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Co-occurrence of chronic musculoskeletal pain and long-term opioid treatment is well-established. Despite the very common use of physical therapy by persons with chronic musculoskeletal pain, these providers have not engaged efforts to manage co-occurring long-term opioid treatment.  

Physical therapy and mindfulness interventions can operate along common mechanistic pathways to disrupt the downward spiral of pain, catastrophic appraisal, and unconscious behavioral response including long-term opioid treatment.  Strong scientific premise suggests that integrating physical therapy and mindfulness treatments may be especially beneficial for persons with co-occurring chronic musculoskeletal pain and long-term opioid treatment.  

PT-IN-MIND refines an intervention that combines physical therapy and mindfulness interventions using the principles of Mindfulness-Oriented Recovery Enhancement (MORE) for patients with chronic musculoskeletal pain and long-term opioid treatment, then assesses the competency with which physical therapists provide the combined intervention and, finally, and evaluates the feasibility of this combined intervention in preparation for PT-IN-MIND’s future clinical trial.


A multi-site randomized feasibility trial is in preparation for conducting our future fully powered trial. Our 3 aims will be carried out sequentially.

  • Aim 1 refines a mindfulness-based intervention protocol currently being used by physical therapists with patients after spine surgery.  We need stakeholder feedback to refine this protocol for patients with chronic musculoskeletal pain and long-term opioid treatment being managed by physical therapists in outpatient setting.  Our future trial will require the training of physical therapists to provide this refined mindfulness-based intervention protocol. 
  • Aim 2 evaluates 2 different intensities of this mindfulness-based protocol training program for consideration for our future trial. 
  • Aim 3 will evaluate physical therapists’ fidelity to the refined mindfulness-based treatment protocol while assessing key feasibility outcomes.


    • Principal Investigator (PI) & University of Utah Site PI:  Jake Magel, PT, PhD, DSc 
    • University of Florida & Brooks Rehabilitation Site PI:  Jason Beneciuk, PhD, PT, DPT
    • Co-Investigators:
      • Julie Fritz, PhD, PT
      • Adam J. Gordon, MD, MPH, FACP, DFASAM
      • Eric Garland, PhD, LCSW
      • Adam Hanley, PhD
      • Jinching Shen, PhD
      • Elizabeth Siantz, PhD, MSW
    • Study Coordinator: Priscilla Blosser, RN, BSN


    • Department of Physical Therapy and Athletic Training at the University of Utah Hospital and Clinics
    • Brooks Rehabilitation and the Department of Physical Therapy at the University of Florida College of Public Health and Health Professions


    If you would like to learn more about PT-IN-MIND, you can contact us at or