What we treat · Cognitive Functional Therapy
The evidence-based approach most providers don’t know
Cognitive Functional Therapy (CFT) is a structured approach to persistent pain that treats the whole system — the beliefs, the guarding, the avoided movements, the sleep and stress that turn pain up — instead of chasing tissue that healed long ago. It’s the approach validated in the 2023 Lancet RESTORE trial, and I’m one of a handful of practitioners in Colorado trained in it.
What’s the evidence?
The RESTORE trial, published in The Lancet in 2023, randomized nearly 500 people with chronic low back pain to CFT or usual care. CFT produced large, clinically significant improvements in pain and disability — sustained at 12 months, and still holding at the three-year follow-up published in 2025. Effect sizes of that durability are rare in chronic pain research.
How is CFT different from regular physical therapy?
Three ways. First, it starts with your story — a detailed history that makes sense of why your pain system became protective, because pain that makes sense is pain you can change. Second, it uses graded behavioral experiments: we test the movements you’ve been told (or told yourself) are dangerous, and you experience the pain changing in real time. Third, it addresses the lifestyle amplifiers — sleep, stress, activity patterns — that keep the system sensitized.
Then I add the part most CFT practitioners can’t: thirty years of strength coaching to rebuild real capacity once the pain system calms down. Desensitization without strength is temporary. Strength without desensitization never starts.
Who is CFT for?
Anyone whose pain has persisted past normal healing time — typically three months or more — and hasn’t responded to tissue-focused treatment. Back pain is the best-studied application, but the principles apply to persistent pain generally: necks, shoulders, knees, post-surgical pain, and the fear of movement that follows all of them.
Common questions
Is CFT "it’s all in your head"?
No. Your pain is real and physical. CFT is grounded in the neuroscience of how real pain is produced and amplified — and how it can be turned down. Nothing about it dismisses what you feel.
How many CFT sessions does it take?
The RESTORE protocol used about seven sessions over twelve weeks. My clients typically land in the same range: 6–8 sessions, then independence.
Do I need a referral?
No referral needed. Book a consultation directly — the first conversation establishes whether you’re a fit before you commit to anything.
Related to this
- Chronic back pain isn’t a life sentence
Cognitive Functional Therapy for chronic low back pain in Denver — validated in the 2023 Lancet RESTORE trial. For when PT and injections haven’t worked.
- Sciatica that hasn’t responded to the usual treatments
Radicular leg pain that didn’t respond to chiropractic, epidurals, or short-course PT. A nervous-system-informed approach to persistent sciatica in Denver.
Find out if this is your way out
A 30-minute consultation — your story, my honest read on whether I can help, and a clear plan if I can.
Book a consultationOr call (720) 257-9328 · See how it works