Pain Disengagement Training (Open Pilot)

Mass General Brigham

Status: Enrolling

Conditions: Chronic Musculoskeletal Pain

Treatments: Behavioral: Pain Disengagement Training

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT06870162

2025p000348

1K23AT012789-01 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

The investigators aim to conduct an open pilot trial to determine the initial feasibility of a self-directed writing-based intervention in individuals with chronic musculoskeletal pain and elevated pain catastrophizing. The investigators will assess the feasibility of recruitment, acceptability of the treatment, credibility and participant satisfaction, treatment adherence, and feasibility of assessments following pre-specified benchmarks.

Full description

Mind-body interventions are some of the most effective treatments for chronic pain, yet due to lack of resources, many are inaccessible to the patients who need them. The investigators seek to fill this gap by developing and testing Pain Disengagement Training (PDT) for the treatment of chronic pain catastrophizing, a key risk factor for pain interference. The investigators will administer the PDT treatment in a small number (approximately 10) of participants to evaluate initial benchmarks (the feasibility of recruitment, acceptability of the treatment, credibility and participant satisfaction, treatment adherence, and feasibility of assessments) and to assess participants' experience with the intervention using qualitative exit interviews. Results will inform the refinement of the intervention for a future larger trial.

Enrollment: 10 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Outpatient adults (i.e., greater than or equal to 18)
2. Has self reported chronic musculoskeletal pain (i.e., pain persisting for at least 3 months)
3. Pain score greater than or equal to 4 (moderate) on the Numerical Rating Scale
4. Pain catastrophizing score greater than or equal to 20 on Pain Catastrophizing Scale
5. Willingness to engage in a writing-based intervention and self-reported ability to write or type for at least 30 minutes in a sitting
6. Received care at Massachusetts General Hospital
7. English verbal and writing fluency

Exclusion criteria

1. Clinically significant change in therapy or medication in the past 3 months
2. Severe untreated mental health condition (e.g., psychosis)
3. Active suicidality with history of plan or current intent
4. Serious illness expected to worsen in the next 6 months (e.g., cancer)
5. Untreated substance use problem that, per patient's self-report, would interfere with the ability to complete the intervention.

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

---

10 participants in 1 patient group

Pain Disengagement Training

Experimental group

Description:

The intervention involves approximately 8 sessions. The first session will involve a psychoeducation component describing the association between negative emotions and pain and the rationale for the intervention strategies. The intervention sessions will consist of approximately 30 minutes of writing alternating between imaginal exposure writing and positive writing periods alternating back and forth (e.g., 3-5 minutes of imaginal exposure writing followed by 3-5 minutes of positive writing before returning to imaginal exposure writing, etc.). Exposure writing will involve writing about a pain-related catastrophic worry repeatedly until it becomes less anxiety-provoking. The positive writing topics will change with each prompt and will be structured by session theme (e.g., values/goals, meaningful activities). They will also complete between session practice by setting aside a time for worrying and then completing a meaningful activity.

Treatment:

Behavioral: Pain Disengagement Training