cognitive behavioral therapy techniques for distress and pain in breast cancer patients a metaanalysis this metaanalysis is the first to examine cognitive behavioral therapy cbt techniques for distress and pain specifically in breast cancer patients twenty studies that used cbt techniques with breast cancer patients were identified and effect sizes were calculated to determine 1 whether cbt techniques have a significant impact on distress and pain 2 if individual or group treatments are more effective 3 whether severity of cancer diagnosis influences distress and pain outcomes and 4 if there is a relationship between cbt technique efficacy for distress and pain results revealed effect sizes of d 031 for distress p 005 there were no significant differences in effects between those with or without metastases p 005 the correlation between effect sizes for distress and pain was not significant p 007 overall the results support the use of cbt techniques administered individually to manage distress and pain in breast cancer patients however more welldesigned studies are needed