Cited by 181Posttraumatic Stress Disorder ResearchMusculoskeletal pain and rehabilitationPain Management and Treatment

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The Development of an Integrated Treatment for Veterans with Comorbid Chronic Pain and Posttraumatic Stress Disorder

Otis, John D., Keane, Terence M., Kerns, Robert D., Monson, Candice, Scioli, Erica·2009·Pain Medicine

DOI 10.1111/j.1526-4637.2009.00715.x

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Abstract

OBJECTIVE: The purpose of this article is to describe the development of the first integrated treatment for Veterans with comorbid chronic pain and posttraumatic stress disorder (PTSD). DESIGN: Descriptive, including pre- and posttreatment assessment results from a pilot study of six veterans with comorbid chronic pain and PTSD. SETTING: Northeastern Department of Veterans Affairs Medical Center. INTERVENTIONS: Using components of cognitive processing therapy (CPT) for PTSD and cognitive behavioral therapy (CBT) for chronic pain management, a 12-session integrated treatment for veterans with comorbid chronic pain and PTSD was developed. A therapist manual and patient workbook that included weekly readings and homework assignments were created. Participants received pre- and posttreatment evaluations using measures of pain, PTSD, physical disability, and psychological distress. The treatment development process is reviewed and the benefits and challenges of implementing this integrated treatment are presented. RESULTS: Several themes emerged over the course of implementing the treatment, including the importance of establishing participant trust, regular therapy attendance, and addressing participant avoidance. Of the six participants recruited for the pilot study, three withdrew from the study and three completed the integrated treatment. Participants reported that they generally liked the format of treatment, appreciated learning about the ways that chronic pain and PTSD share some common symptoms, and ways that the two disorders can interact with one another. The assessment results of those who completed treatment suggest that this treatment approach is feasible and may have clinical benefit. CONCLUSIONS: Participants appeared to benefit from receiving the integrated treatment for pain and PTSD. A randomized clinical trial is currently being conducted to evaluate the efficacy of this treatment approach.

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Authors: Otis, J. D., Keane, T. M., Kerns, R. D., Monson, C., & Scioli, E.
Affiliations: VA Boston Healthcare System (US)
Corresponding author: Otis, John D.
ORCID: Otis, John D.
Keane, Terence M.
Kerns, Robert D.
Monson, Candice
Venue: Pain Medicine
Publisher: Oxford University Press (OUP)
Published: 2009-10
Volume: 10
Issue: 7
Pages: 1300-1311
ISSN: 1526-2375 (ISSN-L)
1526-4637
DOI: 10.1111/j.1526-4637.2009.00715.x
OpenAlex: W1966659648
Cited by: 178
References: 46
Citations by year: 2026: 6 · 2025: 11 · 2024: 10 · 2023: 9 · 2022: 12 · 2021: 6 · 2020: 17 · 2019: 9 · 2018: 14 · 2017: 7 · 2016: 17 · 2015: 20 · 2014: 6 · 2013: 9 · 2012: 8
FWCI: 8.86
Type: journal article
Language: en
Open access: closed
Licence: doi.wiley.com/10.1002/tdm_license_1 (tdm, 2161 d)
Locations: Pain Medicine (publishedVersion)
PubMed (publishedVersion)
Funders: U.S. Department of Veterans Affairs (C3322R)
Topics: Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Keywords: chronic pain, post-traumatic stress disorder, comorbidities, veterans, integrated treatment, cognitive processing therapy, cognitive behavioral therapy, treatment development, therapist manual, patient workbook, treatment feasibility, participant trust, avoidance
MeSH terms: Chronic Disease, Female, Humans, Male, Middle Aged, Pain, Pain Measurement, Pilot Projects, Stress Disorders, Post-Traumatic, United States, Veterans, Cognitive Behavioral Therapy, Treatment Outcome, Delivery of Health Care, Integrated

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The Development of an Integrated Treatment for Veterans with Comorbid Chronic Pain and Posttraumatic Stress Disorder

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