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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.


  • Across 750 certified instructors, more than 10,000 patients have received Empowered Relief.
  • Empowered Reliefis available in 7 languages and is being delivered in 22 countries.
  • Cleveland Clinic has integrated Empowered Relief as standard care within Spine Surgery. In Cleveland Clinic alone >600 patients have received ER prior to their spine surgery. Empowered Relief is also standard care for certain pain procedures, such as low-dose ketamine infusions.
  • Cleveland Clinic has integrated Empowered Relief as standard care for all patients with chronic pain. Implementation article describing integration of Empowered Relief into surgical and chronic pain care pathways (2022, Davin et al:
  • Humana has adopted Empowered Reliefinto its clinical portfolio.
  • Empowered Relief is being piloted in the U.K. National Health Service orthopedic surgery patients.
  • Lehigh Valley Health Network, Cedar Sinai Healthcare, various Canadian pain clinics, the Canadian VA, and the Phoenix VA have adopted Empowered Relief as standard care.
  • As an instructor-delivered intervention, Empowered Relief may be delivered in-person or via Zoom.
  • 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.
  • Information on upcoming clinician certification workshops:

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 Reliefis 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 Reliefrelative 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 Reliefin 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 Reliefclinically 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, PCORI, CIHR).

  • 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), and those taking prescription opioids (PI: Ziadni). A Canadian Institutes for Health Research study (PI: Carriere) is examining Empowered Relief in primary care for patients with acute injury. A national study of Empowered Relief in Denmark is underway.
  • National comparative effectiveness trial.  The Stanford team is conducting a national comparative effectiveness trial of online delivered single-session Empowered Reliefvs. 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)

  • 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 national clinical trial begins March 2023.