Emotional Awareness and Expression Therapy for Chronic Pain

Overseen By Stephen Wegener, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Johns Hopkins University

Disqualifiers: Non-ambulatory, Pregnant, Severe TBI, others

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

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 11

Duration: 8 weeks

30 Participants Needed

Trial Summary

What is the purpose of this trial?

The purpose of this single-arm trial is to determine the feasibility of emotional awareness and expression therapy (EAET) for individuals with persistent pain following orthopedic trauma. As part of this study, participants will be asked to attend weekly EAET treatment sessions and complete assessments (including pre-treatment, post-treatment, and follow-up) consisting of questionnaires and sensory testing procedures.

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 is best to discuss this with the trial coordinators or your doctor.

What data supports the effectiveness of the treatment Emotional Awareness and Expression Therapy (EAET) for chronic pain?

Research shows that Emotional Awareness and Expression Therapy (EAET) can reduce chronic pain, with some studies indicating it may be more effective than cognitive behavioral therapy (CBT) for conditions like fibromyalgia. EAET focuses on addressing emotional conflicts and trauma, which are often linked to chronic pain, and has shown promise in improving pain and functioning in various trials. ^{1 2 3 4 5}

How is Emotional Awareness and Expression Therapy (EAET) different from other treatments for chronic pain?

Emotional Awareness and Expression Therapy (EAET) is unique because it focuses on addressing emotional processing and trauma, which are often linked to chronic pain, rather than just managing symptoms. Unlike other treatments, EAET emphasizes understanding and expressing emotions to reduce pain, and it has shown some advantages over cognitive behavioral therapy (CBT) in certain cases. ^{1 2 3 4 5}

Research Team

Rachel Aaron, PhD

Principal Investigator

Johns Hopkins University

Eligibility Criteria

This trial is for adults who've had surgery to fix severe bone injuries from trauma and are now dealing with ongoing pain. They should have been treated initially at a participating hospital, not be coming in due to complications or revisions, and their pain scores must average above 3 out of 10.

Inclusion Criteria

I had surgery for a bone injury at a participating hospital.

I have a recent injury to my bones or joints.

I have had a fracture in my pelvis or hip socket.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants attend weekly EAET treatment sessions with a mental health provider, each lasting around 60 minutes

8 weeks

8 visits (in-person)

Follow-up

Participants complete follow-up assessments including questionnaires and sensory testing to examine pain processing

12 months

3 visits (in-person)

Treatment Details

Interventions

• Emotional Awareness and Expression Therapy

Trial Overview The study is testing Emotional Awareness and Expression Therapy (EAET) for people with lasting pain after orthopedic trauma. Participants will attend weekly EAET sessions and complete various assessments before, after, and following the therapy.

Participant Groups

Group I: Emotional Awareness and Expression Therapy Experimental Treatment 1 Intervention

Emotional Awareness and Expression Therapy (EAET) is a non-pharmacological intervention designed to address persistent pain.

Emotional Awareness and Expression Therapy is already approved in United States for the following indications:

Approved in United States as Emotional Awareness and Expression Therapy for:

• Chronic musculoskeletal pain

Who Is Running the Clinical Trial?

Johns Hopkins University

Lead Sponsor

Trials

2,366

Recruited

15,160,000+

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Collaborator

Trials

2,103

Recruited

2,760,000+

Findings from Research

Emotional awareness and expression therapy (EAET) significantly reduced pain severity in older veterans with chronic musculoskeletal pain compared to cognitive behavioral therapy (CBT), with 41.7% of EAET patients experiencing over 30% pain reduction post-treatment.

The study involved 53 veterans and showed that EAET not only outperformed CBT in pain reduction but also had small to medium advantages in secondary outcomes like anxiety, suggesting that addressing emotional processing can be beneficial in chronic pain management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Emotional Awareness and Expression Therapy Achieves Greater Pain Reduction than Cognitive Behavioral Therapy in Older Adults with Chronic Musculoskeletal Pain: A Preliminary Randomized Comparison Trial. Yarns, BC., Lumley, MA., Cassidy, JT., et al.[2021]

A pilot study involving 16 older veterans showed that group-based video telehealth Emotional Awareness and Expression Therapy (vEAET) was highly acceptable and feasible, with participants attending an average of 7.4 out of 8 sessions and reporting high satisfaction.

The therapy resulted in significant reductions in pain severity, with 14 out of 16 veterans achieving at least a 30% reduction in pain, and 3 veterans experiencing a 90-100% reduction, indicating strong preliminary efficacy for managing chronic musculoskeletal pain.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Video telehealth emotional awareness and expression therapy for older U.S. military veterans with chronic pain: A pilot study. Yarns, BC., Molaie, AM., Lumley, MA., et al.[2023]

A single-session telehealth class called 'Pain, Stress, and Emotions' (PSE) using Emotional Awareness and Expression Therapy (EAET) significantly reduced pain intensity and interference in 74 adults with chronic pain, with a medium effect size of 0.60 at 4 weeks.

Participants reported high satisfaction with the PSE class, and one-quarter experienced clinically meaningful pain reduction, suggesting that this easily delivered intervention could be beneficial for managing chronic pain, although further controlled studies are needed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

"Pain, Stress, and Emotions": Uncontrolled trial of a single-session, telehealth, emotional awareness and expression therapy class for patients with chronic pain. Ziadni, MS., Sturgeon, JA., Lumley, MA.[2023]

Emotional Awareness and Expression Therapy (EAET) has been shown to effectively reduce pain in patients with chronic pain conditions like fibromyalgia and irritable bowel syndrome, based on recent randomized controlled trials.

EAET demonstrated superior outcomes compared to cognitive-behavioral therapy for fibromyalgia, with high patient retention and rare adverse events, suggesting it could be a preferred treatment option for certain patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Emotional Awareness and Expression Therapy for Chronic Pain: Rationale, Principles and Techniques, Evidence, and Critical Review. Lumley, MA., Schubiner, H.[2020]

Emotional awareness (EA) is crucial in understanding chronic pain (CP), as it relates to the presence and severity of pain, highlighting the need for emotional processes in pain management.

Psychological interventions that enhance EA and address emotional processing can be effective in treating centrally-mediated chronic pain, suggesting that integrating emotional care into pain treatment could improve recovery outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Emotional awareness and other emotional processes: implications for the assessment and treatment of chronic pain. Lumley, MA., Krohner, S., Marshall, LM., et al.[2022]

References

1. England pubmed.ncbi.nlm.nih.gov

Emotional Awareness and Expression Therapy Achieves Greater Pain Reduction than Cognitive Behavioral Therapy in Older Adults with Chronic Musculoskeletal Pain: A Preliminary Randomized Comparison Trial. [2021]

2. United States pubmed.ncbi.nlm.nih.gov

Video telehealth emotional awareness and expression therapy for older U.S. military veterans with chronic pain: A pilot study. [2023]

3. Switzerland pubmed.ncbi.nlm.nih.gov

"Pain, Stress, and Emotions": Uncontrolled trial of a single-session, telehealth, emotional awareness and expression therapy class for patients with chronic pain. [2023]

4. United States pubmed.ncbi.nlm.nih.gov

Emotional Awareness and Expression Therapy for Chronic Pain: Rationale, Principles and Techniques, Evidence, and Critical Review. [2020]

5. England pubmed.ncbi.nlm.nih.gov

Emotional awareness and other emotional processes: implications for the assessment and treatment of chronic pain. [2022]