Referrals and Case Consultation for Physicians and Clinicians

Patients I see and how I work

Chronic pain is at the center of my clinical work, from long-lasting neck and low back pain to widespread pain such as fibromyalgia, and I also treat migraine and chronic headache. I work especially with high-achieving professionals. Most patients come to me after a physician's evaluation of their pain or headache, and medical diagnosis, medication and any further workup stay with their physicians while psychological treatment runs alongside that care.

I lead with Emotional Awareness and Expression Therapy (EAET), which I trained in with its co-developers, Mark Lumley and Howard Schubiner, and which helps people work through past stressors and emotions they have learned to avoid. I also use Pain Reprocessing Therapy, which helps people reappraise pain so that it provokes less fear, and I completed the Pain Reprocessing Therapy Center's Foundational (Level I) training. The third method is attachment-oriented psychodynamic therapy informed by ISTDP (intensive short-term dynamic psychotherapy), and my approach explains how I combine the three.

How to refer a patient

Referrals start through my contact page or by email at admin@jinpsychological.com, and patients can book a free 15-minute discovery call there too, and treatment begins with a 60-minute initial consultation by secure video or in person on a Friday. The practice is private pay and does not bill insurance, and fees are on Services and fees. With a release of information signed by the patient and by you, I keep you and the rest of the care team, whether in neurology, primary care, sports medicine, rheumatology or physical medicine and rehabilitation, updated on our work. I welcome referrals early in a patient's care, so that psychological treatment can be part of the plan from the start.

Expert case consultation

The expert case consultation is a single 75-minute appointment with no commitment to ongoing treatment. Referring clinicians can book it for a consultation on a complex case, and patients can book it for a second opinion or a full review of their case. The fee is $425, and booking starts through the contact page.

Background in primary care and pain research

At the University of Washington I was an Acting Assistant Professor in Family Medicine, working in primary care behavioral health. I saw patients in primary care and sports medicine clinics, in person and remotely, and I provided clinical consultation to family medicine residents and primary care physicians.

My research asks how stress and emotion relate to chronic pain. In a 2026 research letter in the Journal of General Internal Medicine, my colleagues and I reported a 2023 online survey of 673 Black, Latine and Asian American adults with self-reported chronic pain. With stressful life events, racial group, age and gender taken into account, the association between race-based discrimination and centralized pain symptoms ran entirely through anger and perceived injustice, which EAET's anger work addresses.

What the research shows

Behavioral treatment has a recognized place in migraine care. The American Headache Society's 2021 consensus statement, by Ailani and colleagues in Headache, describes CBT, biofeedback and relaxation as effective preventive treatments for migraine, rated Grade A, and notes that they can be used alone or alongside medication. A 2025 meta-analysis in Headache by Treadwell and colleagues covered 50 randomized trials in adults. Compared with no treatment or usual care, CBT reduced migraine frequency by about 1.1 days a month (standardized mean difference −0.33, 95% CI −0.55 to −0.11; 10 trials, 839 participants), and relaxation training by about 1 day a month compared with control conditions (standardized mean difference −0.31, 95% CI −0.50 to −0.11; 13 trials, 1,091 participants).

EAET, which leads my migraine work, now has a preliminary randomized trial in migraine, reported in 2026 in Pain Medicine by Kaufmann and colleagues. Pain Reprocessing Therapy has a 2025 case series in Headache by Fishbein and colleagues, in which headache days fell substantially in all three patients with chronic migraine.

EAET has been compared directly with CBT. A 2024 randomized trial in JAMA Network Open by Yarns and colleagues assigned 126 older veterans with chronic pain at one VA medical center, with a mean pain duration of 23 years, to one therapy or the other. Each therapy ran for nine 90-minute sessions in person, eight of them in groups. The difference in pain severity on the 0-to-10 Brief Pain Inventory was −1.59 points after treatment (95% CI −2.35 to −0.83) and −1.01 at six months (95% CI −1.78 to −0.24), in favor of EAET. By the trial's estimates, 63.5% of the EAET group and 17.1% of the CBT group had at least a 30% reduction in pain after treatment. In a 2017 trial in Pain by Lumley and colleagues, 40 groups of adults with fibromyalgia (230 people) were randomized to eight 90-minute group sessions of EAET, CBT or education. Pain severity at the six-month primary endpoint was similar across the arms, and EAET did better than CBT on overall fibromyalgia symptoms and widespread pain, with more patients reaching at least a 50% reduction in pain (22.5%, compared with 8.3% with CBT).

Pain Reprocessing Therapy outperformed placebo and usual care by a wide margin. In a 2022 randomized trial in JAMA Psychiatry by Ashar and colleagues, 151 adults with primary chronic back pain in Boulder, Colorado, with a mean pain duration of 10 years, were assigned to the therapy, an open-label placebo injection or usual care. The therapy consisted of a telehealth evaluation and education session with a physician and eight individual therapy sessions over four weeks. After treatment, 66% of the therapy group (33 of 50) were pain-free or nearly pain-free, compared with 20% with placebo and 10% with usual care. In the 2025 five-year follow-up, 55% of the followed-up therapy group (21 of 38) were pain-free or nearly so, compared with 26% with placebo and 36% with usual care.

Short-term psychodynamic therapy reduced somatic symptoms more than usual care, minimal treatment or a waitlist in a 2020 meta-analysis by Abbass and colleagues of 17 randomized trials (2,004 participants) in functional somatic disorders such as functional gut disorders, fibromyalgia and mixed chronic pain.

Questions from clinicians

What does a pain psychologist do?

A pain psychologist assesses and treats the psychological side of persistent pain and related physical symptoms, such as stress, fear of pain, avoided emotion and long-standing relational patterns, through psychotherapy and consultation alongside the medical care that physicians provide.

Can psychologists prescribe medication in Washington?

No. Psychologists in Washington do not prescribe, so medication decisions stay with the patient's physicians, and my work complements that care.

Do headache guidelines recommend behavioral treatment for migraine?

The American Headache Society does. Its 2021 consensus statement, by Ailani and colleagues in Headache, describes CBT, biofeedback and relaxation as effective preventive treatments with Grade A evidence, and it notes that combining them with medication may work better than either alone.

Can a psychologist help with chronic pain?

Yes. A 2020 Cochrane review by Williams and colleagues covered 75 randomized trials in adults with chronic pain other than headache. CBT reduced pain at the end of treatment more than treatment as usual, including waiting lists (standardized mean difference −0.22, 95% CI −0.33 to −0.10; 29 studies, 2,572 participants; moderate certainty). In the 2024 veterans trial, EAET reduced pain more than CBT.

Is there a test for central sensitization?

The Central Sensitization Inventory (CSI) is a symptom questionnaire that rates the symptoms associated with central sensitization. A 2018 systematic review in Pain Practice by Scerbo and colleagues, covering 14 studies, found that it yields reliable and valid data for rating those symptoms. A 2013 study in The Journal of Pain by Neblett and colleagues, the inventory's developers, compared 121 patients at one pain center with 129 nonpatients. A score of 40 out of 100 best separated the patients with diagnosed central sensitivity syndromes from the nonpatients (sensitivity 81%, specificity 75%, AUC .86).

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References

Abbass, A., Town, J., Holmes, H., Luyten, P., Cooper, A., Russell, L., Lumley, M. A., Schubiner, H., Allinson, J., Bernier, D., De Meulemeester, C., Kroenke, K., & Kisely, S. (2020). Short-term psychodynamic psychotherapy for functional somatic disorders: A meta-analysis of randomized controlled trials. Psychotherapy and Psychosomatics, 89(6), 363–370. https://doi.org/10.1159/000507738

Ailani, J., Burch, R. C., Robbins, M. S., & Board of Directors of the American Headache Society. (2021). The American Headache Society Consensus Statement: Update on integrating new migraine treatments into clinical practice. Headache, 61(7), 1021–1039. https://doi.org/10.1111/head.14153

Ashar, Y. K., Gordon, A., Schubiner, H., Uipi, C., Knight, K., Anderson, Z., Carlisle, J., Polisky, L., Geuter, S., Flood, T. F., Kragel, P. A., Dimidjian, S., Lumley, M. A., & Wager, T. D. (2022). Effect of pain reprocessing therapy vs placebo and usual care for patients with chronic back pain: A randomized clinical trial. JAMA Psychiatry, 79(1), 13–23. https://doi.org/10.1001/jamapsychiatry.2021.2669

Ashar, Y. K., Low, E. L., Knight, K., Schubiner, H., Gordon, A., LeRoux, A., Lumley, M. A., & Wager, T. D. (2025). Pain reprocessing therapy vs placebo and usual care for patients with chronic back pain: 5-year follow-up of a randomized clinical trial. JAMA Psychiatry, 82(10), 1049–1051. https://doi.org/10.1001/jamapsychiatry.2025.1844

Fishbein, J. N., Schuster, N. M., Anders, A., Portera, A. M., & Herbert, M. S. (2025). Pain reprocessing therapy for migraine: A case series. Headache, 65(9), 1660–1665. https://doi.org/10.1111/head.15043

Jin, J., Shea, M., Yarns, B. C., & Jin, J. (2026). The impact of race-based discrimination on chronic pain beyond life adversity: An online survey study among U.S. adults. Journal of General Internal Medicine, 41(3), 872–874. https://doi.org/10.1007/s11606-025-09669-2

Kaufmann, D., Sturgeon, J. A., Mirow, S., Zinkhan, G., Schlesinger, N., Yarns, B. C., Kommit, K., Miller, A., & Lumley, M. A. (2026). Emotional awareness and expression therapy for migraine: A preliminary randomized controlled trial. Pain Medicine, 27(8), 948–951. https://doi.org/10.1093/pm/pnag034

Lumley, M. A., Schubiner, H., Lockhart, N. A., Kidwell, K. M., Harte, S. E., Clauw, D. J., & Williams, D. A. (2017). Emotional awareness and expression therapy, cognitive behavioral therapy, and education for fibromyalgia: A cluster-randomized controlled trial. Pain, 158(12), 2354–2363. https://doi.org/10.1097/j.pain.0000000000001036

Neblett, R., Cohen, H., Choi, Y., Hartzell, M. M., Williams, M., Mayer, T. G., & Gatchel, R. J. (2013). The Central Sensitization Inventory (CSI): Establishing clinically significant values for identifying central sensitivity syndromes in an outpatient chronic pain sample. The Journal of Pain, 14(5), 438–445. https://doi.org/10.1016/j.jpain.2012.11.012

Scerbo, T., Colasurdo, J., Dunn, S., Unger, J., Nijs, J., & Cook, C. (2018). Measurement properties of the Central Sensitization Inventory: A systematic review. Pain Practice, 18(4), 544–554. https://doi.org/10.1111/papr.12636

Treadwell, J. R., Tsou, A. Y., Rouse, B., Ivlev, I., Fricke, J., Buse, D. C., Powers, S. W., Minen, M., Szperka, C. L., & Mull, N. K. (2025). Behavioral interventions for migraine prevention: A systematic review and meta-analysis. Headache, 65(4), 668–694. https://doi.org/10.1111/head.14914

Williams, A. C. de C., Fisher, E., Hearn, L., & Eccleston, C. (2020). Psychological therapies for the management of chronic pain (excluding headache) in adults. Cochrane Database of Systematic Reviews, 2020(8), Article CD007407. https://doi.org/10.1002/14651858.CD007407.pub4

Yarns, B. C., Jackson, N. J., Alas, A., Melrose, R. J., Lumley, M. A., & Sultzer, D. L. (2024). Emotional awareness and expression therapy vs cognitive behavioral therapy for chronic pain in older veterans: A randomized clinical trial. JAMA Network Open, 7(6), Article e2415842. https://doi.org/10.1001/jamanetworkopen.2024.15842