• Magdalena R Naylor, Francis J Keefe, Bart Brigidi, Shelly Naud, and John E Helzer.
• Department of Psychiatry, University of Vermont College of Medicine, 1 South Prospect Street, UHC, Burlington, VT 05401, USA Department of Psychiatry and Behavioral Sciences, Duke University Medical School, Durham, NC, USA Department of Medical Biostatistics, University of Vermont, Burlington, VT, USA.
• Pain. 2008 Feb 1; 134 (3): 335345335-345.

AbstractWe developed Therapeutic Interactive Voice Response (TIVR) as an automated, telephone-based tool for maintenance enhancement following group cognitive-behavioral therapy (CBT) for chronic pain. TIVR has four components: a daily self-monitoring questionnaire, a didactic review of coping skills, pre-recorded behavioral rehearsals of coping skills, and monthly personalized feedback messages from the CBT therapist based on a review of the patient's daily reports. The first three components are pre-recorded and all four can be accessed remotely by patients via touch-tone telephone on demand. Following 11 weeks of group CBT, 51 subjects with chronic musculoskeletal pain were randomized to one of two study groups. Twenty-six subjects participated in 4 months of TIVR, while a control group of 25 subjects received standard care only. The TIVR group showed maximum improvement over baseline at the 8-month follow-up for seven of the eight outcome measures; improvement was found to be significant for all outcomes (p

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