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Empowered Relief® is a single-session (2-hour) intervention that rapidly equips patients with effective pain relief skills. Empowered Relief was developed by Beth Darnall in 2013 at the Stanford University School of Medicine. Empowered Relief is delivered by certified clinicians only.

The Empowered Relief line of science includes published evidence from four randomized controlled trials conducted at Stanford University School of Medicine involving patients with chronic pain and patients undergoing different types of surgery. All four trials have yielded clinically meaningful results and durable efficacy. Multidimensional benefits across a range of symptoms suggest that Empowered Relief is an all-purpose intervention for people with acute and chronic pain.

Adoption for Chronic Pain.

  • Across 800 certified instructors, more than 10,000 patients have received Empowered Relief.

  • Empowered Relief is available in 7 languages and in 25 countries.

  • Lehigh Valley Health Network, Cedars Sinai Healthcare, various Canadian pain clinics, the Canadian VA, and the Phoenix VA healthcare system in the U.S. has adopted Empowered Relief as standard care (meaning it is offered/recommended to all patients).

  • Cleveland Clinic has integrated Empowered Relief as standard care for all patients with chronic pain. Implementation article describing integration of Empowered Relief into chronic pain care pathways (2022, Davin et al: https://www.frontiersin.org/articles/10.3389/fpain.2022.856252/full)

  • In 2022 Allegheny Health Network received a generous donation from an anonymous donor to allow all patients in the broader health network receive Empowered Relief at no cost.

  • Humana has adopted Empowered Relief into its clinical portfolio.

Adoption for Post-Surgical Pain and Recovery.

  • Spine Surgery: Cleveland Clinic has integrated Empowered Relief as standard care for all patients undergoing spine surgery. Implementation article describing integration of Empowered Relief into chronic pain care pathways (2022, Davin et al: https://www.frontiersin.org/articles/10.3389/fpain.2022.856252/full)

  • Empowered Relief is adopted in the U.K. National Health Service for orthopedic surgery patients.

  • Stanford Hospitals and Clinics has adopted Empowered Relief as standard care for orthopedic trauma surgery patients (2023).

Results from Published Clinical Trials on Empowered Relief

Published Study 1: Chronic Low Back Pain  (N=263)

This NIH-funded randomized controlled trial revealed that single-session Empowered Relief is clinically equivalent to 16 hours of cognitive behavioral therapy (gold-standard behavioral treatment for chronic pain) at 3 months and 6 months post-treatment for reducing pain-related distress, pain intensity, pain interference, pain bothersomeness, depression, anxiety, fatigue and sleep disturbance.

Open access publication:  Darnall et al. 2021 publication in JAMA Netw Open received international coverage, an NIH press release and coverage in the NYTimes (Nov 2021).

Six-month treatment outcomes data show sustained clinically meaningful benefits for Empowered Relief and new superiority over CBT (Darnall et al, in development).

Published Study 2: Mixed-Type Chronic Pain  (N=105)

Study of online-delivered Empowered Relief revealed multi-dimensional and superior symptom reduction for patients who receive Empowered Relief relative to those who receive standard care.

Open access publication:  Ziadni et al. 2021 publication in JMIR.

Published Study 3: Breast Cancer Surgery  (N=63)

This randomized controlled trial tested a fully automated, on-demand version of Empowered Relief (called My Surgical Success) in women undergoing breast cancer surgery at Stanford Hospital. Women who engaged with the brief digital treatment required about one week less opioids after breast cancer surgery relative to women who received the digital health education control intervention (no active pain relief skills).

Open access publication:  Darnall et al. 2019 publication in Pain Medicine.

Study 4: Orthopedic Trauma Surgery  (N=84)

This randomized controlled trial to tested a fully automated, on-demand version of Empowered Relief in orthopedic trauma surgery at Stanford Hospital, with the majority receiving their assigned treatment on an iPad in the hospital days 1-3 after surgery. Patients who received the on-demand version of Empowered Relief (called My Surgical Success) reported less pain after surgery, and the analgesic benefits persisted to 3 months after surgery. Results suggest that Empowered Relief clinically meaningful and sustained analgesia and enhances recovery after surgery.

Open access publication:  Ziadni et al. June 2022 publication in Anesthesia and Analgesia.

Active research.

Across projects and principal investigators, current and past nationally funded research on Empowered Relief research totals $18M (NIH, U.S; PCORI, U.S.; CIHR, Canada).

  • Multiple patient populations. Four additional NIH-funded randomized controlled trials are active and involve different principal investigators studying efficacy in different pain diagnoses and patient populations including patients with migraine (PI: Sturgeon; NINDS), and those taking prescription opioids (PI: Ziadni; NIDA). A Canadian Institutes for Health Research study (PI: Carriere; CIHR) is examining Empowered Relief in primary care for patients with acute injury.

  • National comparative effectiveness trial.  The Stanford team is conducting a national comparative effectiveness trial of online delivered single-session Empowered Relief vs. online delivered 8-session CBT for mixed-etiology chronic pain (N=1200). This 6-site national trial launched in January 2023 and includes Humana as a collaborator. (PI: Darnall) https://www.pcori.org/research-results/2021/comparative-effectiveness-online-cognitive-behavioral-therapy-vs-online-single-session-pain-relief-skills-class-chronic-pain

  • Nurse-delivered Empowered Relief. Holly Watson, MS, MA, ANP-BC is principal investigator for a study funded by the American Society for Pain Management Nurses entitled “Addressing Pain Care Inequities with Empowered Relief Delivered by American Society for Pain Management Nursing Member Nurses: A Randomized Controlled Trial (the ERA study).” The study involves online nurse-delivered Empowered Relief tested in 170 individuals with mixed etiology chronic pain in the U.S.

  • Denmark: A national study of Empowered Relief is underway in Denmark.

  • Prescription opioid misuse. A NIDA funded randomized controlled trial is testing a fully automated version of Empowered Relief that is tailored to patients with chronic pain and comorbid opioid misuse (PI: Darnall). The intervention is interactive and available on-demand thus scaling access to home-based care. Enrollment for this international clinical trial begins July 2023.

Additional details:

  • As an instructor-delivered intervention, Empowered Relief® may be delivered in-person or via Zoom.

  • Versions of Empowered Relief® exist for chronic pain and for acute/surgical pain. Certification prepares clinicians to deliver both versions.

  • A Teen Empowered Relief® is developed and under study at Stanford University (led by Dr. Laura Simons) with an expected public release date in early 2024.

  • Information on upcoming clinician certification workshops: https://empoweredrelief.stanford.edu/