Meditation Versus Education for Improving Depression in Chronic Pain, a Randomized Controlled Trial
Chronic Pain, Depression
About this trial
This is an interventional treatment trial for Chronic Pain focused on measuring Opioid Therapy, Sahaj Samadhi Meditation, Health Enhancement Program
Eligibility Criteria
Inclusion Criteria:
- ≥18 years of age;
- 2. Significant depressive symptomology (PHQ-9 score ≥10);
- Chronic pain (pain ≥3 months duration in any body region, by self-report);
- Be willing and able to attend all 4 training sessions of SSM/HEP and 75% of follow-up sessions;
- Understanding of English language (spoken and written);
- Able to sit for 20-25 minutes without significant discomfort;
- Regular access to internet and ability to participate in video calls
Exclusion Criteria:
- Other major psychiatric conditions including substance use disorder, psychosis and cognitive impairment as excluded by the Mini-International Neuropsychiatric Interview (MINI) Screening and Standard tool; severe depression (PHQ-9 ≥20) and risk of imminent suicide as per MINI and/or PHQ-9;
- Non-correctable, clinically significant sensory impairment;
- Acutely unstable medical illnesses, including delirium or acute cerebrovascular or cardiovascular events within the last 6 months;
- A terminal medical diagnosis with prognosis of less than 12 months;
- Currently practising any form of mind-body intervention;
- Inability to provide informed consent
Sites / Locations
- Bridgepoint Collaboratory, Sinai Health
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Active Control Group
Intervention Group
Ten to fifteen participants in the HEP arm will participate in the program for 4 consecutive days (2hrs/day) in the 1st week, followed by 75 min/week reinforcement sessions for 11 weeks. The Health-Enhancement Program (HEP) was designed and used as a manualized active control in meditation-based intervention trials. HEP controls for several non-specific factors found in a meditation groups, including: group support and morale, behavioural activation, reduction of stigma, facilitator attention, treatment duration, and time spent on at-home practice. HEP is tailored to be structurally equivalent to SSM with similar-sized groups, meeting schedule, total contact hours, amount of home practice and encouragement to keep practice logs.
Ten to fifteen participants in the SSM arm will be trained for 4 consecutive days (2hrs/day) in the 1st week, followed by 75 min/week reinforcement sessions for 11 weeks. This standardized, manualized therapy will be delivered by certified meditation instructors. On day 1, participants will learn the nature of meditation, and then undergo personal guided meditation. Training on days 2-4 includes understanding the nature of the mind and the thoughts arising from it, guided meditations by the instructor, and a discussion of meditation processes. Weekly 75 min reinforcement sessions will include 20 minutes of guided meditation practice, and then focus on participants' experiences with meditation during the week, additional observations, and a review of relevant knowledge to support their home practice. Participants will also be encouraged to practice twice daily at home for 20 minutes per session.