Chronic Pain Therapists in Indianapolis, IN

Photo of Dorit Tomandl, Marriage & Family Therapist in Indianapolis, IN
Dorit Tomandl
Marriage & Family Therapist, LMFT
Verified Verified
1 Endorsed
Indianapolis, IN 46240
The word psychotherapist is greek and means "Healer of the Soul". When you come into my office, I will not label you with anxiety, depression, addiction or any other disorder. You will hear me ask questions like: How is your addiction protecting you from pain? What do you not feel when depression numbs you? Once you witness and heal the wounds of your soul (you can also call it trauma), the symptoms (the 'disorder') can disappear. If you are interested in having a deeper understanding and awareness of your emotions, I will help you to develop a relationship with yourself that is characterized by curiosity, respect and compassion.
The word psychotherapist is greek and means "Healer of the Soul". When you come into my office, I will not label you with anxiety, depression, addiction or any other disorder. You will hear me ask questions like: How is your addiction protecting you from pain? What do you not feel when depression numbs you? Once you witness and heal the wounds of your soul (you can also call it trauma), the symptoms (the 'disorder') can disappear. If you are interested in having a deeper understanding and awareness of your emotions, I will help you to develop a relationship with yourself that is characterized by curiosity, respect and compassion.
(317) 203-8288 View (317) 203-8288
Photo of Rachael S Glasser, Marriage & Family Therapist in Indianapolis, IN
Rachael S Glasser
Marriage & Family Therapist, MS, MA, LMFT
Verified Verified
Indianapolis, IN 46240
I have training in Medical Family Therapy which explores the emotional impact of illness on all members of the family.
We all create a set of expectations of ourselves, our world, and others, beginning with our earliest relationships. I enjoy working with clients who are interested in exploring how these beliefs either strengthen or distort our approach to relationships, medical issues, trauma, and/or challenges. I have a general practice dealing with issues of depression, anxiety, adjustment, marital, and family issues. I also work with clients and their families who are coping with medical and/or genetic diagnoses. I see soldiers and/or their spouses who are adjusting to military related issues and deployments.
I have training in Medical Family Therapy which explores the emotional impact of illness on all members of the family.
We all create a set of expectations of ourselves, our world, and others, beginning with our earliest relationships. I enjoy working with clients who are interested in exploring how these beliefs either strengthen or distort our approach to relationships, medical issues, trauma, and/or challenges. I have a general practice dealing with issues of depression, anxiety, adjustment, marital, and family issues. I also work with clients and their families who are coping with medical and/or genetic diagnoses. I see soldiers and/or their spouses who are adjusting to military related issues and deployments.
(317) 427-6369 View (317) 427-6369
Photo of Michael F Herrmann, Clinical Social Work/Therapist in Indianapolis, IN
Michael F Herrmann
Clinical Social Work/Therapist, LCSW, PhD
Verified Verified
Indianapolis, IN 46260
Much of my practice fouses on working with a variety of stress related disorders and diseases as well as pain management.
(Biofeedback and Neurobiofeedback see profile for details.) I have been a clinican since 1973. It is through this depth of experience I have come to realize that we are all just innocent beings who, through conditioning, forgot who we truly are - perfect, loving, and whole. Therapy then becomes a process of remembrance and realignment with our true Self.
Much of my practice fouses on working with a variety of stress related disorders and diseases as well as pain management.
(Biofeedback and Neurobiofeedback see profile for details.) I have been a clinican since 1973. It is through this depth of experience I have come to realize that we are all just innocent beings who, through conditioning, forgot who we truly are - perfect, loving, and whole. Therapy then becomes a process of remembrance and realignment with our true Self.
(317) 527-1517 View (317) 527-1517
Photo of Chloe Shaffer, Counselor in Indianapolis, IN
Chloe Shaffer
Counselor, MA, LPC, LMHCA, NCC
Verified Verified
2 Endorsed
Indianapolis, IN 46208  (Online Only)
Waitlist for new clients
I am most skilled in Anxiety Disorders, Anger Management, and people with Chronic Pain.
My name is Chloe Shaffer, and I am an (LPC) in Illinois and (LMHCA) in Indiana. I provide virtual counseling to adults residing only in Indiana at this time. I do accept Medicaid insurance, contact me to check eligibility. Waitlist due to upcoming maternity leave; returns 8/5/24.
I am most skilled in Anxiety Disorders, Anger Management, and people with Chronic Pain.
My name is Chloe Shaffer, and I am an (LPC) in Illinois and (LMHCA) in Indiana. I provide virtual counseling to adults residing only in Indiana at this time. I do accept Medicaid insurance, contact me to check eligibility. Waitlist due to upcoming maternity leave; returns 8/5/24.
(812) 608-3532 View (812) 608-3532
Photo of Katherine Georgeoff Mohr, Clinical Social Work/Therapist in Indianapolis, IN
Katherine Georgeoff Mohr
Clinical Social Work/Therapist, MSW, LCSW, LCAC
Verified Verified
Indianapolis, IN 46202  (Online Only)
Sleep troubles, Trauma, Chronic Pain, Anxiety or Depression negatively impacting your life? I believe clients are the expert of themselves. I have additional tools through training and experience to be part of a team approach with a client in the process of recovering from Insomnia, traumatic event(s) and other issues, in a relatively short amount of time when compared to typical therapies. Evidence-Based Therapy may be of interest to you because the rigorously researched therapy has shown to have consistent outcomes, tends to be less sessions than standard supportive therapy, which can be more cost-effective since less visits.
Sleep troubles, Trauma, Chronic Pain, Anxiety or Depression negatively impacting your life? I believe clients are the expert of themselves. I have additional tools through training and experience to be part of a team approach with a client in the process of recovering from Insomnia, traumatic event(s) and other issues, in a relatively short amount of time when compared to typical therapies. Evidence-Based Therapy may be of interest to you because the rigorously researched therapy has shown to have consistent outcomes, tends to be less sessions than standard supportive therapy, which can be more cost-effective since less visits.
(765) 436-1048 View (765) 436-1048
Photo of KP Puckett, Marriage & Family Therapist Associate in Indianapolis, IN
KP Puckett
Marriage & Family Therapist Associate, MS, LMFTA
Verified Verified
Indianapolis, IN 46216
Waitlist for new clients
I have worked with many clients who have felt that something was wrong with them for most of their lives, and these messages have caused deep pain. Through my training and through building connection, trust, and comfort, we better identify where these painful narratives come from. Clients are more able to then choose alternative narratives and experience themselves and their lives differently. My specialization lies in working with individual adults and couples who are LGBTQIA+, neurodivergent, and non-monogamous. I am passionate about supporting people during periods of change, exploration, and healing from complex trauma.
I have worked with many clients who have felt that something was wrong with them for most of their lives, and these messages have caused deep pain. Through my training and through building connection, trust, and comfort, we better identify where these painful narratives come from. Clients are more able to then choose alternative narratives and experience themselves and their lives differently. My specialization lies in working with individual adults and couples who are LGBTQIA+, neurodivergent, and non-monogamous. I am passionate about supporting people during periods of change, exploration, and healing from complex trauma.
(317) 754-7038 View (317) 754-7038
Photo of Hillary Blake, Psychologist in Indianapolis, IN
Hillary Blake
Psychologist, PsyD , HSPP
Verified Verified
Indianapolis, IN 46260
I assist children and adolescents in coping with medical conditions or symptoms such as headaches, pain, adherence problems, and FND.
I am a clinical psychologist who provides assessment and treatment for individuals with a wide range of emotional and physical conditions. In psychotherapy I utilize evidence based interventions and have extensive training in biofeedback, SPACE, DBT, CBT, and parent training. I was previously an Assistant Professor in Clinical Psychology at Riley Hospital. I continue to remain involved at Riley as a Visiting Professor at the IU School of Medicine. I have been featured in regional and national news as a mental health expert.
I assist children and adolescents in coping with medical conditions or symptoms such as headaches, pain, adherence problems, and FND.
I am a clinical psychologist who provides assessment and treatment for individuals with a wide range of emotional and physical conditions. In psychotherapy I utilize evidence based interventions and have extensive training in biofeedback, SPACE, DBT, CBT, and parent training. I was previously an Assistant Professor in Clinical Psychology at Riley Hospital. I continue to remain involved at Riley as a Visiting Professor at the IU School of Medicine. I have been featured in regional and national news as a mental health expert.
(317) 854-4694 View (317) 854-4694
Photo of Melissa Nulton, Clinical Social Work/Therapist in Indianapolis, IN
Melissa Nulton
Clinical Social Work/Therapist, LCSW
Verified Verified
Indianapolis, IN 46280
Melissa practices using cognitive-behavioral therapy, acceptance and commitment therapy, solution-focused therapy, motivational interviewing, trauma-informed care, and mindfulness therapy and practices to help to heal psychological trauma and to help reduce physical pain.
Melissa Nulton is a Licensed Clinical Social Worker who has been working in the mental health field since 2002. She started as a Case Manager in a community mental health center and then transitioned to becoming a Licensed Clinician once she obtained her Licensed Clinical Social Work licensure in 2010. She graduated with a Bachelor of Arts degree in 2000, as well as a Master of Social Work degree with High Distinction in 2008 from Indiana University.
Melissa practices using cognitive-behavioral therapy, acceptance and commitment therapy, solution-focused therapy, motivational interviewing, trauma-informed care, and mindfulness therapy and practices to help to heal psychological trauma and to help reduce physical pain.
Melissa Nulton is a Licensed Clinical Social Worker who has been working in the mental health field since 2002. She started as a Case Manager in a community mental health center and then transitioned to becoming a Licensed Clinician once she obtained her Licensed Clinical Social Work licensure in 2010. She graduated with a Bachelor of Arts degree in 2000, as well as a Master of Social Work degree with High Distinction in 2008 from Indiana University.
(317) 597-1817 View (317) 597-1817
Photo of Mary Elizabeth Guynn in Indianapolis, IN
Mary Elizabeth Guynn
MA, MHC
Verified Verified
2 Endorsed
Indianapolis, IN 46256  (Online Only)
They cover up old and current wounds, hurts, and pain.
Silent and negative non-verbal thoughts to ourselves about life's circumstances can and will hurt us. They are the misbeliefs or lies we silently tell ourselves, over and over again about why we feel the way we feel when we experience suffering. Our silent, negative non-verbal thoughts become our negative self-talk and keep us stuck in life's circumstances. We can choose to make a difference. We can choose to recognize the misbeliefs or lies we tell ourselves so that we can start the healing process of moving forward.
They cover up old and current wounds, hurts, and pain.
Silent and negative non-verbal thoughts to ourselves about life's circumstances can and will hurt us. They are the misbeliefs or lies we silently tell ourselves, over and over again about why we feel the way we feel when we experience suffering. Our silent, negative non-verbal thoughts become our negative self-talk and keep us stuck in life's circumstances. We can choose to make a difference. We can choose to recognize the misbeliefs or lies we tell ourselves so that we can start the healing process of moving forward.
(317) 900-4103 x113 View (317) 900-4103 x113
Photo of Peace of Mind Counseling Services, LLC, Counselor in Indianapolis, IN
Peace of Mind Counseling Services, LLC
Counselor, PhD, LMHC, NCC, ACS, EMDR
Verified Verified
1 Endorsed
Indianapolis, IN 46240
​Most people come to counseling either feeling stuck in their present situation or in significant emotional pain. Our ambition is to help you resolve or learn ways to better manage your concern(s) in a safe and experiential environment. It would be a great privilege to join you during this time in your life. Be confident that your therapeutic work is of great value to us, and it is our mission to support you in a nonjudgmental, culturally-sensitive, and caring manner.
​Most people come to counseling either feeling stuck in their present situation or in significant emotional pain. Our ambition is to help you resolve or learn ways to better manage your concern(s) in a safe and experiential environment. It would be a great privilege to join you during this time in your life. Be confident that your therapeutic work is of great value to us, and it is our mission to support you in a nonjudgmental, culturally-sensitive, and caring manner.
(317) 953-5683 View (317) 953-5683
Photo of Amy Amico, Clinical Social Work/Therapist in Indianapolis, IN
Amy Amico
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
1 Endorsed
Indianapolis, IN 46227
Navigating challenges in life can leave one feeling exhausted and stressed. Anxiety, depression, and negative self-talk can become a struggle, and leave one feeling unsupported and alone. Whether it is caring for a loved one, journeying through the foster care or adoption systems, a life change, facing mental health symptoms as a result of chronic illness, grief and loss, or an unexpected circumstance that you would never choose for yourself, I am here to support and promote resiliency, growth, and self-confidence. I provide a safe place for you to courageously unpack your story to gain clarity and reach goals. www.pathwaysindy.com
Navigating challenges in life can leave one feeling exhausted and stressed. Anxiety, depression, and negative self-talk can become a struggle, and leave one feeling unsupported and alone. Whether it is caring for a loved one, journeying through the foster care or adoption systems, a life change, facing mental health symptoms as a result of chronic illness, grief and loss, or an unexpected circumstance that you would never choose for yourself, I am here to support and promote resiliency, growth, and self-confidence. I provide a safe place for you to courageously unpack your story to gain clarity and reach goals. www.pathwaysindy.com
(463) 222-0858 View (463) 222-0858
Photo of Amy Ikerd, Clinical Social Work/Therapist in Indianapolis, IN
Amy Ikerd
Clinical Social Work/Therapist, MSW, LCSW, LCAC
Verified Verified
8 Endorsed
Indianapolis, IN 46226
NOTE: At this time, I am only offering EMDR Intensives or EMDR for a recent traumatic event. Through my experience working in mental health and addiction treatment, I've adopted a style of therapy that is both direct AND empowering and supportive. My experience allows for me to be flexible in my treatment approach, ensuring that I am providing counseling services that are individualized to meet your needs. My therapy strengths are in treating addictive disorders, PTSD/complex trauma, anxiety disorders, chronic pain, and working with first responders.
NOTE: At this time, I am only offering EMDR Intensives or EMDR for a recent traumatic event. Through my experience working in mental health and addiction treatment, I've adopted a style of therapy that is both direct AND empowering and supportive. My experience allows for me to be flexible in my treatment approach, ensuring that I am providing counseling services that are individualized to meet your needs. My therapy strengths are in treating addictive disorders, PTSD/complex trauma, anxiety disorders, chronic pain, and working with first responders.
(317) 943-8817 View (317) 943-8817
Photo of Erin Jones, Clinical Social Work/Therapist in Indianapolis, IN
Erin Jones
Clinical Social Work/Therapist, LCSW
Verified Verified
Indianapolis, IN 46222
I enjoy working with clients to help them improve their relationship issues, feeling disconnected, family dynamic issues, changing behaviors, loneliness, hopelessness, emotional pain and traumas. I use a holistic approach looking at the whole person: mind, body and soul. I feel it is an honor to be involved in helping clients improve their spiritual, emotional and mental wellbeing.
I enjoy working with clients to help them improve their relationship issues, feeling disconnected, family dynamic issues, changing behaviors, loneliness, hopelessness, emotional pain and traumas. I use a holistic approach looking at the whole person: mind, body and soul. I feel it is an honor to be involved in helping clients improve their spiritual, emotional and mental wellbeing.
(317) 279-6527 View (317) 279-6527
Photo of Lana Lipe, Clinical Social Work/Therapist in Indianapolis, IN
Lana Lipe
Clinical Social Work/Therapist, LCSW
Verified Verified
Indianapolis, IN 46240  (Online Only)
There are many times in our lives where we recognize that our behaviors and beliefs may not be serving our current life path. In fact, we may recognize that those behaviors we used to protect ourselves are holding us back from truly living the life we want and deserve. I primarily work with adults who need support around: anxiety, gender identity, sexuality, perfectionism, compassion fatigue, grief, and chronic illness.
There are many times in our lives where we recognize that our behaviors and beliefs may not be serving our current life path. In fact, we may recognize that those behaviors we used to protect ourselves are holding us back from truly living the life we want and deserve. I primarily work with adults who need support around: anxiety, gender identity, sexuality, perfectionism, compassion fatigue, grief, and chronic illness.
(808) 862-6589 View (808) 862-6589
Photo of Angie J Hernandez in Indianapolis, IN
Angie J Hernandez
CHT
Verified Verified
1 Endorsed
Indianapolis, IN 46239  (Online Only)
Do you experience chronic pain or want to reduce stress and anxiety? Maybe you've tried every treatments offered but still experience pain? Hypnosis is a comfortable treatment option for chronic conditions.
Are you ready to change your life or maybe you just want some help getting un-stuck? I can assist you in making changes that just seem so hard to achieve on your own. You can stop smoking, lose weight or even change your outlook with hypnosis and it can happen quite fast. I help you make the change but I also teach you techniques you can use on your own when faced with life's challenges.
Do you experience chronic pain or want to reduce stress and anxiety? Maybe you've tried every treatments offered but still experience pain? Hypnosis is a comfortable treatment option for chronic conditions.
Are you ready to change your life or maybe you just want some help getting un-stuck? I can assist you in making changes that just seem so hard to achieve on your own. You can stop smoking, lose weight or even change your outlook with hypnosis and it can happen quite fast. I help you make the change but I also teach you techniques you can use on your own when faced with life's challenges.
(574) 248-4662 View (574) 248-4662
Photo of Shelley Spencer-Hellmich, Marriage & Family Therapist in Indianapolis, IN
Shelley Spencer-Hellmich
Marriage & Family Therapist, PhD, LMFT, LCAC, CADACIV, CDVC
Verified Verified
Indianapolis, IN 46240  (Online Only)
"At times I use psychophysiological techniques such as hypnosis and guided imagery for enhancing your ability to manage health issues such as anxiety, weight, and addictions, along with other areas such as pain management.
"I work with adults, children and adolescents. I often work with relationship, marital and family issues. I help couples with communication issues and provide ideas to work on outside of the session. Children often see me for stress management techniques to utilize at school and home; and I teach them techniques to help increase focus and concentration."
"At times I use psychophysiological techniques such as hypnosis and guided imagery for enhancing your ability to manage health issues such as anxiety, weight, and addictions, along with other areas such as pain management.
"I work with adults, children and adolescents. I often work with relationship, marital and family issues. I help couples with communication issues and provide ideas to work on outside of the session. Children often see me for stress management techniques to utilize at school and home; and I teach them techniques to help increase focus and concentration."
(317) 891-5894 View (317) 891-5894
Photo of Just Words, Counselor in Indianapolis, IN
Just Words
Counselor, MAMHC, MDiv
Verified Verified
Indianapolis, IN 46240
You are my ideal client if you are ready to change your life, relationships, or to maintain an mental illness. I work with those who have experienced /experiencing grief or loss, chronic illness, pain, marriage issues, divorce, anger, anxiety, depression, insomnia, post traumatic stress, or sexual abuse. (male or female) I also enjoy working with those who want to discover who they are, and identify what they are feeling. If you desire someone to assist you with the above concerns please allow me to help you identify, understand and create the change you desire.
You are my ideal client if you are ready to change your life, relationships, or to maintain an mental illness. I work with those who have experienced /experiencing grief or loss, chronic illness, pain, marriage issues, divorce, anger, anxiety, depression, insomnia, post traumatic stress, or sexual abuse. (male or female) I also enjoy working with those who want to discover who they are, and identify what they are feeling. If you desire someone to assist you with the above concerns please allow me to help you identify, understand and create the change you desire.
(317) 942-3322 View (317) 942-3322
Photo of Michael Jones, Psychologist in Indianapolis, IN
Michael Jones
Psychologist, PsyD, HSPP
Verified Verified
Indianapolis, IN 46240
Are you going through difficult changes in your life? Divorce, relationship problems, illness, career uncertainty? Feeling depressed, anxious? Having age-related problems? Memory, fear, adjustment, grief? Have you had bad experiences you can't get over, that haunt you, or keep tripping you up? Do others notice that you're different? Do you feel different to yourself; feel that your life is just stuck, without direction, motivation? Does some of this sound like you? Then I can help. You and I can form a productive, helpful relationship through which to take on the issues that are holding you back.
Are you going through difficult changes in your life? Divorce, relationship problems, illness, career uncertainty? Feeling depressed, anxious? Having age-related problems? Memory, fear, adjustment, grief? Have you had bad experiences you can't get over, that haunt you, or keep tripping you up? Do others notice that you're different? Do you feel different to yourself; feel that your life is just stuck, without direction, motivation? Does some of this sound like you? Then I can help. You and I can form a productive, helpful relationship through which to take on the issues that are holding you back.
(317) 793-2320 View (317) 793-2320
Photo of Heather Meyer, Counselor in Indianapolis, IN
Heather Meyer
Counselor, MS, LMHC
Verified Verified
Indianapolis, IN 46240
I have experience with such issues as: ADHD, Autism, ODD, Depression, Anxiety, Trauma, Chronic Health/Pain Issues and Relationship Challenges.
I will help you get through your difficult life challenges so you can feel more confident, happy and whole. If you are struggling with your health, significant loss, or difficult circumstances within your family or work life, I can guide you, educate you, support you, connect you, and most importantly believe in you, so you can shift from hurt to hope, chaos to calm, and overwhelm to opportunity. I do this work because I truly believe each person is worthy to feel valued, heard, and understood and to have a fulfilling life that is meaningful and purposeful.
I have experience with such issues as: ADHD, Autism, ODD, Depression, Anxiety, Trauma, Chronic Health/Pain Issues and Relationship Challenges.
I will help you get through your difficult life challenges so you can feel more confident, happy and whole. If you are struggling with your health, significant loss, or difficult circumstances within your family or work life, I can guide you, educate you, support you, connect you, and most importantly believe in you, so you can shift from hurt to hope, chaos to calm, and overwhelm to opportunity. I do this work because I truly believe each person is worthy to feel valued, heard, and understood and to have a fulfilling life that is meaningful and purposeful.
(317) 494-7243 View (317) 494-7243
Photo of Leah Elizabeth Whitmire, Counselor in Indianapolis, IN
Leah Elizabeth Whitmire
Counselor, MA, MT-BC, LMHCA
Verified Verified
Indianapolis, IN 46205
Are you looking for a unique approach to therapy that incorporates cutting edge, expressive arts therapy methods to help you make meaningful changes in your life? Would you like to use music, movement, breath, and the arts to enhance your wellbeing? I specialize in serving clients with mental health and wellness needs including anxiety, depression, chronic pain, PTSD, life transitions, career, stress, and relationship issues. For clients looking for a creative, expressive, embodied approach to wellness, learn how my integrative music psychotherapy and counseling services can help you reach your goals!
Are you looking for a unique approach to therapy that incorporates cutting edge, expressive arts therapy methods to help you make meaningful changes in your life? Would you like to use music, movement, breath, and the arts to enhance your wellbeing? I specialize in serving clients with mental health and wellness needs including anxiety, depression, chronic pain, PTSD, life transitions, career, stress, and relationship issues. For clients looking for a creative, expressive, embodied approach to wellness, learn how my integrative music psychotherapy and counseling services can help you reach your goals!
(317) 647-1238 View (317) 647-1238

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Chronic Pain Therapists

How does chronic pain therapy work?

Engaging with a psychotherapist to help treat chronic pain does not mean that one’s pain is all in their head. Therapy for chronic-pain patients has been shown to benefit both the mind and the body, targeting physical symptoms and increasing daily functioning. In other words, for many, addressing their emotional health through therapy affects their physical health. A therapist can help a client challenge unhelpful thoughts about pain and develop new ways to respond to it, such as distraction or calming breathing techniques. Studies have found that therapy can be as effective as surgery for certain cases of chronic pain and many doctors recommend trying psychotherapy in advance of considering invasive surgery.

What are the most effective treatment options for chronic pain?

Stress, anxiety, depression, catastrophizing, ruminating, lack of activity, and social withdrawal all make chronic pain worse. Addressing these issues, research shows, can help people gain control over their pain symptoms. Therapeutic approaches such as cognitive behavioral therapy, biofeedback, and mindfulness-based stress reduction, along with greater pain-management education, have been found to help people reduce fear and disability.

Are there new treatments for chronic pain?

Many cases of chronic pain, particularly those involving back pain, remain medically unexplained. But there is evidence that changes in the brain or nervous system are caused by previous physical ailments such as tissue damage; in such cases, the brain may continue to send out pain signals despite the physical cause having healed. To aid patients under these circumstances, a recently developed treatment known as pain reprocessing therapy (PRT) is designed to help the brain “unlearn” this response. A PRT practitioner helps individuals to reduce the “threat value” of their ongoing pain signals until they can reappraise them as less threatening and fear-inducing. They also help an individual to develop new emotional regulation skills.

How long does therapy for chronic pain take?

There is no set timeline for recovery from chronic pain, especially as there may be a range of physical and psychological causes for any individual’s discomfort, but most patients should expect to see a therapist for a number of weeks or months, typically spanning at least 12 sessions. Studies of pain reprocessing therapy found that many individuals’ experience of pain lessened in eight sessions over four weeks.