Evaluating Emotional Awareness and Expression Therapy Versus Cognitive Behavioral Therapy for Veterans With Chronic Musculoskeletal Pain in VA Healthcare Settings

What This Trial Is About

Many Veterans live with chronic musculoskeletal pain, often alongside mental health challenges like depression, anxiety, or PTSD related to past trauma. This trial evaluates Emotional Awareness and Expression Therapy EAET, a talk therapy designed to help individuals understand and express emotions linked to trauma, aiming to reduce pain and improve mental health. Previous studies showed EAETs promising effects compared to cognitive behavioral therapy for chronic pain CBT-CP in Veterans, but this trial tests its use in real-world VA healthcare settings. The study includes two treatment groups one receives EAET, focusing on expressing and resolving emotional conflicts through techniques like stress writing and role playing the other group receives CBT-CP, which teaches cognitive and behavioral skills such as relaxation and activity pacing to manage pain. Clinicians at up to seven VA hospitals are trained to deliver these therapies, and Veterans receive either treatment as part of a randomized trial to assess effectiveness and implementation challenges. Participants will be assessed at baseline, 10 weeks, 6 months, and 12 months for changes in pain severity and related symptoms including pain interference, physical functioning, sleep, fatigue, mental health symptoms, and quality of life. Feedback from Veterans and healthcare staff will help identify factors that support or hinder the use of EAET in typical clinical care. The study runs from early 2026 to mid-2030, with ongoing monitoring of outcomes over one year after treatment begins.

A Pragmatic Trial of EAET for Veterans With Chronic Pain