Preference for the modality of psychosocial treatment for anxiety in adults with comorbid anxiety and chronic musculoskeletal pain

Chronic musculoskeletal pain (MSKP) is a common and challenging condition often occurring with generalized anxiety disorder (GAD). Cognitive behavior therapy (CBT) is a first-line treatment for GAD, but limitations on the potential availability or engagement in CBT have encouraged consideration of remote and autonomous treatment options. Yet, little is known about preferences for different modalities of CBT. This study evaluated relative preferences for in-person, telehealth, or digital CBT among individuals with comorbid MSKP and anxiety. Using local and national online advertising, we recruited a sample of 85 individuals with MSKP and self-reported clinical levels of anxiety (mean age: 40.3, 74.4% female, 67.1% White). Results indicated a significant preference for in-person therapy over digital treatment. Nonetheless, multiple indices of higher pain-related fear and distress were linked to a greater relative preference for digital therapy. Dissemination of scalable digital treatment for anxiety for adults with MSKP may find the best reception among individuals with these characteristics.