Emotional Awareness and Expression Therapy for People With Persistent Pain Following Orthopedic Trauma

Inclusion Criteria:

* One or more acute orthopedic injuries
* The patient sustained an orthopedic injury including, but not limited to:

  * Pelvic or acetabulum fracture
  * Open/displaced comminuted fracture of long bones
  * Upper extremity injuries with a major nerve involvement
  * Injuries with significant injuries to major blood vessels
  * Traumatic amputation of big toe, thumb, or proximal to the wrist or ankle.
* Initial admission to the trauma or orthopedic center/service of the participating hospital OR all necessary screening and patient characteristic data available in medical record (determination based on information available at time of enrollment)
* 18 years old or older
* Received operative fixation for at least one acute orthopaedic injury at a participating hospital. Patients should be recruited at the time of primary injury, not revision or complication surgery
* Average Brief Pain Inventory Score \> 3/10
* Presence of pain most days (\> 3 days/week) for past three months

Exclusion Criteria:

* peri-prosthetic fractures of the femur (regardless of etiology)
* non-ambulatory due to an associated spinal cord injury
* non-ambulatory pre-injury
* currently pregnant
* moderate or severe traumatic brain injury (TBI), as evidenced by intracranial hemorrhage present on admission CT
* major amputation(s) of the upper or lower extremities
* non-English speaking
* Likely to have severe problems with maintaining follow-up for any of the following reasons:

  * The patient has been diagnosed with a severe psychiatric conditions
  * The patient has current alcohol and/or drug addiction based on medical record or patient self-report.
  * The patient is intellectually challenged without adequate family support
  * The patient lives outside the hospital's catchment area
  * The patient follow-up is planned at another medical center
  * The patient is a prisoner
  * The patient is homeless
  * Other