https://orcid.org/0000-0003-3428-3435
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ABSTRACT
Objectives
Emotional Awareness and Expression Therapy (EAET) targets trauma and emotional conflict to reduce or eliminate chronic pain, but video telehealth administration is untested. This uncontrolled pilot assessed acceptability, feasibility, and preliminary efficacy of group-based video telehealth EAET (vEAET) for older veterans with chronic musculoskeletal pain.
Methods
Twenty veterans were screened, and 16 initiated vEAET, delivered as one 60-minute individual session and eight 90-minute group sessions. Veterans completed posttreatment satisfaction ratings and pain severity (primary outcome), pain interference, anxiety, depression, functioning, social connectedness, shame, and anger questionnaires at baseline, posttreatment, and 2-month follow-up.
Results
Satisfaction was high, and veterans attended 7.4 (SD = 0.6) of 8 group sessions; none discontinued treatment. Veterans attained significant, large reductions in pain severity from baseline to posttreatment (p < .001, Hedges’ g = −1.54) and follow-up (p < .001, g = −1.20); 14 of 16 achieved clinically significant (≥ 30%) pain reduction, and 3 achieved 90–100% pain reduction. Secondary outcomes demonstrated significant, medium-to-large improvements.
Conclusions
In this small sample, vEAET produced better attendance, similar benefits, and fewer dropouts than in-person EAET in prior studies. Larger, controlled trials are needed.
Clinical Implications
Group vEAET appears feasible and highly effective for older veterans with chronic pain.
Clinical implications
Group-based emotional awareness and expression therapy administered via video telehealth (vEAET) was acceptable, feasible, and highly effective for multiracial/multiethnic older adults with chronic pain.
By the end of vEAET treatment, 14 of 16 older adults with chronic pain showed clinically significant (at least 30%) pain reduction, and 3 older adults had essentially complete resolution of chronic pain (90–100% pain reduction).
In this small trial, attendance at sessions was higher than in prior trials of in-person EAET, and no patients dropped out of vEAET, suggesting that video telehealth is a potential modality to improve access to EAET.
Acknowledgments
The authors would like to thank Alexander Alas for his comments on a prior version of this manuscript.
Disclosure statement
Each author signed a form for disclosure of potential conflicts of interest. Dr. Lumley is co-developer of emotional awareness and expression therapy (EAET), has received fees for professional training in EAET, and is a research consultant for Cognifisense, Inc. None of the other authors have any financial or other conflicts of interest in relation to the work described.
Data availability statement
Consistent with VA policy, the data that support the findings of this study are available from the corresponding author, B.C.Y., upon reasonable request. va.gov
Ethical principles
The authors affirm having followed professional ethical guidelines in preparing this work. These guidelines include obtaining informed consent from human participants, maintaining ethical treatment and respect for the rights of human participants, and ensuring the privacy of human participants and their data, such as ensuring that individual participants cannot be identified in reported results or from publicly available original or archival data.
Role of the funder
The U.S. Department of Veterans Affairs did not have any role in the design and conduct of the study; collection, management, analysis, and interpretation of data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.
Required disclaimer
“These contents do not represent the views of the U.S. Department of Veterans Affairs or the United States Government.”