Access Type

Open Access Dissertation

Date of Award


Degree Type


Degree Name




First Advisor

Mark A. Lumley


Chronic pain is a leading cause of suffering, disability, and high health care costs. Traditional treatment approaches such as medical or cognitive-behavioral interventions have produced variable and often limited results. Research has suggested

that increased rates of stressful life events, emotional disorders, and emotion regulation deficits contribute to the development and maintenance of chronic pain problems that lack clear, peripheral, biological causes. This study examined the effectiveness of an

innovative, emotion-focused treatment that directly targets patients' unresolved stress and emotional avoidance and sought to identify predictors of treatment outcome. Additionally, this study explored the effects of a novel, emotional assessment on treatment outcome by randomizing half of the participants to complete this assessment

prior to treatment.

To be included in the study, patients reported chronic pain for at least 3 months duration that had substantial psychological factors that contributed to the pain. Forty-six patients participated (76% women and 91% Caucasian). Pain, pain-related disability,

depression, general emotional distress, and satisfaction with life were assessed at baseline, post-treatment, and a 3-month follow-up. Stressful life events and emotion regulation ability were also assessed at baseline. The 4-session group treatment uses

readings, writing about emotions, meditation, and other techniques to help people identify, understand, and verbalize emotions related to stressful life events or emotional conflict.

Results indicated significant improvements for pain, pain-related disability and acceptance, depression, general emotional distress, and satisfaction with life. Effect sizes were generally medium or large and reliable change analyses indicated that approximately half of the patients showed at least a moderate effect across all the

outcome domains. Increased levels of baseline depression and stress generally predicted improved treatment outcomes, whereas poorer baseline emotion regulation predicted inconsistent results. The baseline emotional assessment had no significant effect on the outcome measures. This study suggests that this emotion-focused

treatment led to substantial improvements in pain, pain-related functioning, and emotional symptoms. Further research should seek to clarify the predictors of treatment outcome and the process by which it works.