Implementation of Nurse-guided Web-based Cognitive Behavioral Therapy for Pain Management

Inclusion Criteria: - 1. patients at the primary care or rheumatology clinic with daily pain for 6 months or longer affecting the low back, neck, hip, knee or widespread pain; 2. at least moderate in average pain severity, defined as a weekly average pain severity score of 5 or greater 24; 3. at least 18 years of age; 4. reliable phone (landline or cell), and 5. have home computer with reliable internet access. Exclusion Criteria: 1. planned elective surgery during the study period; 2. very severe symptoms of depression (i.e., The eight-item Patient Health Questionnaire depression scale (PHQ8) score of ≥ 20); 3. ongoing unresolved disability claims; 4. inflammatory arthritis (e.g., lupus, rheumatoid arthritis, ankylosing spondylitis, etc.); 5. cancer-related musculoskeletal pain; 6. history of bipolar disorder or schizophrenia; and 7. takes daily opioid for more than one year.