# Mechanisms of Psychosocial Treatments for Chronic Low Back Pain

> **NIH NIH R01** · UNIVERSITY OF WASHINGTON · 2021 · $801,066

## Abstract

Abstract
Chronic low back pain (CLBP) is a significant problem affecting millions of Americans. Psychosocial
approaches have been shown to be efficacious for addressing the multidimensional nature of CLBP. Three of
the most widely implemented nonpharmacological techniques for CLBP management are Cognitive Therapy
(CT), Mindfulness Meditation (MM), and Behavioral Activation (BA). However, there is a critical lack of
research examining if these techniques work via the mechanisms specified by theory. Research examining
mechanisms – how does treatment work (mediation) – is needed. Moreover, although past research
underscores the problem of relapse following treatment, the mechanisms underlying the loss of treatment-
related gains (experienced by many but not all individuals) are not well understood; hence relapse prevention
interventions lack a precise, empirically guided formulation. Ecological momentary assessment (EMA) and
ActiGraph technology embedded within a randomized controlled trial, consisting of daily measures of process
and outcome, is ideal for testing mechanism models both during treatment and during the critical period
following treatment. Thus, the current proposal seeks to utilize EMA and ActiGraph to examine if changes in
cognitive content, cognitive process, and activity level are mechanisms specific to CT, MM and BA respectively
for reducing pain interference (primary outcome), or if they are mechanisms shared by CT, MM and BA. Time
course of lagged effects will be examined within the context of the specific and shared mechanisms model both
during treatment and during the critical time epoch immediately following treatment. Elucidating the
mechanisms of these three specific pain coping skills will lead to streamlined CLBP interventions, and provide
a basis for development of precisely formulated relapse prevention interventions.

## Key facts

- **NIH application ID:** 10219158
- **Project number:** 5R01AT008559-05
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Melissa Anne Day
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $801,066
- **Award type:** 5
- **Project period:** 2017-08-15 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10219158

## Citation

> US National Institutes of Health, RePORTER application 10219158, Mechanisms of Psychosocial Treatments for Chronic Low Back Pain (5R01AT008559-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10219158. Licensed CC0.

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