Pain Reprocessing Therapy for Chronic Back Pain

Recruiting in Palo Alto (17 mi)

Overseen byJonathan K. Ashar, Ph.D.

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: University of Colorado, Denver

No Placebo Group

Trial Summary

What is the purpose of this trial?

This trial compares three treatments for chronic pain: a new therapy (PRT), a well-known therapy (CBT), and usual care. It focuses on adults with chronic pain, especially those from diverse and lower-income backgrounds. PRT aims to change how patients perceive their pain, making it seem less threatening and more manageable.

Research Team

Jonathan K. Ashar, Ph.D.

Principal Investigator

University of Colorado, Denver

Eligibility Criteria

This trial is for adults with chronic back pain lasting at least 6 months, where the back pain is more frequent and severe than leg pain. Participants must have a consistent level of pain and be able to attend telehealth appointments. Those with recent major medical events, surgeries, or psychiatric issues, or who are involved in litigation related to their pain cannot join.

Inclusion Criteria

My back pain has been at least 4 out of 10 in the last week.

I have had back pain for most days in the past 6 months.

My back pain is more severe than my leg pain.

See 1 more

Exclusion Criteria

You were hospitalized for mental health reasons in the past 5 years.

I have lost 20lbs or more recently without trying.

Major, interfering changes in employment or housing anticipated over the next six months

See 15 more

Treatment Details

Interventions

Cognitive Behavioral Therapy for Chronic Pain (CBT-CP) (Behavioral Intervention)
Pain Reprocessing Therapy (PRT) (Behavioral Intervention)
Usual care (Other)

Trial OverviewThe study compares Pain Reprocessing Therapy (PRT), Cognitive Behavioral Therapy (CBT) for Chronic Pain, and usual care to determine which method best reduces chronic back pain and improves associated problems. It aims to find out if PRT can effectively lower chronic pain compared to CBT or ongoing treatments.

Participant Groups

3Treatment groups

Experimental Treatment

Active Control

Group I: Pain reprocessing therapy (PRT)Experimental Treatment1 Intervention

PRT has 5 components: 1) education about the origin of pain in the brain, its reversibility, and the pain-fear cycle; 2) reinforcing education using personal biography; 3) "somatic tracking" of pain through mindfulness and reappraisal of pain sensations as non-dangerous; 4) lowering the level of personal threat that may trigger pain sensation; and 5) inducing positive affect in periods of pain. Patients will attend 1 assessment and education telehealth session with a physician followed by 8, 50-minute, therapist-led sessions. Pacing will be flexible, ranging from 5-12 weeks, to increase accessibility. Treatment will be provided by experienced PRT clinicians. All PRT sessions will be remotely-delivered.

Group II: Cognitive Behavioral Therapy for Chronic Pain (CBT-CP)Active Control1 Intervention

CBT-CP, considered the leading psychological treatment for chronic pain, is a structured, time-limited intervention that aims to teach patients how to better manage chronic pain and improve their quality of life. Participants will receive 9, 50-minute sessions of CBT-CP over 5 - 12 weeks. The VA CBT-CP protocol contains an initial orientation involving education and familiarization with the CBT-CP approach to chronic pain. The protocol then includes sessions that focus on topics such as exercise, relaxation, pleasant activities, cognitive coping, and sleep. All CBT-CP sessions will be remotely-delivered.

Group III: Usual CareActive Control1 Intervention

Participants will be asked to continue whatever they are already doing to care for their back pain. Length of the usual care condition will be 5 weeks, the expected mean completion time of the PRT and CBT arms, and may be adjusted at mid-enrollment to match treatment arm length more closely.