Emotional Awareness and Expression Therapy for Chronic Pain

Overseen By Brandon C Yarns, MD, MS

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of California, Los Angeles

Disqualifiers: Schizophrenia, Bipolar, Suicide risk, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests the effectiveness of Emotional Awareness and Expression Therapy (EAET) for Veterans with chronic pain and mental health issues such as depression, anxiety, or PTSD. EAET, a type of talk therapy, focuses on understanding and expressing emotions related to past trauma. The trial compares EAET to cognitive behavioral therapy for chronic pain (CBT-CP) to determine which is more effective in real-world VA clinics. Veterans with musculoskeletal pain, such as back pain or fibromyalgia, lasting over three months and experiencing moderate daily pain may be suitable candidates for this trial. Feedback from doctors, therapists, and Veterans will help identify what makes EAET effective or challenging to use. As an unphased trial, this study offers Veterans the chance to contribute to innovative research that could enhance therapy options for chronic pain and mental health.

Will I have to stop taking my current medications?

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 Emotional Awareness and Expression Therapy (EAET) is safe for Veterans with chronic pain?

Research shows that Emotional Awareness and Expression Therapy (EAET) is safe and manageable for individuals. In past studies, participants who tried EAET reported less pain and improved mobility. They also experienced fewer mental health issues, such as depression or anxiety. These findings suggest that EAET can be a useful tool for managing pain and emotions.

In 2019, the U.S. Department of Health & Human Services recognized EAET as a Best Practice for pain management, highlighting its effectiveness. Research conducted at a VA hospital in Los Angeles found that EAET was more effective than cognitive behavioral therapy for chronic pain (CBT-CP) in older Veterans.

Overall, EAET has helped people without causing serious side effects. It focuses on helping individuals understand and express their emotions, leading to better pain management and improved mental health. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about Emotional Awareness and Expression Therapy (EAET) for chronic pain because it targets emotional factors, which many standard treatments like medication or physical therapy often overlook. Unlike typical approaches that focus on managing symptoms physically, EAET helps individuals become more aware of their emotions and express them, aiming to resolve emotional conflicts that might contribute to pain. This therapy uses unique techniques such as writing about stress and role-playing difficult relationships, potentially offering a holistic way to improve both emotional and physical well-being.

What evidence suggests that Emotional Awareness and Expression Therapy (EAET) might be an effective treatment for chronic pain?

Research has shown that Emotional Awareness and Expression Therapy (EAET), which participants in this trial may receive, can effectively reduce chronic pain and improve mental health. Studies have found that EAET often leads to a significant drop in pain levels, with more people experiencing at least a 30% decrease in pain compared to those undergoing cognitive behavioral therapy for chronic pain (CBT-CP), another treatment option in this trial. EAET also helps individuals move more easily and feel less depressed and anxious. The U.S. Department of Health & Human Services has recognized it as a Best Practice for managing pain. Most participants continue with EAET, indicating it is well-received and potentially effective. ^{2 6 7 8 9}

Are You a Good Fit for This Trial?

This trial is for Veterans with chronic pain who may also have mental health issues like depression, anxiety, or PTSD. It's designed to see if Emotional Awareness and Expression Therapy (EAET) can help reduce their pain and improve mental health in a real-world healthcare setting.

Inclusion Criteria

Veteran at one of 7 VA healthcare systems

I have had musculoskeletal pain for at least 3 months.

My pain level is 4 or higher on a scale of 0 to 10.

Exclusion Criteria

Poorly controlled major psychiatric illness (e.g., schizophrenia, bipolar I disorder with acute psychotic symptoms)

Active suicide or violence risk

Active severe drug/alcohol use disorder

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Training and Implementation

Clinicians at up to 7 VA hospitals are trained in EAET and implement it with Veterans to assess feasibility and ease of use in real clinics.

1 year

Follow-up

Participants are monitored for changes in pain interference, PTSD symptoms, physical functioning, and other outcomes.

12 months

What Are the Treatments Tested in This Trial?

Interventions

• Emotional Awareness and Expression Therapy (EAET)

Trial Overview The study compares EAET—a talk therapy focusing on understanding and expressing emotions related to trauma—with Cognitive Behavioral Therapy for Chronic Pain (CBT-CP). The goal is to determine the effectiveness of EAET when used by various healthcare professionals in everyday clinical practice.

How Is the Trial Designed?

Group I: Emotional awareness and expression therapy (EAET) Experimental Treatment 1 Intervention

Seeks to reduce physical (e.g., pain) and emotional (e.g., depression, anxiety) symptoms by helping individuals become aware of their emotions, express them, and resolve emotional conflicts. It will use techniques such as writing about stress, role playing how to handle difficult relationships, recognizing and expressing anger and other feelings, and being more open with others.

Group II: Cognitive behavioral therapy for chronic pain (CBT-CP) Active Control 1 Intervention

Seeks to help individuals function better and improve symptoms by teaching various cognitive and behavioral skills to manage symptoms. It will use techniques such as relaxation training, engaging in pleasant activities, pacing yourself, and changing unhelpful ways of thinking.

Who Is Running the Clinical Trial?

University of California, Los Angeles

Lead Sponsor

Trials

1,594

Recruited

10,430,000+

National Center for Complementary and Integrative Health (NCCIH)

Collaborator

Trials

886

Recruited

677,000+

University of Colorado, Denver

Collaborator

Trials

1,842

Recruited

3,028,000+

University of Texas Health Science Center at San Antonio (South Texas) ADRC

Collaborator

Trials

1

Recruited

350+

Yale University

Collaborator

Trials

1,963

Recruited

3,046,000+

Greater Los Angeles Veterans Research and Education Foundation

Collaborator

University of Utah

Collaborator

Trials

1,169

Recruited

1,623,000+

VA Greater Los Angeles Healthcare System

Collaborator

Trials

53

Recruited

8,700+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11177167/

Emotional Awareness and Expression Therapy vs Cognitive ... Both EAET and CBT were presented as effective for chronic pain and had written manuals with similar amounts of discussion, experiential ...

2. clinicaltrials.gov clinicaltrials.gov/study/NCT07218757

Phase 1 Pilot of a Pragmatic Trial of EAET for Veterans ... EAET has helped people feel less pain, move better, and experience fewer mental health symptoms. Because of these strong results, the U.S. ...

3. sciencedirect.com sciencedirect.com/science/article/pii/S0022399922003531

Internet-based emotional awareness and expression ... Primary outcomes were reductions of somatic symptoms (PHQ-15) and pain intensity (BPI-4) at post-treatment, with a 4-month evaluation of effect duration. We ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7309024/

Emotional Awareness and Expression Therapy for Chronic Pain Retention in EAET was high (77.2% of patients attended at least 75% of sessions), and somewhat better than in CBT (64% of patients), and over 90 ...

5. hematologyadvisor.com hematologyadvisor.com/news/emotional-awareness-and-expression-therapy-beneficial-for-pain-relief/

Emotional Awareness and Expression Therapy Beneficial ... At posttreatment, a clinically significant (at least 30 percent) pain reduction occurred in more participants receiving EAET than CBT (63 versus ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9715975/

“Pain, Stress, and Emotions”: Uncontrolled trial of a single ... A growing body of evidence from trauma- and emotion-focused interventions for chronic pain suggests the possibility of enhanced effects (6–8).

7. sciencedirect.com sciencedirect.com/science/article/pii/S1064748124000460

Emotional Awareness and Expression Therapy for Older ... Two preliminary trials showed large-to-very-large benefits, including one small randomized clinical trial that showed a significant, large effect size advantage ...

8. link.springer.com link.springer.com/article/10.1007/s00482-025-00878-6

To feel is to heal—introduction to Emotional Awareness ... Conclusion. EAET is particularly effective for treating chronic (primary) pain conditions such as fibromyalgia and musculoskeletal pain. However ...

9. bmjopen.bmj.com bmjopen.bmj.com/content/15/3/e093102

study protocol for a single-arm feasibility clinical trial EAET is a newly developed psychological intervention designed to treat chronic pain by helping patients process psychological trauma and conflict to reduce ...