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
Spinal Manipulation and Clinician-Supported Biopsychosocial Self-Management for Acute Back Pain: The PACBACK Randomized Clinical Trial.
Journal Article JAMA · December 29, 2025 IMPORTANCE: Low back pain (LBP) is influenced by interrelated physical, psychological, and social factors. However, most treatments focus on symptom reduction without addressing the underlying biopsychosocial needs of patients. OBJECTIVE: To determine the ... Full text Link to item CiteExploring physiotherapist experiences and beliefs about psychologically informed practice to inform development of a training programme.
Journal Article Physiotherapy · December 2025 AIM: To explore physiotherapists' experiences, beliefs, and opinions about psychologically informed practice (PIP) in order to design a training programme for non-psychologist clinicians to enhance their PIP skills. DESIGN: This study adopted an interpreti ... Full text Link to item CiteStudy design and protocol of a randomized, pragmatic, comparative effectiveness trial evaluating a sequenced strategy for improving outcomes in people with knee osteoarthritis pain (SKOAP): Conservative treatment evaluation.
Journal Article Semin Arthritis Rheum · December 2025 BACKGROUND: Treatment guidelines for knee osteoarthritis (KOA) vary across organizations, partly due to the lack of high-quality evidence. Experts disagree on the role of psychological management, pharmacologic treatments including opioids, and interventio ... Full text Link to item CiteRecent Grants
Neural correlates and behavioral impact of withdrawal-induced hyperalgesia among people who smoke with and without chronic pain
ResearchCo Investigator · Awarded by National Institutes of Health · 2025 - 2030A Mobile Health Behavior Intervention to Reduce Pain and Improve Health-III (MORPH-III)
ResearchPrincipal Investigator · Awarded by Wake Forest University · 2024 - 2029Innovative modeling of the biopsychosocial model in animals: Validation of outcomes for assessing emotional and cognitive domains affected by naturally occurring chronic pain in dogs
ResearchPrincipal Investigator · Awarded by North Carolina State University · 2024 - 2027View All Grants