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Map Of Edinburgh Centre for Overall, cognitive-behavioural treatments proved more effective than no treatment on measures of reported pain, mood, cognitive coping and appraisals, behavioural activity and social engagement. They proved more effective than pharmacological, educational and occupational therapy interventions on measures of reported pain, cognitive coping and appraisal, and in reducing the frequency of pain-related behaviour. Perhaps surprisingly, however, cognitive-behavioural interventions were no more effective than the others in reducing negative, fearful or catastrophic thoughts. Nor were they more effective in changing mood. This may be because the most important therapeutic process in these interventions was that patients engaged in higher levels of activity than they previously had. As we suggested earlier in the chapter, this may change their beliefs about their ability to exercise, to control their pain while doing so, and their mood. Whatever the cause, there is mounting evidence that cognitive change is an important mediator of change in therapy. Map Of Edinburgh Centre 2016.