Date of Award


Document Type


Degree Name

Doctor of Psychology (PsyD)


Graduate Department of Clinical Psychology

First Advisor

Mary Peterson, PhD

Second Advisor

Kathleen Gathercoal, PhD

Third Advisor

Laura Fisk, PsyD


Chronic pain is a well-known, significant problem in the United States, affecting approximately 55% of adults in Western countries. Opioid use to manage chronic pain impacts individual’s social, psychological, and physiological health. The shortcomings of monotherapy, such as opioid use, have been led to extensive research to develop and assess the outcome of multi-disciplinary evidence-based programs. Rather than eliminating pain, interventions focus on pain management and improving quality of life, independence, and mobility. This quasiexperimental study examined the effectiveness of the Persistent Pain Program (PPP), an 8-week Cognitive Behavioral Treatment program and movement therapy intervention for patients living in a rural area of Oregon. Outcome data for 168 patients enrolled in this program between 2015 and 2017 were analyzed. Pre, post, and follow-up assessments included the Brief Pain Inventory (BPI), Patient Health Questionnaire-9 (PHQ-9), Pain Self Efficacy Questionnaire (PSEQ), the Oswestry Low Back Pain and Disability Questionnaire (OLBPD), and Tampa Scale of Kinesiphobia (TSK). Data were analyzed using a repeated measure MANOVA, to assess the differences from pre-intervention, through post intervention, and post follow-up. The results indicated that from pre-intervention to post-intervention most tests showed small to moderate improvements. Also, examining the period from post intervention through follow-up (assessed at greater than 6 months post-treatment) most measures indicated that patients were able to maintain their progress. Lastly, in comparison of pre-intervention and post-follow up, the results confirmed that the intervention showed small to moderate improvements on all outcome measures. The results suggest the PPP was associated with reduced pain severity and depressive symptoms and improved movement. Limitations and recommendations for future research are discussed.