# Resilience Skills Self-Management for Chronic Pain

> **NIH NIH R01** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2020 · $510,267

## Abstract

PROJECT SUMMARY / ABSTRACT
Chronic spinal pain is associated with loss of function and significant disability. When spine pain is comorbid
with fibromyalgia, symptom severity and disability are amplified. Interventions capable of improving functional
status, reducing symptoms, and enhancing well-being are critically needed. Both medications and cognitive-
behavioral therapy (CBT) have demonstrated similar, modest effects for reducing symptoms in chronic pain.
Behavioral treatments for chronic pain like CBT act predominantly by decreasing negative states rather than by
Resilience-based interventions target the enhancement of
positive emotions and well-being rather than focusing solely on negative emotions and behaviors. Although
relatively under-used in chronic pain populations, resilience-based interventions have been used successfully
in other clinical settings including depression, cardiovascular disease, diabetes, and HIV.
promoting positive states associated with resilience.
Thus, adding
resilience-enhancing strategies to CBT for pain holds promise for further enhancing the effectiveness of CBT.
In addition, most current behavioral interventions require specialized training and as such are not widely
available. Medical assistants (MAs) are well-positioned in the healthcare system to play a pivotal role in helping
individuals with chronic pain improve their functional abilities through innovative self-management strategies.
The MA-led self-management programs proposed herein leverage the unique training and capabilities of MAs,
while considering minimizing costs and maintaining the flow of clinical practice. The benefits of resilience-
enhanced CBT that targets increasing patient well-being are also expected to extend beyond pain to potentially
include genomic effects. Telomere shortening is predictive of disease and mortality and is considered an index
for premature cellular aging. Our pilot data suggest that in addition to age and other physical and psychological
stressors, inadequately managed pain can also affect telomere attrition. Thus, in addition to demonstrating the
efficacy of online CBT self-management with resilience-enhancing activities (CBTRE), this application seeks to
evaluate the impact of CBTRE on telomere health. Our central hypothesis is that our MA-supported CBTRE
program will demonstrate superior efficacy to standard MA-supported online CBT self-management (eCBT)
alone (Aim 1) through the enhancement of well-being (Aim 2). Both the CBTRE and eCBT interventions will
improve telomere health with greater benefits being attributable to the CBTRE condition due to the mediating
benefits of well-being (Aim 3). Therefore, we will conduct a randomized controlled trial of 300 individuals with
spinal pain who also meet fibromyalgia criteria to investigate the effectiveness of the CBTRE program in
promoting functional status, improved symptoms, and genomic health using resources already in most medical
settings (i.e., MAs). By demons...

## Key facts

- **NIH application ID:** 9900058
- **Project number:** 5R01NR017096-04
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Afton L Hassett
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $510,267
- **Award type:** 5
- **Project period:** 2017-05-09 → 2022-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9900058

## Citation

> US National Institutes of Health, RePORTER application 9900058, Resilience Skills Self-Management for Chronic Pain (5R01NR017096-04). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/9900058. Licensed CC0.

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