Chronic Pain, Trauma, and Recovery

Time: 9:00pm-4:00pm

Location: Virtual

Instructor: Matthew Jakupcak, Ph.D.

CE credits: 6 CE's (pending)

Course Description:

This workshop highlights for learners the prevalence and high rate of comorbidity between chronic pain and trauma-related reactions such as PTSD, depression, and health-related anxiety, particularly among veteran populations. Theoretical mutual-maintenance models (Asmundson, Coons, Taylor & Katz, 2002; Sharp & Harvey, 2001) are helpful for clinicians to understand how these two conditions interact to create a "vicious cycle" of arousal and avoidance, where physical pain, bodily vigilance and cued trauma reactions reinforce one another, leading to significant disability and reduced quality of life.

Dr. Jakupcak will present information specific to the interrelationships between chronic pain and trauma, including posttrauma reactions such as Post Traumatic Stress Disorder (PTSD), depression, and healthy anxiety. In addition, Dr. Jakupcak will review the applications evidence-based treatments that can address both chronic pain functioning and common co-occurring mental health conditions, including Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and Behavioral Activation (BA).

 Objectives:

At the end of this training participants will:

1. Be able to describe theoretical frameworks where PTSD symptoms (like hyperarousal and avoidance) increase pain sensitivity and bodily vigilance, informing greater disability and impairment. (Mutual Maintenance Models)
2. Learn about specific evidence-based therapies such as CBT, ACT and BA to help patients re-engage in life activities despite pain and stress. This course emphasizes "valued living"—moving toward what matters rather than just "fixing" symptoms. (Breaking the Cycle)
3. Develop strategies for addressing specific common hurdles to recovery such as opioid use, sleep disturbances, and the "numbing" symptoms of trauma and PTSD that often interfere with traditional pain rehabilitation. (Clinical Challenges)

References:

Holley AL, Wilson AC, Noel M, Palermo TM. Post-traumatic stress symptoms in children and adolescents with chronic pain: A topical review of the literature and a proposed framework for future research. Eur J Pain. 2016 Oct;20(9):1371-83. 

Otis JD, Comer JS, Keane TM, Checko Scioli E, Pincus DB. Intensive Treatment of Chronic Pain and PTSD: The PATRIOT Program. Behav Sci (Basel). 2024 Nov 16;14(11):1103. 

Ravn S, Hartvigsen J, Hanse M, Sterling M, Elmose T. Do post-traumatic pain and post-traumatic stress symptomatology mutually maintain each other? A systematic review of cross-lagged studies. Pain 2018;159:2159–69.