Exploring the Efficacy of Cognitive Behavioral Therapy for Chronic Pain in Veterans With Serious Mental Illness

What this Trial Is About

Chronic musculoskeletal pain greatly impacts Veterans, especially those with serious mental illness (SMI), leading to poorer mental and physical health and hindering recovery. Despite high rates of chronic pain in this group, there is limited research on non-drug pain management strategies. This research evaluates Cognitive Behavioral Therapy for Chronic Pain (CBT-CP), an evidence-based psychotherapy, to understand its effects on pain-related functioning, quality of life, and pain severity in Veterans with SMI and chronic low back pain. Participants will be randomly assigned to either the CBT-CP program or an active control group called Health & Wellness (H&W). CBT-CP involves 12 weekly individual sessions including pain education, goal-setting, and skill-building, with a booster session one month after the last session. The H&W group will receive 10 weekly sessions focused on general physical and emotional wellbeing topics without pain management content. Each session lasts 60 minutes and is led by trained interventionists following a structured manual. Veterans will be assessed at the start, after treatment (approximately 4 months), and at a 6-month follow-up (about 10 months after starting) using tools like the Brief Pain Inventory-Interference, Veterans RAND 36-Item Health Survey, and PEG-3 scale. Additionally, one-week ecological momentary assessments will track daily pain and functioning. Researchers will monitor changes in pain, mental health symptoms, physical activity, and treatment engagement throughout the study, which includes a total participation period of about 10 months.

CBT-CP for Veterans With SMI