NCT06004804

Brief Summary

This study is being performed to compare the effects of three types of group-based psychological treatments delivered over video telehealth for chronic musculoskeletal pain in older U.S. military Veterans. The three types of psychological treatments are: Cognitive-Behavioral Therapy (CBT), Emotional Awareness and Expression Therapy (EAET), and Mindfulness Meditation (MM). In addition, the investigators will evaluate which patients respond best to each treatment and how each treatment works. The investigators are performing the study because chronic pain is a big problem among Veterans. Older Veterans are the focus because they have the highest rates of chronic pain, perhaps as high has 80%. The investigators are looking at psychological treatments because they are less risky than medications or procedures for older Veterans. Telehealth is an important aspect of the proposal, as delivery over telehealth could improve access to treatments. CBT is endorsed nationally by VA, but no standardized MM is available through VA, and only a few VA sites use EAET, which is a newer treatment focusing on how stress and emotions affect pain. The project aims to evaluate a standardized form of MM and the newer treatment, EAET, compared to the standard CBT used widely in VA.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
216

participants targeted

Target at P75+ for not_applicable

Timeline
17mo left

Started Oct 2023

Longer than P75 for not_applicable

Geographic Reach
1 country

2 active sites

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress65%
Oct 2023Sep 2027

First Submitted

Initial submission to the registry

August 16, 2023

Completed
6 days until next milestone

First Posted

Study publicly available on registry

August 22, 2023

Completed
1 month until next milestone

Study Start

First participant enrolled

October 1, 2023

Completed
4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 30, 2027

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

September 30, 2027

Last Updated

September 22, 2025

Status Verified

September 1, 2025

Enrollment Period

4 years

First QC Date

August 16, 2023

Last Update Submit

September 19, 2025

Conditions

Keywords

Chronic painPsychological interventionMusculoskeletal diseaseTelehealth

Outcome Measures

Primary Outcomes (2)

  • Brief Pain Inventory: Mean Pain Severity

    Average of 4 self report items: current pain, worst pain over the last 7 days, least pain over the last 7 days, and average pain over the last 7 days. Each item is scored 0-10 (0 = no pain; 10 = pain as bad as can be), yielding a total score between 0 and 10.

    Change from baseline to 8 weeks

  • Brief Pain Inventory: Mean Pain Severity

    Average of 4 self report items: current pain, worst pain over the last 7 days, least pain over the last 7 days, and average pain over the last 7 days. Each item is scored 0-10 (0 = no pain; 10 = pain as bad as can be), yielding a total score between 0 and 10.

    Change from baseline to 20 weeks

Secondary Outcomes (10)

  • Brief Pain Inventory: Pain Interference

    Change from baseline to 8 weeks

  • Brief Pain Inventory: Pain Interference

    Change from baseline to 20 weeks

  • Patient Health Questionnaire-8

    Change from baseline to 8 weeks

  • Patient Health Questionnaire-8

    Change from baseline to 20 weeks

  • Generalized Anxiety Disorder 7-item

    Change from baseline to 8 weeks

  • +5 more secondary outcomes

Other Outcomes (22)

  • Emotional Approach Coping Scales

    Change from baseline to 4 weeks

  • Emotional Approach Coping Scales

    Change from baseline to 8 weeks

  • Emotional Approach Coping Scales

    Change from baseline to 20 weeks

  • +19 more other outcomes

Study Arms (3)

Emotional Awareness and Expression Therapy

EXPERIMENTAL

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.

Behavioral: Emotional Awareness and Expression Therapy

Mindfulness Meditation

EXPERIMENTAL

Seeks to help individuals achieve present moment awareness, self-compassion, and acceptance of chronic pain. It will use techniques such as the body scan, grounding, mindful breathing, mindful walking, loving kindness, and compassionate breathing.

Behavioral: Mindfulness Meditation

Cognitive Behavioral Therapy

ACTIVE COMPARATOR

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.

Behavioral: Cognitive Behavioral Therapy

Interventions

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.

Also known as: EAET
Emotional Awareness and Expression Therapy

Seeks to help individuals achieve present moment awareness, self-compassion, and acceptance of chronic pain. It will use techniques such as the body scan, grounding, mindful breathing, mindful walking, loving kindness, and compassionate breathing.

Also known as: MM
Mindfulness Meditation

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.

Also known as: CBT
Cognitive Behavioral Therapy

Eligibility Criteria

Age60 Years - 95 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Eligible individuals are
  • Veterans;
  • age 60-95 years;
  • have at least 3 months of musculoskeletal pain, including the following conditions: back, neck, leg, or pelvic pain; temporomandibular joint disorders; fibromyalgia; tension headaches; or any combination of these disorders; and
  • have an average daily pain intensity of at least 4 on a 0 to 10 scale.

You may not qualify if:

  • pain conditions likely to respond pharmacologic or surgical treatment only when they are the primary or sole complaint: hip or knee osteoarthritis, leg pain greater than back pain (to exclude radiculopathy), electromyography-confirmed "tunnel" syndromes (e.g., carpal tunnel syndrome), gout, neuralgias, migraine, and cluster headaches;
  • non-musculoskeletal pain conditions: autoimmune disease that typically generates pain (e.g., rheumatoid arthritis), cancer pain, sickle cell disease, burn pain, infection associated with pain, and cauda equina syndrome; and
  • these conditions or circumstances: severe psychiatric disorder such as schizophrenia or bipolar I disorder not controlled with medications, active suicide or violence risk, active severe alcohol or substance use disorder, substantial cognitive impairment or dementia (assessed using telephone Mini-Mental State Examination (tMMSE) score \<19), previously completed EAET, CBT-CP, or MM/MBSR, currently enrolled in another psychological pain treatment, currently in pain-related litigation or applying for pain-related compensation or compensation increase, unable to fluently read or converse in English, no home internet access.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

VA Greater Los Angeles Healthcare System, West Los Angeles, CA

West Los Angeles, California, 90073-1003, United States

RECRUITING

VA Connecticut Healthcare System West Haven Campus, West Haven, CT

West Haven, Connecticut, 06516-2770, United States

RECRUITING

MeSH Terms

Conditions

Chronic PainMusculoskeletal Diseases

Interventions

MindfulnessCognitive Behavioral Therapy

Condition Hierarchy (Ancestors)

PainNeurologic ManifestationsSigns and SymptomsPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Behavior TherapyPsychotherapyBehavioral Disciplines and Activities

Study Officials

  • Brandon C Yarns, MD MS BME

    VA Greater Los Angeles Healthcare System, West Los Angeles, CA

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Karin C Liu, MPH

CONTACT

Brandon C Yarns, MD MS BME

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
INVESTIGATOR, OUTCOMES ASSESSOR
Masking Details
The study will rely on a blinded outcomes assessor who will be blind to condition assignment. Investigators will be blind to outcomes until the conclusion of the trial.
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Three-Group Parallel Comparison Trial
Sponsor Type
FED
Responsible Party
SPONSOR

Study Record Dates

First Submitted

August 16, 2023

First Posted

August 22, 2023

Study Start

October 1, 2023

Primary Completion (Estimated)

September 30, 2027

Study Completion (Estimated)

September 30, 2027

Last Updated

September 22, 2025

Record last verified: 2025-09

Data Sharing

IPD Sharing
Will share

Datasets that meet VA standards for disclosure to the public will be made available within 1 year of publication. Prior to their distribution, a local privacy officer will certify that all datasets contain no PHI. Final datasets will be maintained locally until enterprise-level resources become available for long-term storage and access. Guidance on request and distribution processes will be provided by ORD. Those requesting datasets will be asked to sign a Letter of Agreement.

Shared Documents
STUDY PROTOCOL, SAP, ICF, ANALYTIC CODE
Time Frame
Datasets that meet VA standards for disclosure to the public will be made available within 1 year of publication. The analytical datasets and statistical code used in publications will be retained for 6 years, in accordance with VA record retention policy.
Access Criteria
Datasets that meet VA standards for disclosure to the public will be made available within 1 year of publication. The analytical datasets and statistical code used in publications will be retained for 6 years, in accordance with VA record retention policy.

Locations