Shared Reading May Help People Living with Chronic Pain, Study Finds

Summary: Shared Reading shows promise as a therapeutic approach for people with chronic pain and could be an alternative or complement to Cognitive Behavioural Therapy (CBT).

Source: University of Liverpool

Overview

Researchers from the University of Liverpool, The Reader, and the Royal Liverpool University Hospitals Trust, with funding from the British Academy, have investigated how a literature-based group intervention called Shared Reading (SR) compares with Cognitive Behavioural Therapy (CBT) for people living with chronic pain. The study, led by Dr Josie Billington from the University’s Centre for Research into Reading, Literature and Society (CRILS), was published in the BMJ Journal for Medical Humanities.

What is chronic pain?

Chronic pain is a persistent and often complex sensory and emotional experience that can last longer than six months. Unlike acute pain that directly signals tissue damage and prompts immediate protective responses, chronic pain can involve long-term changes in the nervous system. Nerves that normally would not signal pain can begin to send pain messages to the brain even when there is no ongoing tissue damage. Treatments can target either the peripheral nerves or the central processing of pain; psychological approaches such as CBT aim to alter how the brain interprets and responds to pain signals.

What is Shared Reading?

Shared Reading is a group-based, literature-centered approach developed by the national charity The Reader. Sessions typically involve small groups (2–12 people) meeting weekly to read fiction, short stories, and poetry aloud together. The material is chosen for its literary interest rather than being tailored to a specific clinical condition. Regular pauses encourage participants to reflect on the text and share thoughts, memories, and personal associations prompted by the reading. The process fosters a social, reflective environment where personal experiences arise in response to shared material, rather than focusing exclusively on participants’ symptoms.

How the study was conducted

The study recruited people with severe chronic pain from a pain clinic at Broadgreen NHS Hospital Trust. Participants gave informed consent and were assigned to either a 5-week CBT group or a 22-week Shared Reading group running in parallel. After completing CBT, members of the CBT group were offered the opportunity to join the SR group. The research used mixed methods: self-report measures recorded affect before and after each session, participants kept twice-daily pain and emotion diaries, and qualitative data came from audio/video recordings, transcriptions of sessions, and individual interviews.

Key findings

The research identified qualitative and preliminary quantitative differences in how CBT and Shared Reading affected participants:

• CBT helped participants develop systematic strategies to manage emotions related to pain. Sessions often focused directly on experiences of pain, with limited thematic deviation.
• Shared Reading triggered a broader range of personal memories and life experiences—work, childhood, relationships, family—that reached beyond the immediate timeframe of pain. This wider thematic range appeared to help participants reclaim aspects of identity beyond illness, supporting the sense of a whole person rather than solely a patient.
• SR appeared to transform passive suffering into articulated reflection, enabling participants to confront and tolerate difficult emotions in a sustained, conversational context.
• Preliminary quantitative data from the pilot sample indicated possible mood and pain improvements lasting up to two days following Shared Reading sessions, suggesting short-term benefits that support further research with larger samples.

Implications

Dr Josie Billington and colleagues suggest that Shared Reading could serve as an alternative to CBT or as a longer-term follow-up or adjunct to CBT. While CBT focuses effectively on short-term emotion management and cognitive strategies, SR offers a space for emotional material to surface and be explored through literature and group discussion, potentially leading to deeper, longer-term changes in how people live with chronic pain.

Study details and funding

Funding: This research was funded by the British Academy.

Source: University of Liverpool (Simon Wood).

Original research: “A comparative study of cognitive behavioural therapy and shared reading for chronic pain” by Josie Billington et al., BMJ Journal for Medical Humanities. Published online March 2017. DOI: 10.1136/medhum-2016-011047.