Emotional Awareness and Expression Therapy (EAET)
Project Summary
Emotional Awareness and Expression Therapy (EAET) is a promising psychological approach that directly addresses the trauma, stress, and emotional conflicts that often contribute to chronic pain in Veterans. This pragmatic trial will compare EAET with the VA’s current standard, Cognitive Behavioral Therapy for Chronic Pain, when the treatments are administered by VA clinicians in usual care settings at seven VA healthcare systems. The trial will generate actionable evidence on comparative effectiveness, treatment responsiveness among subgroups with trauma-related comorbidities, and implementation and cost outcomes.
Principal Investigator
Brandon Yarns
Impact and Contribution to PMC and Society
EAET represents a novel, neuroscience-informed approach that targets core emotional drivers of chronic pain, offering a path to meaningful pain reduction—and potentially pain resolution—for many Veterans. By testing EAET against the current VA standard in a pragmatic, multisite trial, this project will evaluate whether EAET could serve as a preferred treatment option, particularly for Veterans with trauma-related comorbidities. The findings will equip healthcare leaders with needed evidence to guide future policy and resource allocation. These contributions align directly with PMC’s mission to expand access to scalable, high-impact, nonpharmacological pain interventions.
Details
Institutions:
VA Greater Los Angeles Healthcare System
David Geffen School of Medicine at UCLA
Institute Providing Oversight:
National Center for Complementary and Integrative Health (NCCIH)
For an overview, visit clinicaltrials.gov NCT07218757
Project Narrative
Chronic pain is the leading cause of disability among U.S. military Veterans and is frequently maintained by trauma-related and emotional processes that are not directly addressed by many existing interventions. Emotional Awareness and Expression Therapy (EAET) is a neuroscience-informed intervention designed to directly target these emotional and trauma-related drivers of pain. Prior trials suggest that EAET may produce greater pain reduction for Veterans than standard treatments, but its comparative effectiveness and implementation feasibility in usual-care settings across diverse VA healthcare systems are unknown.
This pragmatic trial will compare group-based EAET with the current VA standard, Cognitive Behavioral Therapy for Chronic Pain (CBT-CP), for moderate-to-severe chronic non-cancer pain in more than 600 Veterans at seven geographically diverse VA healthcare systems. EAET and CBT-CP will be delivered by VA clinicians in usual care settings. Patient-reported outcomes will be collected at baseline, 10 weeks (posttreatment, primary endpoint), and 6- and 12-months posttreatment to evaluate pain intensity, functioning, emotional symptoms, and treatment responsiveness among clinical and demographic subgroups, particularly those with trauma-related comorbidities. A mixed-methods implementation evaluation and comprehensive cost analysis will examine treatment feasibility, acceptability, and system-level value.
The results of this project will provide the evidence needed to determine whether EAET should become a preferred treatment option for chronic non-cancer pain and will generate practical guidance on implementation requirements, scalability, and sustainability. This work directly advances the PMC’s mission by producing rigorous real-world evidence to guide policy, resource allocation, and dissemination of effective nonpharmacological pain treatments for Veterans.