Development of a Couple-based Mindfulness Intervention for Chronic Pain

Chronic pain is a costly public health problem that is associated with poor quality of life.
Previous research has demonstrated extensive evidence showing that pain coping is not
manifested by patients in isolation but within the context of significant relationships such
as marriage. For instance, a partner may avoid or reject their partners' negative emotions
about pain, provide unempathic responses to their partners' pain, or change their thoughts
about pain. The patient's pain experience and the couples' relationship also have a cyclical
relationship, in which both can affect each other and the overall quality of life for both
partners. Currently, current clinical practice does not target both partners to alleviate
pain. This is highly problematic given that a number of chronic pain patients—those with
interpersonal distress—often do not complete, and thus, do not benefit fully from existing
treatments. Even if treatment is completed, individuals may not maintain improvements if
they return to distressed social environments that undermine individual coping efforts.
Thus, it is clear that new interventions derived from integrative models of individual and
dyadic coping are needed to alleviate pain and suffering in patients who are at risk for
poor treatment outcomes. This research study aims to develop a novel psychological
intervention aimed at couples in which one partner has chronic pain. Our central hypothesis
is that a theoretically integrative intervention that improves both partners' psychological
flexibility (i.e., acceptance, mindfulness, values-based action) and relational flexibility
(i.e., emotional disclosure, empathic responding) skills will be feasible and valid and that
it will alleviate pain and improve quality of life. This is a departure from current
practice, which focuses solely on the patient's individual functioning, does not address the
spouse's psychological inflexibility, and does not address relationship issues.