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Research reveals transformative impact of mind/body approaches in chronic pain

A girl sitting with her hands on her temples like she has a headache.
Study identifies conditions for success and challenges, paving the way for future treatment 

Counseling researchers from the University of Rochester’s Warner School of Education have revealed promising insights into the effectiveness of mind/body interventions in treating chronic pain. The study, led by Douglas Guiffrida, professor of counseling and human development, alongside doctoral student Rachel Carter, Daniel Miller ‘21W (PhD), Jennifer Farah ‘21W (PhD) and former faculty member Scott McGuinness, not only supports the efficacy of the therapy in relieving chronic physical pain, but also identifies key conditions contributing to its success. 

Published in the Journal of Psychotherapy Integrationthe research focused on clients with chronic pain conditions unresponsive to mainstream medical treatments. Participants underwent a 10-week small group psychotherapy intervention integrating emotion-focused therapy and mindfulness. Through in-depth interviews and treatment observations, researchers gained valuable insights into the nuanced benefits and limitations of this intervention. 

Chronic pain affects over 20 percent of U.S. adults, surpassing the combined impact of heart disease, diabetes and cancer. Traditional medical interventions often fall short in treating chronic pain, making breakthroughs in mind/body interventions crucial. This qualitative study explores the perspectives of participants engaged in a small group psychotherapy intervention, providing an important first step in understanding the healing potential of mind/body approaches.

Guiffrida, who directs the advanced certificate program in mind/body healing and wellness at the Warner School, emphasizes that chronic pain has significant implications for physical and mental well-being. “Associated with issues such as depression, anxiety and sleep disturbances, innovative treatment approaches are necessary,” he says.

While common treatments include medication, physical therapy and surgery, recent research suggests psychological connections to both the causes and cures of chronic pain. This study contributes to empirical research supporting the efficacy of mind/body approaches, emphasizing emotional awareness and expression therapy in tandem with mindfulness.

Results of this small-scale qualitative study revealed that 36 percent of participants experienced significant improvements in both physical pain and emotional well-being, 46 percent noted moderate improvements, and 18 percent reported no changes. Conditions under which the integrated approach was perceived by participants as highly effective, moderately effective, or ineffective in alleviating chronic pain were also identified. 

Participants who experienced the most improvements shared commonalities, such as a strong belief in the approach’s effectiveness from the beginning, emotional expression in the group, comfort with others’ emotions, and completion of out-of-session homework. Those with moderate gains were open to the approach but skeptical, often continuing with medical interventions and perceiving the mind/body approach to be only a partial explanation of their physical pain relief, and only partially engaged in out-of-session homework. Those with no improvements expressed doubt from the beginning, an inability to express emotions, and discomfort in the group setting. They also articulated how their pain served them adaptively, providing benefits such as care from loved ones and a sense of control over their emotions, making it difficult to live without.

“Our study delineates the optimal conditions for the effectiveness of mind/body interventions, encompassing clients who exhibit a strong belief in mind/body interventions and trust both the process and the individuals involved—including fellow group members and facilitators,” says Guiffrida. “Successful participants attended sessions consistently, diligently completed assigned homework, demonstrated comfort with their own and others' intense emotions, and were willing to recognize and release secondary gains associated with their pain. We recommend psychotherapists evaluate these aspects at the outset when considering the implementation of mind/body interventions."

These findings contribute to the understanding of chronic pain treatment, informing future treatment protocols and interventions. They highlight the need for personalized approaches in mind/body interventions, recognizing the diverse perspectives and challenges. The study also supports previous research on emotional awareness and expression therapy for chronic pain treatment and emphasizes the potential to increase effectiveness by integrating mindfulness. 

Guiffrida emphasizes the transformative potential of mind/body psychotherapy, saying, “Our findings underscore the power of integrating mindfulness and emotion-focused approaches in addressing chronic pain. By understanding the nuanced experiences of individuals participating in this intervention, we pave the way for future breakthroughs in the treatment landscape, offering hope and healing to those grappling with the challenges of chronic pain."