Chronic Pain in Older Adults: A Neuroscience-Based Psychological Assessment and Treatment Approach

Date of CE Release: 01/13/2022

Date of CE Expiration: 01/13/2023

Learner Notification



Brandon C. Yarns, MD, MS
VA Greater Los Angeles Healthcare System, David Geffen Schoolof Medicine at UCLA


Tongtong A. Zhu, MD
David Geffen School of Medicine at UCLA, VA Greater Los AngelesHealthcare System


Ali Najafian Jazi, MD, MS
VA Greater Los Angeles Healthcare System


Summary: Over 100 million Americans suffer from chronic pain, and older pain patients have high rates of disability and more comorbidities and polypharmacy than younger adults. Psychological chronic pain treatments are highly suitable for older adults, as they can help decrease risk from opioids and other medical or surgical procedures. Yet established options—cognitive-behavioral therapy, acceptance and commitment therapy, and mindfulness meditation—produce only modest and time-limited benefits. This may be because they approach all chronic pain similarly, focus on accepting or coping with pain rather than pain reduction, and overlook major emotional and interpersonal drivers of chronic pain (e.g., life stress and trauma). An alternative approach, developed by Lumley & Schubiner (2019) and informed by recent research, will be presented in this webinar. The approach focuses on reducing or eliminating chronic pain with treatments based on the underlying mechanisms in individual cases. Chronic pain conditions with damage to peripheral tissues (e.g., knee/hip osteoarthritis, fracture) or peripheral nerves (e.g., diabetic neuropathy) often respond to medical or surgical interventions. Chronic pain conditions with central nervous system involvement (i.e., centralized pain conditions such as fibromyalgia and most musculoskeletal pain) have been shown to be highly responsive to two newer psychological treatments, Pain Reprocessing Therapy (PRT) and Emotional Awareness and Expression Therapy (EAET), which focus on life stress, emotions, and brain changes. PRT has evidence of normalizing brain activity, and EAET has demonstrated large benefits for older adults in two clinical trials. Both have been highlighted recently in the Washington Post and New York Times, and in a documentary, This Might Hurt. Key aspects of the treatments can be learned to increase the confidence and competence of geriatric mental health providers to assess and effectively treat chronic pain.


UAN: JA4008163-9999-22-001-H04-P
Activity Type: Knowledge Based

Objectives for Webinar:

  1. Understand the relationships between stress, emotions, the brain, and subtypes of chronicpain.
  2. Perform a brief, integrative assessment to elicit evidence of pain centralization.
  3. Use basic principles from Pain Reprocessing Therapy (PRT) and Emotional Awareness and Expression Therapy (EAET) to address centralized chronic pain in older adults.

 Acknowledgement of Support

This webinar is supported in part by an unrestricted educational grant provided by the American Board of Psychiatry and Neurology (ABPN).


Accreditation Statement

In support of improving patient care, this activity has been planned and implemented by Amedco LLC and American Association for Geriatric Psychiatry.  Amedco LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.



Amedco LLC designates this enduring material for a maximum of 1.0 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 



Amedco LLC designates this activity for a maximum of1.0 ANCC contact hours.



Amedco LLC designates this activity for a maximum of 1.0 knowledge-based CPE contact hours.



Amedco LLC designates this activity for a maximum of 1.0 psychologist contact hours. 


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Social Workers

As a Jointly Accredited Organization, Amedco is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. Amedco maintains responsibility for this course. Social workers completing this course receive 1.0 GENERAL continuing education credits.


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Disclosure of Relevant Financial Relationships:

The following table of disclosure information is provided to learners and contains the relevant financial relationships that each individual in a position to control the content disclosed to Amedco.  All of these relationships were treated as a conflict of interest, and have been resolved.  (C7 SCS 6.1-­‐6.2, 6.5)


All individuals in a position to control the content of CE are listed in the program book. If their name is not listed below, they disclosed that they had no relevant financial relationships.


Brandon C. Yarns

No relevant financial relationship exists

Tongtong A. Zhu

No relevant financial relationship exists

Ali Najafian Jazi

No relevant financial relationship exists



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AAGP January Webinar Presentation Slides 

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