PainRelief.com Interview with:
Beth Darnall, PhD
Director, Stanford Pain Relief Innovations Lab
Associate Professor, Stanford University School of Medicine
Department of Anesthesiology, Perioperative and Pain Medicine
Psychiatry and Behavioral Sciences (by courtesy)
Wu Tsai Neurosciences Institute (affiliate faculty)
Palo Alto, CA 94304
PainRelief.com: What is the background for this study? What are the main findings?
Best pain care integrates patient education and tools to help them manage pain and reduce their symptoms1. Multi-session psychological or “behavioral” pain treatment approaches, such as 8-session cognitive behavioral therapy (CBT), are effective for equipping people with pain management skills. However, our prior research showed that patient access to these treatments is often poor, in part due to the costs and time burdens (e.g., up to 16 hours of treatment time).2
Findings from our study suggest that a one-time 2-hour pain relief skills class (“Empowered Relief”) was non-inferior to 8-session CBT for reducing multiple symptoms, including pain catastrophizing, pain intensity, and pain interference at 3 months post-treatment. We also found the single-session pain class imparted substantial reductions for pain bothersome, sleep disturbance, anxiety, fatigue and depression.
PainRelief.com: What should readers take away from your report?
Response: This NIH-funded study adds to a growing body of research investigating the efficacy of Empowered Relief. Equipping individuals with effective pain relief skills that lead to broad and lasting symptom reduction that, for many people, appears require less time and cost than previously thought.
PainRelief.com: What recommendations do you have for future research as a result of this work?
- Our next steps: we hope to conduct a pragmatic national study testing the comparative effectiveness of online delivered Empowered Relief vs. online delivered 8-session CBT.
- Future research should examine for whom a single-session pain relief skills class is sufficient, and for whom it is insufficient. We need to understand which patients require longer course treatment such as 8-session CBT and delivered resource-intensive treatments in targeted fashion.
- Future research should include diverse patients (race and ethnicity) as well as diverse chronic pain conditions.
PainRelief.com: Is there anything else you would like to add?
- While this study was conducted in people with chronic low back pain, half of the sample had two chronic pain conditions, and about 20% had three or more pain conditions.
- We recently conducted a randomized controlled trial of online delivered Empowered Relief in patients with mixed etiology chronic pain and those trial results are currently in press at Journal of Medical Internet Research (Ziadni et al).
- Empowered Relief is designed to reduce patient stigma with its name and didactic format (it is not “psychological therapy”)
This study was funded by the National Institutes of Health (NIH) National Center for Complementary and Integrative Health (NCCIH) R01AT008561 (Drs. Beth Darnall and Sean Mackey). Dr. Darnall discloses that she is principal investigator for research funding from the NIH (NIDA) and from the Patient Centered Outcomes Research Institute (PCORI) specifically for research on opioids or opioid tapering in chronic pain (neither institute funded the current work). She is Chief Science Advisor at AppliedVR (unrelated to the current work). She has authored five books on pain and opioids and receives royalties for four. She has received consultancy fees from Axial Healthcare for developing physician education materials for safe opioid prescribing and deprescribing. She serves on the Board of Directors of the American Academy of Pain Medicine, and serves on the Board of Directors for the Institute for Brain Potential. She is a scientific member of the NIH Interagency Pain Research Coordinating Committee.
1. Darnall B. To treat pain, study people in all their complexity. Nature. 2018;557(7703):7.
2. Darnall BD, Scheman J, Davin S, et al. Pain Psychology: A Global Needs Assessment and National Call to Action. Pain Med. 2016;17(2):250-263
3. Darnall BD, Roy A, Chen AL, et al. Comparison of a Single-Session Pain Management Skills Intervention With a Single-Session Health Education Intervention and 8 Sessions of Cognitive Behavioral Therapy in Adults With Chronic Low Back Pain: A Randomized Clinical Trial. JAMA Netw Open. 2021;4(8):e2113401. doi:10.1001/jamanetworkopen.2021.13401
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