The author concludes that the evidence of effectiveness and cost-utility ratio described should be treated with caution. Despite the relative cost-effectiveness of the intervention, the RCT evidence on which this calculation is based is weakened by flawed randomisation processes which limits the generalisability of findings. Research in this area is also weakened by the dependence on largely self-report outcome measures, although there are few alternatives when outcomes of interest include mood, beliefs and pain. The author adds that the modest cost-utility ratio calculated for the evaluation of in-patient pain programmes over out-patient equivalents should be viewed with caution in light of inadequacies in the evidence base.