BACKGROUND: Chronic low back pain (CLBP) is common and often refractory to existing treatments, necessitating long-term opioid therapy, which has substantial risks. Mindfulness-based (MBT) and cognitive behavioral (CBT) therapies are safe and can be effective for CLBP. AIMS: To better understand how MBT and CBT may help improve opioid-treated CLBP: METHODS: This qualitative study involved a...
ABSTRACT Background Healthcare workers experienced amplified depression and burnout during COVID-19. Both Mindfulness Based Stress Reduction (MBSR) and psilocybin have been shown to reduce depressive symptoms in this population, however the psychological mechanisms by which adding psilocybin to mindfulness training improves depression and trait mindfulness remain incompletely characterized....
Background Psychedelic-assisted psychotherapy (PAP) has demonstrated great promise for a variety of mental health problems. Many clinicians and researchers who are engaged in providing PAP report personal experiences with psychedelics; these experiences are often positive. Still, there are ongoing questions regarding the relevance of therapists personal experience with psychedelic drugs for the...
BACKGROUND: Spanish-speaking individuals in the U.S. face a number of barriers to quality pain care and limited access to culturally adapted treatments. While mindfulness-based interventions are effective for chronic pain, few have been translated for Spanish-speaking populations. This pilot study tested a brief, Spanish-language adaptation of Mindfulness-Oriented Recovery Enhancement (Spanish...
Mindfulness-based interventions are efficacious nonpharmacologic treatments for chronic pain, yet the psychological mechanisms mediating the pain-relieving effects of mindfulness-based interventions remain incompletely understood. One potential mechanism may involve nondual awareness, a state of consciousness characterized by attenuation of the subject-object duality, reduced self-referential...
OBJECTIVE Opioid misuse exacts a tremendous toll on society. Mindfulness-Oriented Recovery Enhancement (MORE) is an efficacious treatment for opioid misuse. Yet, the cost-effectiveness of this intervention remains unknown.
Chronic pain affects many cancer survivors yet remains underdiagnosed and inadequately managed. Existing treatments (e.g., opioids, NSAIDs) carry risks like addiction and limited long-term relief, while non-pharmacological options show modest effectiveness. Given these limitations innovative, evidence-based interventions are needed. Mindfulness-Oriented Recovery Enhancement (MORE), a multimodal...
Mindfulness-Oriented Recovery Enhancement (MORE) aims to foster adaptive attention and pain reappraisal. While research has demonstrated MORE's efficacy, the progression through which participants modify their relationship to pain remains unclear. To understand this process, we conducted a qualitative study with data from a clinical trial of MORE for patients with lumbosacral radicular pain...
Knee osteoarthritis (KOA) is a prevalent chronic pain condition that significantly impairs quality of life and is often treated with interventions that carry risks or provide limited relief. Reiki, a non-invasive complementary therapy, has shown early promise for pain management but lacks rigorous evaluation among American adults with KOA. This study evaluated the specific efficacy of Reiki and...
Background Depression and burnout, which are common among healthcare workers, were exacerbated by the COVID-19 pandemic. Mindfulness-Based Stress Reduction (MBSR) and psilocybin have been reported to reduce depressive symptoms, but the efficacy of the combination requires comparison to an active treatment control. We sought to evaluate the safety and preliminary efficacy of psilocybin and MBSR...
Background: Polysubstance use is common in alcohol use disorder (AUD) and associated with poor treatment outcomes. Cannabis and cocaine often co-used with alcohol, have no approved medication treatments and respond poorly to common behavioral treatments. Thus, treatments that can reduce use of these substances alongside AUD are critically needed. Objectives: We tested whether...
Individuals with substance use disorders often report altered interoceptive awareness of internal bodily signals. However, it is unclear whether these alterations also extend to patients with chronic pain who misuse opioids, and whether interventions that enhance interoceptive awareness, such as mindfulness-based therapies, may reduce opioid misuse in this population. At baseline, participants...
Meditation is a family of ancient and contemporary contemplative mind-body practices that can modulate psychological processes, awareness, and mental states. Over the last 40 years, clinical science has manualized meditation practices and designed various meditation interventions that have shown therapeutic efficacy for disorders including depression, pain, addiction, and anxiety. Over the past...
Key Points Question What is the comparative effectiveness of mindfulness-based therapy (MBT) and standard-of-care cognitive behavioral therapy (CBT) among adults with opioid-treated chronic low back pain (CLBP)? Findings In this randomized clinical trial of 770 adults with opioid-treated CLBP, although there were no differences between groups, both the MBT and CBT groups experienced improved...
Abstract Objective This clinical trial sought to evaluate the safety and preliminary efficacy of psilocybin and MBSR for frontline healthcare providers with symptoms of depression and burnout related to the COVID-19 pandemic. Methods This was a randomized controlled trial that enrolled physicians and nurses with frontline clinical work during the COVID-19 pandemic and symptoms of depression and...
In two randomized controlled trials, we tested the effect of two attentional mindfulness meditation practices on positive mental health. We hypothesized that attentional meditation would increase various positive emotions (gratitude, interest, hope, pride, elevation, and awe) via three processes induced by mindfulness (body awareness, meta-awareness, and self-transcendence) and that positive...
Introduction: Traditional, 8-week, mindfulness-based interventions can effectively treat chronic pain, but require a time and resource investment too burdensome for many patients and providers. The solution to this logistical challenge may be to distill the core, therapeutic elements of an efficacious 8-week, mindfulness-based intervention, Mindfulness-Oriented Recovery Enhancement (MORE), into...
The opioid crisis emerged in part due to the overprescribing of opioid analgesics for chronic pain. Although not the only source of the current epidemic of opioid use disorder (OUD), the prescription of opioids for chronic pain remains one vector for the development of opioid misuse and OUD. However, opioid tapering is not appropriate for all patients, and some patients may need to remain on...
Positive emotions are a promising target for intervention in chronic pain, but mixed findings across trials to date suggest that existing interventions may not be optimized to efficiently engage the target. The aim of the current pilot mechanistic randomized controlled trial was to test the effects of a positive emotion-enhancing intervention called Savoring Meditation on pain-related neural...
Self-referential processing is a core feature of human experience and includes a variety of mental faculties that support conception of the self, including internal representations that associate salient information to one's identity. It is well understood that self-referential processing is important for the onset, maintenance, prevention and treatment of psychiatric conditions, including...
Surgical procedures often improve health and function but can sometimes also result in iatrogenic effects, including chronic pain and opioid misuse. Due to the known risks of opioids and the physical, emotional, and financial suffering that often accompanies chronic pain, there has been a call for greater use of complementary non-pharmacological treatments like mindfulness-based interventions....
This article reports qualitative outcomes from a randomized controlled trial comparing eight weeks of cognitive-behavioral group therapy for chronic pain (CBT-CP) and mindfulness-based group therapy (MBT) in individuals with chronic low back pain (CLBP). Approximately 10 months post-treatment, 108 participants completed structured qualitative interviews to express how the study treatment...
Methadone treatment (MT) fails to address the emotion dysregulation, pain, and reward processing deficits that often drive opioid use disorder (OUD). New interventions are needed to address these factors. To evaluate the efficacy of MT as usual (usual care) vs telehealth Mindfulness-Oriented Recovery Enhancement (MORE) plus usual care among people with an OUD and pain. This study was a...
In addition to its health benefits, mindfulness has been theorized in classical contemplative frameworks to elicit self-transcendent experiences as a means of promoting universal love and compassion. Increasing feelings of love may be especially clinically relevant for the treatment of opioid misuse, in that addictive use of opioids dysregulates neurobiological processes implicated in the...
This systematic review aimed to compile existing evidence examining the effects of mindfulness-based interventions (MBIs) for chronic low back pain (CLBP). CLBP leads to millions of disabled individuals in the United States each year. Current pharmacologic treatments are only modestly effective and may present long-term safety issues. MBIs, which have an excellent safety profile, have been...