Psychosocial Therapies for Chronic Pain
(MATCH Trial)
Trial Summary
Do I need to stop my current medications to join the trial?
The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the trial coordinators.
What data supports the effectiveness of the treatment Cognitive Behavioral Therapy (CBT), Hypnotic Cognitive Therapy (HYP-CT), and Mindfulness-Based Cognitive Therapy (MBCT) for chronic pain?
Research shows that Cognitive Behavioral Therapy (CBT) is a well-established treatment for chronic pain, with multiple studies demonstrating its effectiveness in reducing pain and improving related issues. Hypnotic Cognitive Therapy (HYP-CT) has shown promise in managing chronic pain, particularly in group settings, with improvements in pain intensity and interference. Mindfulness-Based Cognitive Therapy (MBCT) is not directly mentioned, but similar therapies have been beneficial for chronic pain management.12345
Is psychosocial therapy for chronic pain safe for humans?
How does the treatment of Cognitive Behavioral Therapy (CBT), Hypnotic Cognitive Therapy (HYP-CT), and Mindfulness-Based Cognitive Therapy (MBCT) for chronic pain differ from other treatments?
This treatment is unique because it focuses on changing the way patients think about and respond to pain, rather than just addressing physical symptoms. It combines techniques like mindfulness, hypnosis, and cognitive restructuring to help patients manage pain by improving their mental and emotional well-being, which is different from treatments that rely solely on medication.29111213
What is the purpose of this trial?
Chronic pain is a prevalent, disabling problem affecting as many as 50% of men and 75% of women Veterans. Cognitive Behavioral Therapy (CBT) is the current gold standard treatment for chronic pain. However, while some individuals do respond to CBT, many individuals do not obtain meaningful benefit. As a result, the average response to CBT treatment in groups of individuals with chronic pain is only modest.To address the need for effective treatments, the investigators have developed and adapted Complementary and Integrative Health (CIH) interventions such as Mindfulness-Based Cognitive Therapy (MBCT) and Hypnotic Cognitive Therapy (HYP-CT) for chronic pain management. Research shows these treatments are beneficial alternatives to CBT. However, as with CBT, response to these treatments varies, and the investigators' preliminary data suggests outcome variability is explained by a number of baseline patient factors. Research is now needed to advance knowledge regarding the pre-treatment patient factors (i.e., predictive markers) that moderate treatment outcome (i.e., patient factors that interact with treatment condition to predict outcome). The findings from this research will provide an empirical basis for developing patient-treatment matching algorithms to prospectively match a given individual to the evidence-based treatment most likely to be beneficial for them.The investigators have initiated a program of research to identify the factors that predict response to psychosocial pain treatments, including HYP-CT, MBCT, and CBT. Preliminary findings suggest that predictive markers such as brain activity (e.g., alpha and beta power, as measured by EEG), and the traits of mindfulness, hypnotizability, and catastrophizing, will predict who benefits most from different treatments. For example, post hoc analyses show that those who are "well-matched" to HYP-CT, based on the identified baseline moderators, achieve twice the amount of pain reduction with treatment, compared to those who are not well- matched. To confirm these findings, prospective research is now needed. The findings from this study will provide a foundation upon which to develop an assessment battery to identify critical values on which to base algorithms for a priori matching of individual patients to different treatments. This has the potential to substantially boost the typically modest average effect sizes that are achieved when using a more traditional "one size fits all" approach.
Research Team
Mark P Jensen, Ph.D.
Principal Investigator
University of Washington
Rhonda M Williams, Ph.D.
Principal Investigator
VA Puget Sound Health Care System
Eligibility Criteria
Adults over 18 with chronic pain, defined as having an average pain intensity of ≥3 on a scale of 0-10 for at least three months. Participants must speak English, have internet access for videoconferencing sessions, and be willing to avoid other clinical trials during the study. They should also be able to attend an in-person EEG assessment and use digital devices for communication.Inclusion Criteria
Exclusion Criteria
Timeline
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Participants are randomized to receive one of the three active treatments (HYP-CT, MBCT, CBT) or usual care for chronic pain management
Follow-up
Participants are monitored for safety and effectiveness after treatment
Open-label extension (optional)
Participants may opt into receiving any of the three treatments after the final 6-month follow-up assessment
Treatment Details
Interventions
- Cognitive Behavioral Therapy (CBT)
- Hypnotic Cognitive Therapy (HYP-CT)
- Mindfulness-Based Cognitive Therapy (MBCT)
Cognitive Behavioral Therapy (CBT) is already approved in United States, European Union, Canada for the following indications:
- Chronic pain
- Anxiety disorders
- Depressive disorders
- Trauma-related disorders
- Chronic pain
- Anxiety disorders
- Depressive disorders
- Trauma-related disorders
- Chronic pain
- Anxiety disorders
- Depressive disorders
- Trauma-related disorders
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
VA Puget Sound Health Care System
Collaborator