CIH Stepped Care for Chronic Pain
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial tests a new approach to treating chronic pain and PTSD (post-traumatic stress disorder) using a combination of mindfulness and meaning-based therapies. Participants begin with simple treatments like psychoeducation and, if needed, progress to more intense therapies based on their response and preference. The trial seeks English-speaking individuals who have chronic pain and PTSD symptoms and have recently visited the University of Washington system. Participants should have experienced pain affecting daily life and have a confirmed PTSD diagnosis or significant symptoms.
As an unphased trial, this study offers a unique opportunity to explore innovative therapies that could improve quality of life.
Do I need to stop my current medications for the trial?
The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.
What prior data suggests that this CIH stepped care approach is safe for treating chronic pain and PTSD?
Studies have shown that mindfulness-based treatments, like the one used in this trial, are generally safe for people with PTSD and chronic pain. Research indicates that most patients tolerate these treatments well.
Mindfulness-based therapies, part of the CIH Stepped Care approach, have been used in other studies for similar conditions. These studies suggest that such therapies usually don't cause serious side effects and can be a good option for those who might not respond well to traditional treatments.
Research also supports the stepped care approach, which adjusts the treatment level based on patient needs. This method allows starting with simpler options and moving to more involved ones only if necessary, helping manage any potential discomfort from the treatment.
Overall, while any treatment carries some risks, evidence suggests that this type of care is quite safe for managing chronic pain and PTSD.12345Why are researchers excited about this trial?
Researchers are excited about integrating mind-body practices into primary care for treating chronic pain and PTSD because it offers a personalized approach that adapts to each patient's needs. Unlike typical treatments that might rely heavily on medication, this method begins with mindfulness and education, and can escalate to more intensive therapy based on how the patient responds. This stepped care approach not only empowers patients by considering their preferences but also aims to reduce the reliance on pharmaceuticals, potentially leading to fewer side effects and improved overall well-being.
What evidence suggests that this trial's treatments could be effective for chronic pain and PTSD?
This trial will compare a mindfulness-based and meaning-based stepped care approach with treatment as usual for co-occurring chronic pain and PTSD. Research has shown that mindfulness-based treatments can aid in managing posttraumatic stress disorder (PTSD). Mindfulness practices, such as meditation, can significantly reduce pain by engaging specific brain processes. These practices have proven effective in managing long-term pain. Studies have also found that therapies like cognitive behavioral therapy (CBT) and mindfulness-based stress reduction (MBSR) can improve outcomes for chronic pain. Guidelines often recommend these treatments for such conditions. Overall, combining mindfulness with meaning-based approaches could benefit individuals with both PTSD and chronic pain.12467
Who Is on the Research Team?
David Reed, PhD
Principal Investigator
University of Washington
Are You a Good Fit for This Trial?
Inclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Initial Mindfulness-Based Education
Participants receive initial mindfulness-based education and self-management strategies
Measurement-Based Care and Monitoring
Participants undergo measurement-based care assessments every 2 weeks and receive feedback
Mindfulness-Based Psycho-Education
Participants receive 4-6 sessions of mindfulness-based psycho-education if needed
Follow-up
Participants are monitored for safety and effectiveness after treatment
What Are the Treatments Tested in This Trial?
Interventions
- CIH Stepped Care
How Is the Trial Designed?
2
Treatment groups
Experimental Treatment
Active Control
CIH Stepped Care is a stepped approach to care delivered by a health coach (e.g., psychologist-in-training or clinical social worker) in-person or remotely (individual person sessions). It is a mindfulness-based and meaning-based stepped care approach for treating co-occurring chronic pain and PTSD that will begin with less intensive treatment (e.g., psychoeducation) and, based on patient response and preference, will be "stepped up" to more intensive treatment when appropriate.
Treatment as usual at the clinic
Find a Clinic Near You
Who Is Running the Clinical Trial?
University of Washington
Lead Sponsor
National Center for Complementary and Integrative Health (NCCIH)
Collaborator
Citations
Mindfulness-based treatments for posttraumatic stress disorder
Abstract. Mindfulness-based treatments for posttraumatic stress disorder (PTSD) have emerged as promising adjunctive or alternative intervention approaches.
Cognitive Therapy, Mindfulness-Based Stress Reduction ...
This article examines potential predictors/moderators of response to psychosocial treatments for chronic pain.
Implementation of Psychotherapies and Mindfulness-based ...
We included CBT, ACT, and MBSR since these EBPs have demonstrated efficacy for improving chronic pain outcomes, are included in treatment guidelines for chronic ...
Mindfulness meditation–based pain relief: a mechanistic ...
The present review delineates findings from recent studies demonstrating that mindfulness meditation significantly attenuates pain through multiple, unique ...
Qualitative findings from a randomized trial of mindfulness ...
This article reports qualitative outcomes from a randomized controlled trial comparing eight weeks of cognitive-behavioral group therapy for chronic pain (CBT- ...
Mindfulness‐based cognitive therapy for chronic ...
Although data are limited, mindfulness‐based cognitive therapy (MBCT) might be a promising treatment for patients with chronic noncancer pain combined with OUD.
Effectiveness of stepped care for mental health disorders
This umbrella review synthesized existing meta-analyses on the effectiveness of stepped care for mental health disorders.
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