorders State Plan Recommendations, a comprehensive plan to help patients, families and caregivers manage Alzheimer’s. “Alzheimer’s is the most common type of dementia-causing illness and the sixth leading cause of death in the United States,” said Health and Human Services Secretary Dr. JudyAnn Bigby. “ Massachusetts alone has 120,000 seniors who suffer from Alzheimer’s disease which doesn’t include the many thousands with younger-onset Alzheimer’s or other related dementias.” The recommendations are:
Court Overturns Judge’s Demand for Abortion for and Sterilization of Mentally-Ill WomanThe Massachusetts Appeals Court recently stepped in to protect the rights of a mentally ill woman to decide herself whether to bear her child or have an abortion. “Mary Moe”, 32, suffers from schizophrenia and bipolar disorder and is pregnant. Doctors had suggested that stopping Moe’s psychiatric medications would place her in serious risk and plunge her “deeper into madness.” But the same drugs would also threaten the health of her baby. At the request of Moe’s medical provider and her parents the state Department of Mental Health asked a court to grant temporary guardianship of Moe to her parents. This would allow the parents, who were already caring for Moe’s son, to give consent to an abortion for their daughter. Norfolk Probate Judge Christina L. Harms approved the guardianship including a direction for any medical facility performing the abortion to sterilize Moe at the same time. The Appeals Court denounced Harms’ ruling, reversing the portion ordering sterilization. Those who work in the family court system generally praise Massachusetts for its progressive attitudes toward incapacitated individuals, saying their voices typically are allowed greater force here than in other states. Yet many worry that the recent ruling, which only came to light when it was reversed on appeal, suggests there could be broader a problem at play- that the courts are not consistently honoring the rights of those declared incompetent. The case also opened a window on the wrenching decisions relatives and courts are forced to make on behalf of people suffering from mental illness, and the difficulty in determining their will. It also raises the question of whether the interests of the parents, who will likely care for the new child, and of society in general, who may pay for medical and other care through MassHealth and other programs, should be considered at all in the decision. More Information and Discussion
Patient Satisfaction - At What Cost? Patient satisfaction is a widely used health care quality metric. However, the relationship between patient satisfaction and health care utilization, expenditures, and outcomes remains ill defined. The study authors conducted a prospective cohort study of adult respondents (N=51,946) to the 2000 through 2007 national Medical Expenditure Panel Survey. They conclude that higher patient satisfaction was associated with less emergency department use, but with greater inpatient use, higher overall health care and prescription drug expenditures, and increased mortality. In combination with reduced emergency department use, increased inpatient care among the most satisfied patients raises the question of whether more-satisfied patients may be differentially hospitalized for elective or less urgent indications. Increased elective admissions combined with increased diagnostic and other procedures may increase the mortality risk. Patients typically bring expectations to medical encounters, often making specific requests of physicians. Satisfaction correlates with the extent to which physicians fulfill patient expectations. Therapeutic responsibilities often require physicians to address topics that may challenge or disturb patients, including substance abuse, psychiatric comorbidity, nonadherence, and the risks of requested but discretionary tests or treatments. Relaxing patient satisfaction incentives may encourage physicians to prioritize the benefits of truthful therapeutic discourse, despite the risks of dissatisfying some patients. See the Archives of Internal Medicine, The Cost of Satisfaction: A National Study of Patient Satisfaction, Health Care Utilization, Expenditures, and Mortality, February 13, 2012. -Cited in/linked from HEALTH CARE WEEKLY UPDATE, Health Care for Massachusetts,Barbara Roop & John Goodson, February 17, 2012
Behavior Programs May Cut Child Obesity Risk Programs that teach parenting skills early on may help prevent obesity in poor U.S. kids, a study published Monday suggests. Researchers found that two programs aimed at preventing behavior problems in low-income, urban preschoolers also seemed to slash their risk of becoming obese later in childhood. In one program, called ParentCorps, 24% of children were obese by about age eight, as were 54% of kids in a control group that did not go through the program. Neither program actually focused on children's diet, exercise or weight. "Most programs are aimed at getting kids to eat less calorie-rich food, exercise more, watch less TV," said lead researcher Dr. Laurie Miller Brotman, a professor of child and adolescent psychiatry at New York University. "And those efforts have, for the most part, failed." "There needs to be a focus on general parenting skills," Dr. Brotman said. For instance, parents may have learned not to use food as reinforcement for good behavior, Dr. Brotman said. And children may have learned to deal with stress in healthier ways -- like not turning to sweets for comfort.
Cognitive Stimulation Slows Mental Decline in Dementia Evidence from multiple clinical trials shows that cognitive stimulation therapies have beneficial effects on memory and thinking in people with mild to moderate dementia, according to a systematic review published in the Cochrane Library. The review also shows that the therapies, which involve discussion of past and present events and topics of interest, word games, puzzles, music, and practical activities such as baking or indoor gardening with trained staff, increased patients' feelings of well-being. However, these therapies had no effect on people with severe dementia. Cognitive stimulation is not the same as cognitive training, which involves repeated cognitive exercises, noted Bob Woods, PhD, from Bangor University, United Kingdom. "Cognitive stimulation has a social element and is intended to offer a variety of enjoyable, stimulating activities," he explained. -See the full article summary on Medscape.com…
The Case for Retaining Bereavement Exclusion in DSM-5 The "bereavement exclusion" (BE) to major depression contained in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) is valid and should remain in the DSM-5, according to authors of a special article published in the February issue of World Psychiatry. Through the notion of BE for major depression, DSM-IV recognizes that depressive symptoms are sometimes normal in recently bereaved individuals. However, BE for major depression is slated for elimination in DSM-5. Those in favor of this action contend that the empirical evidence demonstrates that BE is invalid. This has become one of the more contentious issues regarding DSM-5, which is slated for publication in May 2013. In the article, Jerome C. Wakefield, PhD, DSW, of New York University, and Michael B. First, MD, of Columbia University, both in New York City, state that the "claimed evidence for BE's invalidity does not exist." -See the full summary on Medscape.com… -See Medscape.com summary of subsequent editorial in The Lancet... From the War Zone to the Home Front: Supporting the Mental Health of Veterans and Families One in three U.S. Service Members returning from Iraq or Afghanistan experiences signs of combat stress, depression, post traumatic stress disorder (PTSD) or symptoms of a traumatic brain injury (TBI). Only 50% receive their health care through the VA. Other vets and their families will seek care in community settings. The Red Sox Foundation and Massachusetts General Hospital Home Base Program, in collaboration with the VA’s National Center for PTSD, is providing a free, 14-part series of live, interactive, online trainings for community primary care and mental health providers to help you prepare. Listen and interact with clinical experts who share research, knowledge and experience to help you:
Event Details Dates: Every Thursday at 11:30 AM ET beginning February 23, 2012, for 14 sessionsLocation: Online; participate in any or all of the 14 sessions, which are also available for on-demand viewing after the live event Tuition: Free Credits: Up to 1 CME/CE credit per session
Obesity, Mental Illness 'Dangerously Linked' A "complex interplay" of neurobiological, psychological, and socioeconomic factors contribute to the dangerous association between obesity and mental illness, according to 2 clinical reviews published in the January issue of the Canadian Journal of Psychiatry. In the first review article, the investigators highlight symptoms, challenges, and underlying mechanisms for several psychiatric disorders, according to recent studies. These include the following:
The various clinical approaches to weight management reviewed and considered potentially helpful in the second article include the following:
-See the full Medscape.com summary … PCE in Drinking Water on Cape Linked to Mental Illness Prenatal and early childhood exposure to the organic solvent tetrachloroethylene (PCE) may raise the risk of certain psychiatric illnesses, particularly bipolar disorder, post-traumatic stress disorder (PTSD), and schizophrenia, later in life, new research shows. The population-based, retrospective birth-cohort study showed that children in Cape Cod who were exposed to drinking water contaminated with PCE, which was used to line municipal water pipes, had almost a 2-fold increased risk for bipolar disorder compared with the general population. Used widely in industry and to dry clean clothes, PCE is a well-known neurotoxin. Exposure to PCE has been shown to cause mood changes, anxiety, and depression in people who work with it. To date, the long-term effect of this chemical on children exposed to PCE has been less clear, although there is some evidence that children of people who work in the dry cleaning industry have an increased risk for schizophrenia. The study was published online January 20 in Environmental Health. Environmental Health . 2012;11:2. Published online January 20, 2012. Abstract -See the full summary on Medscape.com… Physical Punishment Harms Children’s Long-Term Development Physically punishing children can significantly affect their long-term development and increase the risk of aggression, antisocial behavior, mental illness, and substance abuse, a new analysis shows. Research has also consistently shown that physical punishment predicts anxiety, depression, slower cognitive development, less long-term compliance, weaker relationships with parents, and other problems, she noted. Joan Durrant, PhD, a clinical child psychologist and professor in the Department of Family Social Services at the University of Manitoba in Winnipeg, Canada, added that these conclusions pertain to ordinary forms of physical punishment such as slapping and spanking. Evidence-Based Recommendation Dr. Durrant added that she hopes this paper, which synthesizes trends in research on physical punishment over 2 decades, will serve as a quick reference for professionals by providing them with the empirical evidence they need to advise parents not to spank. CMAJ. Published online February 6, 2012. -See the full summary on Medscape.com… Strong Support May Protect Gay Youth From Suicide Strong social support may help protect gay, lesbian, bisexual, and transgender (LGBT) youth against suicidal thoughts, new research suggests. The first longitudinal prospective study to examine factors predictive of suicidal ideation and self-harm in this vulnerable, high-risk population indicates that support from friends and family may offer the greatest protection. "Our research shows how critical it is for these young people to have social support and for schools to have programs to reduce bullying," senior author Brian Mustanski, PhD, a clinical psychologist and associate professor of medical social sciences at Northwestern University Feinberg School of Medicine in Chicago, Illinois, said in a release. "I think it really informs us as to what sort of avenues we can take to help reduce suicide in gay youth," he told Medscape Medical News. The study is published in the March issue of the American Journal of Preventive Medicine. -See the full Medscape summary… CBT for Hot Flushes in Breast Cancer The vexing problem of hot flushes and night sweats (HFNS) in women treated for breast cancer can be better tolerated with the assistance of group cognitive behavioral therapy (CBT), according to British researchers. These results from a 96-patient trial were published online February 14 in the Lancet Oncology. Menopausal symptoms are common in breast cancer patients — about 65% to 85% of these women will have HFNS, say Myra Hunter, PhD, from King's College London, United Kingdom, and her colleagues. Many drugs, herbs, and other modalities are used to treat HFNS, but some of the most effective treatments, such as antidepressants and hormone replacement therapy, have problematic adverse effects. In contrast, group CBT is safe and without adverse effects, the authors report. The therapy devised by the investigators taught women how to perform "paced breathing" relaxation and to deal with their symptoms using cognitive and emotional techniques (e.g., avoiding negative thoughts). As well as having less bothersome menopausal symptoms, women in the CBT group received "additional benefits" — namely, improvements in mood, sleep, and quality of life, report the authors. Lancet Oncol. Published online February 14, 2012. Abstract, Comment -See full article summary on Medscape.com… CBT Aids Long-Term Pain Management The benefits of adding cognitive behavioral therapy (CBT) to a chronic pain management protocol are evident in patients up to 3 years after the end of treatment, according to research. The findings were presented at the 6th World Congress of the World Institute of Pain. The new study followed-up 113 patients (64% women), mean age 38 years, who had been through a 6-week pain management program to deal with noncancerous, musculoskeletal pain. Initial and 1 year follow-up results showed similar reductions in pain, catastrophizing, anxiety and depression in the CBT and non-CBT groups. However at the 3-year follow-up, a statistically significant difference emerged between the groups, with the CBT group having maintained a meaningful and clinical improvement in scores, and the non-CBT group having reverted to baseline levels. Asked to comment, Magdalena Naylor, MD, PhD, professor of psychiatry and director of the Clinical Neuroscience Research Unit at the University of Vermont's MindBody Medicine Clinic in Burlington, said there is mounting evidence that CBT can partially reverse abnormal brain anatomy associated with chronic pain, which would explain the persistence of improvements in the CBT group alone. -See the full summary on Medscape.com…
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