Journal
AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY
Volume 30, Issue 12, Pages 1342-1350Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jagp.2022.07.009
Keywords
Chronic pain; emotions; older adults; psychological treatment
Categories
Funding
- U.S. Department of Veterans Affairs
- [IK2CX001884]
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Chronic pain is a serious issue for older adults, and psychotherapy is a promising treatment option. This article presents a novel psychological assessment and treatment approach for older adults with chronic pain, focusing on resolving trauma and emotional conflicts through a therapy called emotional awareness and expression therapy (EAET).
Chronic pain remains a serious healthcare challenge, particularly for older adults who suffer substantial disability and are susceptible to serious risks from pain medications and invasive procedures. Psychotherapy is a promising option for older adults with chronic pain, since it does not contribute to medical or surgical risks. However, standard psychotherapies for chronic pain, including cognitive-behavioral therapy (CBT), acceptance and commitment therapy, and mindfulness-based interventions, produce only modest and time-limited benefits for older adults. In this article, we describe a novel, evidence-based psychological assessment and treatment approach for older adults with chronic pain, including a detailed case example. The approach begins with reviewing patients' pain, psychosocial, and medical histories to elicit evidence of a subtype of chronic pain called centralized (primary, nociplastic, or psychophysiologic) pain, which is highly influenced and may even be caused by life stress, emotions, and alterations in brain function. Patients then undertake a novel psychotherapy approach called emotional awareness and expression therapy (EAET) that aims to reduce or eliminate centralized pain by resolving trauma and emotional conflicts and learning healthy communication of adaptive emotions. Our published preliminary clinical trial (n = 53) indicated that EAET produced statistically significant and large effect size advantages over CBT in pain reduction and marginally greater improvements in pain interference than CBT
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