Video telehealth emotional awareness and expression therapy for older U.S. military veterans with chronic pain: A pilot study

Abstract

ABSTRACT Objectives Emotional Awareness and Expression Therapy (EAET) targets trauma and emotional conflict to reduce or eliminate chronic pain, but video telehealth administration is untested. This uncontrolled pilot assessed acceptability, feasibility, and preliminary efficacy of group-based video telehealth EAET (vEAET) for older veterans with chronic musculoskeletal pain. Methods Twenty veterans were screened, and 16 initiated vEAET, delivered as one 60-minute individual session and eight 90-minute group sessions. Veterans completed posttreatment satisfaction ratings and pain severity (primary outcome), pain interference, anxiety, depression, functioning, social connectedness, shame, and anger questionnaires at baseline, posttreatment, and 2-month follow-up. Results Satisfaction was high, and veterans attended 7.4 (SD = 0.6) of 8 group sessions; none discontinued treatment. Veterans attained significant, large reductions in pain severity from baseline to posttreatment (p < .001, Hedges’ g = −1.54) and follow-up (p < .001, g = −1.20); 14 of 16 achieved clinically significant (≥ 30%) pain reduction, and 3 achieved 90–100% pain reduction. Secondary outcomes demonstrated significant, medium-to-large improvements. Conclusions In this small sample, vEAET produced better attendance, similar benefits, and fewer dropouts than in-person EAET in prior studies. Larger, controlled trials are needed. Clinical Implications Group vEAET appears feasible and highly effective for older veterans with chronic pain.