Pilot Study of CIH Stepped Care Compared to Usual Treatment for Adults with Chronic Pain and PTSD

What this Trial Is About

Researchers are evaluating a CIH Stepped Care approach compared to treatment as usual for adults with co-occurring chronic pain and posttraumatic stress disorder PTSD in two primary care settings, one rural and one urban. This pilot randomized controlled trial aims to assess the feasibility, acceptability, appropriateness, and participant retention of the CIH Stepped Care model, which is mindfulness-based and meaning-centered. The study hypothesizes that by 6 months, these measures will indicate positive reception and at least 70% retention in each treatment condition. The CIH Stepped Care intervention is delivered by a health coach, such as a psychologist-in-training or clinical social worker, through individual sessions either in-person or remotely. This approach begins with less intensive treatments like psychoeducation and can be stepped up to more intensive therapies based on patient response and preference. Participants are randomly assigned to either receive this stepped care or continue with treatment as usual at their clinic. Participants will be assessed at baseline, 3, 6, and 9 months. Those in the CIH Stepped Care group will also complete assessments every two weeks to guide their treatment progression. Researchers will measure feasibility, acceptability, appropriateness, and retention at 6 months as primary outcomes. Secondary outcomes include PTSD symptoms and pain interference. The total study period extends over at least 9 months, with ongoing monitoring through regular assessments.

CIH Stepped Care for Co-occurring Chronic Pain and PTSD