{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T14:51:36Z","timestamp":1782399096663,"version":"3.54.5"},"reference-count":35,"publisher":"BMJ","funder":[{"name":"National Institute of Health Early Phase Pain Investigation Clinical Network","award":["K24NS126570"],"award-info":[{"award-number":["K24NS126570"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2026,6,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Trauma exposure is prevalent among individuals with chronic pain and is associated with poorer pain-related outcomes. Brief, scalable interventions that target overlapping trauma-pain processes are needed. This single-arm pilot study evaluated feasibility, acceptability, and changes in clinical outcomes following Stress, Trauma, and Emotional Processing for Pain (STEPP), a brief modified version of emotional awareness and expression therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adults (N=42) with mixed-etiology chronic pain and trauma exposure were enrolled. STEPP was delivered remotely over three\u2009weekly 1-hour individual sessions. Participants completed questionnaires at baseline, post-treatment, and 1-month, and 3-month follow-up. Feasibility benchmarks (\u226570%) were prespecified for recruitment, treatment, and follow-up completion. Acceptability was assessed using the Treatment Helpfulness Questionnaire (THQ; \u22125 to 5) and Credibility and Expectancy Questionnaire (content credibility and expected benefit; 3\u201327). Linear mixed models and Hedges\u2019 g effect sizes examined changes in pain intensity (0\u201310)\u2009and interference with functioning (0\u2013100), post-traumatic stress disorder symptoms (PTSD; 0\u201380), pain catastrophizing (concerns about pain; 0\u201352), and kinesiophobia (fear of movement; 17\u201368).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All feasibility benchmarks were met. 93% of eligible participants enrolled, 90% of enrolled participants initiated treatment, and 97% initiators completed treatment. Among completers, follow-up completion was 100% at post-treatment and 97% at 1 and 3 months. THQ ratings were high and met benchmarks (post M=4.0\u00b11.2; 1-month M=3.9\u00b11.2; 3-month M=3.8\u00b11.3). Credibility ratings met benchmarks, whereas expectancy ratings did not. Significant improvements were observed from baseline to post-treatment: pain intensity (mean change=\u22120.64, SE=0.23, 95%\u2009CI \u22121.11 to \u22120.18), pain interference (\u22123.34, SE=0.84, 95%\u2009CI \u22125.00 to \u22121.68), PTSD (\u22125.60, SE=1.53, 95%\u2009CI \u22128.64 to \u22122.57), pain catastrophizing (\u22126.69, SE=1.34, 95%\u2009CI \u22129.34 to \u22124.03), and kinesiophobia (\u22125.78, SE=1.21, 95%\u2009CI \u22128.19 to \u22123.37); changes were maintained through 3 months. Effect sizes were small for pain intensity and moderate-to-large for all other outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>STEPP demonstrated feasibility and acceptability, with promising improvements in pain-related and trauma-related outcomes. Randomized controlled trials are needed to establish efficacy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rapm-2026-107849","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T14:30:19Z","timestamp":1782397819000},"page":"rapm-2026-107849","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Pilot study of feasibility, acceptability, and changes in clinical outcomes following a brief trauma-focused intervention for chronic pain"],"prefix":"10.1136","clinical-trial-number":[{"clinical-trial-number":"nct06983327","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3845-6551","authenticated-orcid":false,"given":"Jolin B","family":"Yamin","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women\u2019s Hospital, Chestnut Hill, Massachusetts, USA"},{"name":"Harvard 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michaela","family":"Sawada","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women\u2019s Hospital, Chestnut Hill, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Rist","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, USA"},{"name":"Division of Preventive Medicine, Department of Medicine, Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert R","family":"Edwards","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women\u2019s Hospital, Chestnut Hill, Massachusetts, USA"},{"name":"Harvard Medical School, Boston, Massachusetts, 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