# An Evaluation of MBSR and CBT for Veterans with Chronic Pain

> **NIH VA I01** · VA PUGET SOUND HEALTHCARE SYSTEM · 2020 · —

## Abstract

Background: Pain is one of the most common reasons Veterans seek health care. Mental health conditions
(including PTSD, anxiety, and depression) are estimated to co-occur for 30-50% of Veterans with chronic pain.
Current recommendations for pain management include an integrative approach informed by the
biopsychosocial model. It is increasingly recognized that use of opioids for pain management is associated
with risk of harm, yet treatment studies of non-pharmacologic approaches remain limited. Mindfulness-Based
Stress Reduction (MBSR) and Cognitive Behavioral Therapy for chronic pain (CBT-CP) teach skills intended to
enhance functionality and quality of life in the face of chronic pain. The proposed randomized clinical trial will
evaluate if MBSR and CBT-CP each result in improvements in pain interference that are superior to usual care.
Two hundred twenty-two Veterans with chronic musculoskeletal pain will be randomized to MBSR, CBT-CP or
usual care. Measures pertaining to the primary outcome of pain interference will be collected at baseline, at the
post-MBSR/CBT-CP time point, and at 3- and 6-month follow-up. In addition, measures of pain intensity,
depression, and treatment satisfaction will be applied to more fully characterize the impact of MBSR relative to
CBT-CP and usual care. Exploratory analyses will assess if outcomes differ for MBSR and CBT-CP, the impact
of the interventions on opioid use and indicators of suicidality, and whether Veteran characteristics assessed at
baseline function as treatment moderators. Aims: Primary Aim: Assess if MBSR and CBT-CP each result in
greater reductions in the pain interference subscale of the Brief Pain Inventory (BPI) as compared to usual
care, from baseline to 6 months post-treatment. Secondary Aim: Evaluate if MBSR and CBT-CP are each
superior to usual care in producing improvements in pain severity, treatment satisfaction, and depression.
Exploratory Aim 1: Evaluate whether outcomes for patients randomized to MBSR and CBT-CP differ for
changes in pain interference, pain severity, depression, and treatment satisfaction. Exploratory Aim 2:
Evaluate the impact of MBSR and CBT-CP on utilization of opioid analgesics and markers of suicidality.
Exploratory Aim 3: Evaluate moderators of response to MBSR and CBT-CP to lay the groundwork for
identifying Veterans more likely to succeed in one or the other treatment. Potential moderators assessed will
include: age, gender, baseline depressive symptoms, anxiety sensitivity, and pain catastrophizing.
Design: A three-arm randomized controlled trial comparing MBSR, CBT-CP and usual care. Participants:
222 Veterans at a large urban VA facility with chronic musculoskeletal pain. Interventions: Group MBSR or
group CBT-CP, each 8 weeks in duration. Analyses: Mixed models with assess whether MBSR, CBT-CP each
produce greater reductions in outcome variables from baseline to follow-up compared to usual care.
Implications: If MBSR and CBT-CP are each shown to be sup...

## Key facts

- **NIH application ID:** 10070429
- **Project number:** 1I01RX003283-01A2
- **Recipient organization:** VA PUGET SOUND HEALTHCARE SYSTEM
- **Principal Investigator:** TRACY L. SIMPSON
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2020-10-01 → 2024-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10070429

## Citation

> US National Institutes of Health, RePORTER application 10070429, An Evaluation of MBSR and CBT for Veterans with Chronic Pain (1I01RX003283-01A2). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10070429. Licensed CC0.

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