Trial reportEuropean journal of pain (London, England)2026
Effectiveness of a Transdiagnostic Emotion-Focused Treatment in Clinical Care: A Sequential Single-Case Experimental Design.
Trial report in European journal of pain (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The trial behind it
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundChronic pain frequently co-occurs with emotional problems, highlighting the need for integrated treatment approaches. Previously, we evaluated a hybrid emotion-focused treatment with positive results. However, there is a dire need for studies evaluating treatments in 'real world' clinical contexts. Therefore, this study evaluated the effectiveness of this treatment in regular clinical care.
methodsUsing a sequential single-case experimental AB design with randomized baseline lengths (4, 5 or 6 weeks), pain, emotional problems and cognitive behavioural factors were assessed weekly across a 20-week study period. Additional outcome measurements were collected at pre-, post- and 12-month follow-up. Patients from primary and secondary care (final n = 31) with chronic pain and anxiety/depression were recruited, and their psychologists delivered the treatment. Individual effects were evaluated using non-overlap of all pairs and aggregated effects via multilevel shift models. Acceptability, adherence and fidelity were summarized, and responders and non-responders compared using group-level analyses.
resultsMost (87%) demonstrated a treatment response on ≥ 1 outcome, and over half (55%) on ≥ 3 outcomes. One-third were classified as broad responders. Aggregated analysis showed a significant effect on pain interference. The treatment was viewed as credible and acceptable, with greater satisfaction among responders. Non-responders showed more variability in attendance and lower progression through later treatment phases involving exposure.
conclusionThe findings support the feasibility and potential effectiveness of the hybrid emotion-focused treatment for patients in routine clinical care. The treatment benefits most patients to some extent and a smaller subset of patients to a clinically significant extent. SIGNIFICANCE STATEMENT: This pragmatic trial evaluates effectiveness in a clinically representative patient sample reflecting the complexity of routine care, including pain and psychiatric comorbidity, sociodemographic diversity and health care utilization. The hybrid emotion-focused treatment represents one of several emerging approaches targeting pain-emotion connections. These findings extend results from a prior RCT and highlight the importance of evaluating interventions under real-world clinical conditions.
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