Group-Based Psychological Treatments Over Video Conference for Older Veterans With Chronic Pain

Launched by VA OFFICE OF RESEARCH AND DEVELOPMENT · Aug 16, 2023

Keywords

ClinConnect Summary

This clinical trial is exploring how effective three different group-based psychological treatments are for older veterans suffering from chronic musculoskeletal pain, which includes conditions like back, neck, and leg pain. The treatments being studied are Cognitive-Behavioral Therapy (CBT), Emotional Awareness and Expression Therapy (EAET), and Mindfulness Meditation (MM). The research aims to find out which treatment works best for different patients and how each treatment helps manage pain. Since many older veterans experience chronic pain—sometimes as high as 80%—this study is important because psychological treatments are generally safer than medications or surgeries.

To participate in this trial, individuals must be veterans aged 60 to 95 who have had musculoskeletal pain for at least three months and experience an average pain level of 4 or higher on a scale of 0 to 10. Participants can expect to join group sessions over video conference, making it easier to access these treatments from home. It’s also important to note that certain medical conditions or circumstances may exclude individuals from participating, like severe psychiatric disorders or currently being involved in pain-related litigation. Overall, this study aims to improve pain management options for older veterans through safe and accessible psychological treatments.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Eligible individuals are
• • Veterans;
• • age 60-95 years;
• • have at least 3 months of musculoskeletal pain, including the following conditions: back, neck, leg, or pelvic pain; temporomandibular joint disorders; fibromyalgia; tension headaches; or any combination of these disorders; and
• • have an average daily pain intensity of at least 4 on a 0 to 10 scale.
• Exclusion Criteria:
• • pain conditions likely to respond pharmacologic or surgical treatment only when they are the primary or sole complaint: hip or knee osteoarthritis, leg pain greater than back pain (to exclude radiculopathy), electromyography-confirmed "tunnel" syndromes (e.g., carpal tunnel syndrome), gout, neuralgias, migraine, and cluster headaches;
• • non-musculoskeletal pain conditions: autoimmune disease that typically generates pain (e.g., rheumatoid arthritis), cancer pain, sickle cell disease, burn pain, infection associated with pain, and cauda equina syndrome; and
• • these conditions or circumstances: severe psychiatric disorder such as schizophrenia or bipolar I disorder not controlled with medications, active suicide or violence risk, active severe alcohol or substance use disorder, substantial cognitive impairment or dementia (assessed using telephone Mini-Mental State Examination (tMMSE) score \<19), previously completed EAET, CBT-CP, or MM/MBSR, currently enrolled in another psychological pain treatment, currently in pain-related litigation or applying for pain-related compensation or compensation increase, unable to fluently read or converse in English, no home internet access.