# Improving the Assessment and Treatment of Chronic Pain in Veterans with Serious Mental Illness

> **NIH VA IK2** · BALTIMORE VA MEDICAL CENTER · 2020 · —

## Abstract

Anticipated Impacts on Veteran’s Healthcare: Chronic pain is a critical obstacle to the rehabilitation and
recovery of Veterans with serious mental illness (SMI; schizophrenia spectrum and bipolar disorders). The
Veteran Health Administration (VHA) has made treatment of chronic pain, especially nonpharmacological
approaches, a high priority and initiated a nationwide dissemination of Cognitive Behavioral Therapy for Chronic
Pain (CBT-CP) – an evidence-based psychotherapy – across the VHA system. However, CBT-CP has not been
scientifically tested in SMI populations and is largely not provided to Veterans with chronic pain and co-occurring
SMI, a group with some of the highest rates of chronic pain and associated negative functional outcomes. This
study will: 1) test the feasibility and acceptability of CBT-CP for improving pain-related functional outcomes in
Veterans with SMI; 2) examine the feasibility of ecological momentary assessment (EMA) to capture real-world
experiences of and relationships among pain, mental health symptoms; and 3) evaluate Veteran experiences
with CBT-CP to inform whether CBT-CP requires tailoring to optimize its use with Veterans with SMI and co-
occurring chronic musculoskeletal pain.
Project Background: Chronic pain is one of the most common physical health diagnoses among individuals
with SMI.1-3 Individuals with SMI and chronic pain report worse mental and physical health functioning relative to
people with other mental or physical health conditions. 4-8 Despite knowing about high rates of chronic pain
among individuals with SMI; little research has been conducted to further understand the complex relation
between pain and psychiatric symptoms and consider the usefulness or appropriateness of current treatment
approaches. What is known is problematic; Veterans with SMI are largely not provided options for
nonpharmacological pain management strategies, including CBT-CP, and are more likely to be prescribed pain
medications that pose unique risks to this population. 9-13
Project Objectives: The proposed CDA-2 research will address research and clinical gaps by better assessing
relations among chronic pain, psychiatric symptoms, and related functional impairment; and testing the feasibility
and acceptability of CBT-CP in Veterans with SMI. The first step of this research will focus on completing a small
randomized controlled trial of CBT-CP to examine feasibility and acceptability and explore changes to functioning
and quality life in 45 Veterans randomized to CBT-CP (n=30) relative to a Health & Wellness intervention (n=15).
We will assess rates of recruitment, initial intervention engagement, and session attendance (feasibility); assess
Veteran satisfaction with CBT-CP (acceptability); and preliminarily explore response to CBT-CP. The second step
will use EMA to collect real-time data (three times daily for one week) on Veterans’ pain, SMI symptoms, and their
impact on functioning using an automated telephone survey. ...

## Key facts

- **NIH application ID:** 9948431
- **Project number:** 1IK2RX003069-01A2
- **Recipient organization:** BALTIMORE VA MEDICAL CENTER
- **Principal Investigator:** Letitia Travaglini
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2020-02-01 → 2025-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9948431

## Citation

> US National Institutes of Health, RePORTER application 9948431, Improving the Assessment and Treatment of Chronic Pain in Veterans with Serious Mental Illness (1IK2RX003069-01A2). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9948431. Licensed CC0.

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