A recent study, published in JAMA Network Open and conducted by UCLA Health and the US Veterans Affairs Office, determined that a newer psychotherapy called Emotional Awareness and Expression Therapy (EAET) could significantly reduce chronic pain among older adults. The treatment works by confronting past trauma and stress-related emotions that can exacerbate pain symptoms.

The clinical trial included 126 veterans aged 60 to 95 years with at least three months of musculoskeletal pain. Study participants were randomly assigned to receive either EAET or Cognitive Behavioral Therapy (CBT), with each member of each group receiving one individual session followed by eight group sessions. The primary outcome measured was pain severity, assessed using the Brief Pain Inventory.

The results showed that EAET was superior to CBT in reducing pain severity from baseline to week 10, with 63% of EAET participants achieving at least 30% pain reduction compared to only 17% in the CBT group. At the six-month follow-up, 41% of EAET participants maintained at least 30% pain reduction, while only 14% of CBT participants did.

Furthermore, EAET demonstrated greater improvements than CBT in several secondary outcomes, including anxiety (35% improvement vs. 9%), depression (40% improvement vs. 16%), life satisfaction (27% improvement vs. 7%), post-traumatic stress disorder (PTSD) symptoms (24% improvement vs. 2%), patient-reported global impression of change and overall satisfaction with therapy.

Participants with higher baseline levels of depression, anxiety or PTSD symptoms experienced particularly significant pain reduction following EAET but not CBT. The study’s authors suggest that EAET may be a preferred intervention for medically and psychiatrically complex patients with chronic pain.

“Most people with chronic pain don’t consider psychotherapy at all. They’re thinking along the lines of medications, injections, sometimes surgery or bodily treatments like physical therapy,” said lead author Brandon Yarns, an assistant professor at UCLA Health’s Department of Psychiatry and Biobehavioral Sciences and psychiatrist at the Veteran’s Affairs Greater Los Angeles. “Psychotherapy is an evidence-based treatment for chronic pain. What this study adds is that the type of psychotherapy matters.”