Overview
Over my career, I have played a key role in the development of clinical pain services and pain research programs at Duke Medical Center. For over 20 years, I directed the Duke Pain Management Program and was a leader in the development of Duke Medical Center's multidisciplinary pain programs (both out-patient and in-patient.) I collaborate actively with investigators in other countries (e.g. United Kingdom, South Africa, China, and Australia).
Over the course of my career, I have collaborated closely with investigators both in and outside my lab. Together we have developed and refined a number of treatment protocols for persistent pain conditions (e.g. pain in patients with advanced cancer; sickle cell disease, and persistent joint pain due to osteo- and rheumatoid arthritis) including partner and caregiver-assisted pain coping skills training interventions. We have conducted a number of NIH- and foundation- funded randomized clinical trials testing the efficacy of these and other behavioral interventions (e.g. aerobic exercise protocols, yoga based interventions, mindfulness-based interventions, forgiveness-based interventions, loving kindness meditation, and emotional disclosure).
I currently serve as a Co-Investigator on a number of NIH grants, a number of which are funded by the HEAL Initiative. Many of these grants are testing novel strategies for delivering training in pain coping skills (e.g. video over internet, web-based training, virtual reality interventions, and apps for mobile devices). Along these lines, I collaborated with Dr. Chris Rini to develop an internet-based program for training in pain coping skills called painTRAINER (available at mypaintrainer.org). This program is free to any individuals or health professionals who wish to use it. I have a keen interest in exploring the efficacy of these and other strategies (e.g. training physical therapists, social workers, and nurses) promise to increase access to behavioral pain management interventions making them more widely available to the large population of patients and caregivers who might benefit from them.I have published over 490 papers on topics ranging from pain coping strategies used during mammography to behavioral approaches to managing acute pain and pain at end of life. I have a longstanding interest in mentoring students and early career professionals interested in developing, testing, and disseminating novel protocols for managing pain, stress, and medical symptoms.
Current Appointments & Affiliations
Recent Publications
Why can we hurt ourselves? Human agency and embodied action in the attenuation of self-induced pain.
Journal Article Pain · May 1, 2026 Self-initiated actions often generate sensory signals perceived to be less intense than identical signals generated externally. This phenomenon, known as sensory attenuation, is particularly robust for nonpainful tactile sensations. For pain, however, even ... Full text Link to item CitePrevalence of Tobacco Use in Adults With Chronic Pain: Results From the National Health Interview Survey 2014-2023.
Journal Article Am J Prev Med · May 2026 INTRODUCTION: Chronic pain is linked to elevated tobacco use, but long-term trends in combustible smoking and E-cigarette use in this group remain unclear. Understanding these trajectories is vital for designing effective public health interventions. This ... Full text Link to item CiteInitial testing of a mobile app behavioral pain coping intervention for patients with cancer: Results of a pilot randomized controlled trial.
Journal Article J Psychosoc Oncol · April 8, 2026 OBJECTIVES: Behavioral management is recommended for cancer pain, yet not well integrated into clinical practice. PainPac is an asynchronous mobile application that delivers behavioral pain coping strategies. We evaluated PainPac's feasibility, acceptabili ... Full text Link to item CiteRecent Grants
Navigator-Assisted Non-Pharmacologic Pain Relief for Veterans with Back Pain
ResearchCo Investigator · Awarded by Patient-Centered Outcomes Research Institute · 2026 - 2031Neural correlates and behavioral impact of withdrawal-induced hyperalgesia among people who smoke with and without chronic pain
ResearchCo Investigator · Awarded by National Institute on Drug Abuse · 2025 - 2030A Mobile Health Behavior Intervention to Reduce Pain and Improve Health-III (MORPH-III)
ResearchPrincipal Investigator · Awarded by Wake Forest University · 2024 - 2029View All Grants