The Reality of Modest Effectiveness

The other day I heard someone make the claim that psychological interventions for persistent, or chronic, pain are at best modestly effective. She went on to rhetorically ask why the field should promote such therapies when the empirical support for them is so unimpressive? 

I’ve heard such statements countless times before.

It would be an important point if the field of pain management was filled with effective therapies. Pain management has many offerings in terms of therapies and procedures and, were it the case that these offerings were highly effective, it would make little sense to recommend behavioral therapies that are only modestly effective.

But it is not the case that there are many, highly effective therapies and procedures for the management of persistent pain. With one possible exception, there are actually no highly effective therapies for chronic pain.