Pain Disengagement Training for chronic musculoskeletal pain and high pain catastrophizing

Pain Disengagement Training: A Self-directed Intervention for Pain Catastrophizing (Open Pilot)

This pilot will test a self-directed, writing-based Pain Disengagement Training to see if it helps adults with chronic musculoskeletal pain who have high pain catastrophizing.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 10 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Massachusetts General Hospital (Academic / other)
• Locations: 1 site (Boston, Massachusetts)
• Trial ID: NCT06870162 on ClinicalTrials.gov

What this trial studies

This open pilot will deliver a self-directed, writing-based Pain Disengagement Training to about 10 adults with chronic musculoskeletal pain and elevated pain catastrophizing. The trial will recruit Massachusetts General Hospital patients who meet inclusion criteria (pain ≥3 months, NRS ≥4, PCS ≥20, English fluency, ability to write/type for 30 minutes) and will exclude those with recent major treatment changes, severe untreated mental illness, active suicidality, serious progressive medical illness, or untreated substance use that would interfere. Primary aims are to measure feasibility benchmarks including recruitment, treatment acceptability, credibility, satisfaction, adherence, and feasibility of outcome assessments, and to conduct qualitative exit interviews about participant experience. Results will inform refinement of the intervention before a larger controlled trial.

Who should consider this trial

Good fit: Adults (≥18) with chronic musculoskeletal pain for at least 3 months, moderate pain (NRS ≥4), elevated pain catastrophizing (PCS ≥20), English-fluent, able to write or type for 30 minutes, and who have received care at Massachusetts General Hospital.

Not a fit: People with recent major medication or therapy changes, severe untreated mental illness or active suicidal intent, serious progressive medical illness, untreated substance use that would interfere, non-English speakers, or those unable to write for 30 minutes may not benefit from or be eligible for this pilot.

Why it matters

Potential benefit: If successful, this could provide an accessible, low-cost self-guided program to reduce catastrophic thinking and related pain interference.

How similar studies have performed: Prior mind-body and expressive writing approaches have shown benefits for chronic pain and catastrophizing, but this specific self-directed Pain Disengagement Training is a novel, small open-pilot implementation.

Eligibility criteria

Inclusion Criteria:

1. Outpatient adults (i.e., greater than or equal to 18)
2. Has self reported chronic musculoskeletal pain (i.e., pain persisting for at least 3 months)
3. Pain score greater than or equal to 4 (moderate) on the Numerical Rating Scale
4. Pain catastrophizing score greater than or equal to 20 on Pain Catastrophizing Scale
5. Willingness to engage in a writing-based intervention and self-reported ability to write or type for at least 30 minutes in a sitting
6. Received care at Massachusetts General Hospital
7. English verbal and writing fluency

Exclusion Criteria:

1. Clinically significant change in therapy or medication in the past 3 months
2. Severe untreated mental health condition (e.g., psychosis)
3. Active suicidality with history of plan or current intent
4. Serious illness expected to worsen in the next 6 months (e.g., cancer)
5. Untreated substance use problem that, per patient's self-report, would interfere with the ability to complete the intervention.

Where this trial is running

Boston, Massachusetts

• Massachusetts General Hospital — Boston, Massachusetts, United States (Recruiting)

Study contacts

• Principal investigator: Katherine McDermott, PhD — Massachusetts General Hospital
• Study coordinator: Katherine McDermott, PhD

Conditions Chronic Musculoskeletal Pain; pain catastrophizing