General Guideline Principles for Cognitive Behavioral Therapy
for Patients with CRPS for workers compensation patients

The New York State workers compensation board has developed these guidelines to help physicians, podiatrists, and other healthcare professionals provide appropriate treatment for Cognitive Behavioral Therapy for Patients with CRPS.

These Workers Compensation Board guidelines are intended to assist healthcare professionals in making decisions regarding the appropriate level of care for their patients with ankle and foot disorders.

The guidelines are not a substitute for clinical judgement or professional experience. The ultimate decision regarding care must be made by the patient in consultation with his or her healthcare provider.

Cognitive Behavioral Therapy for Patients with CRPS of Behavioral Interventions

Cognitive Behavioral Therapy for Patients with CRPS of Behavioral Interventions is recommended for the management of both chronic and subacute CRPS.

Indications: There are several reasons to adopt CBT for CRPS problems, including:

  1. Results from typical physical treatment and exercise programmes that are insufficient;


  2. Clinically important issues with nonadherence to advised physical or medicinal programmes;


  3. Mood disorders that make it more difficult to manage the pain condition


  4. Counselling on the return to work for overcoming psychological obstacles (needs a recent or impending medical release to return to work);


  5. Resolution of interpersonal, behavioural, or occupational self-management issues in the workplace, during or after return to work, in cases where these issues pose a danger for job loss or are preventing the return to full duty or employment in accordance with permanent restrictions; and


  6. During opiate withdrawal or detoxification, control of clinically severe behavioural abnormalities and/or anxiety is necessary.


  7. Discomfort causing an interruption in sleep (Currie 00)

Frequency/Dose/Duration: Physical therapy is included in a programme that also incorporates cognitive behavioural therapy (CBT), such as an interdisciplinary or other functional restoration programme, or it may be delivered alone.

Established CBT regimens can be completed in as little as 16 hours or as much as 24 hours. Longer supervised psychological/psychiatric care may be necessary for some individuals (e.g., those with ongoing medical treatments, major problems, medication dependence, or damage related to psychological trauma).

As suggested, adjunctive treatment frequently entails taking medicine for a different illness, like depression. Initially, CBT should often be limited to six sessions or less. In most cases, further appointments are required, particularly for people who have a number of complicated concerns to address.

Provision of further appointments shall be subject to fulfilment of the conditions from the first batch of appointments. The number of sessions required for therapy when it is part of an interdisciplinary or functional restoration programme depends on what is required to meet the program’s treatment goals.

What our office can do if you have workers compensation injuries

We have the experience to help you with their workers compensation injuries. We understand what you are going through and will meet your medical needs and follow the guidelines set by the New York State Workers Compensation Board.

We understand the importance of your workers compensation cases. Let us help you navigate through the maze of dealing with the workers compensation insurance company and your employer.

We understand that this is a stressful time for you and your family. If you would like to schedule an appointment, please contact us so we will do everything we can to make it as easy on you as possible.


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Dr. Nakul Karkare

I am fellowship trained in joint replacement surgery, metabolic bone disorders, sports medicine and trauma. I specialize in total hip and knee replacements, and I have personally written most of the content on this page.

You can see my full CV at my profile page.