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Addressing chronic pain and suicide risk using Mindfulness-Based Cognitive Therapy: Rationale, design and baseline characteristics.

Lisham Ashrafioun, Anna Stephens, Hugh F Crean, Autumn M Gallegos, Kyle Possemato, Wilfred R Pigeon

Contemporary Clinical Trials November 1, 2025 DOI: 10.1016/j.cct.2025.108105 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Randomized clinical trial Peer reviewed
Sample size 76
Population Veterans reporting death or suicidal ideation and functional impairment from chronic pain
Interventions Mindfulness-Based Cognitive Therapy for Pain and Suicide (MBCT-P/S) Health Education
Duration 1-, 3-, and 6-month follow-up
Topics Meditation
Keywords Chronic pain Mindfulness-based cognitive therapy Suicide Veterans
Key findings Recruitment was completed faster than anticipated, supporting recruitment feasibility; baseline data revealed a clinically severe sample differing by condition on key suicide risk variables.

Abstract

Suicide risk and chronic pain are significant public health problems affecting veterans at a disproportionally high rate. There is a dearth of interventions directly targeting both chronic pain and suicide risk. Mindfulness-Based Cognitive Therapy for Pain and Suicide (MBCT-P/S) integrates components from MBCT-Pain and MBCT-Suicide, both of which demonstrate promising effects on their respective targets. We provide an overview of the rationale, design, and baseline characteristics of a randomized clinical trial of MBCT-P/S to assess feasibility and treatment acceptability. We refined a version of the MBCT-P/S drafted by the researchers through an evidence-based consensus method, integrating feedback from relevant subject matter experts. Veterans (n = 76) reporting death or suicidal ideation and functional impairment from chronic pain were recruited using Veterans Health Administration electronic medical record data. After consent, participants completed a baseline assessment and randomized to MBCT-P/S or Health Education. Baseline data revealed a diverse sample of veterans with a clinically severe profile that differed by condition on key suicide risk variables. Recruitment was completed faster than anticipated, supporting recruitment feasibility. Upcoming milestones include the completion of interventions and 1-, 3-, and 6-month follow-up assessments evaluating pain, suicide risk, and other key clinical indicators. Feasibility assessment will also include study retention by condition and therapist fidelity to the MBCT-P/S. Treatment acceptability will be assessed at the 1-month follow-up. Data generated from this study will provide critical insights into conducting a fully-powered efficacy trial evaluating the impact of MBCT-P/S on pain and suicide risk outcomes.

Comparable studies

Other randomized controlled trials on meditation, most cited first.

Study Year Design Participants
Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment 2003 Randomized controlled trial n = 41
Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients 2000 Randomized controlled trial n = 145
Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults 2008 Randomized controlled trial n = 139
Short-term meditation training improves attention and self-regulation Undergraduate Chinese students 2007 Randomized controlled trial n = 40
Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients 2004 Randomized controlled trial n = 73

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