Bio


Dr King is a Clinical Associate Professor in the Department of Anesthesiology and Perioperative Pain Medicine and also serves as the Director of the Pain Psychology Fellowship.

Dr. King’s areas of expertise are in evidence-based therapies including Cognitive Behavioral Therapy for Pain and Insomnia and Acceptance and Commitment Therapy (ACT). She is also board certified in Biofeedback (BCB) by the Biofeedback Certification International Alliance (BCIA). Dr. King has a strong interest in providing interdisciplinary care and specializes in comprehensive functional rehabilitation for patients experiencing chronic pain. She has also developed and is testing integrated protocols for co-occurring chronic pain and insomnia. She provides comprehensive pain evaluations, individual and group treatments, education for both patients and providers, and program development.

Dr King presents at national and international conferences to facilitate knowledge of effective behavioral treatment options for chronic pain patients. Her research focus includes serving as a master CBT trainer for serval NIH grants and is the Director of Behavioral Services for Northern California for the EMPOWER study. She also serves as the Director of the Pain Psychology Fellowship.

Dr. King works with patients to help them regain control of their lives by teaching effective, self-directed coping strategies focused on restoring function, optimizing mood and sleep and increasing time in valued activities with the ultimate goal of improving one’s quality of life.

Clinical Focus


  • Pain Psychology
  • Biofeedback
  • Cognitive Behavioral Therapy for pain
  • Acceptance and Commitment Therapy
  • Functional Rehabilitation
  • Psychology
  • Mindfulness
  • Chronic Pain
  • Insomnia Disorder

Academic Appointments


  • Clinical Associate Professor, Anesthesiology, Perioperative and Pain Medicine

Administrative Appointments


  • Director of Pain Psychology Fellowship, Department of Anesthesiology and Perioperative Medicine (2017 - Present)

Boards, Advisory Committees, Professional Organizations


  • Co-chair Pain and Rehabilitation SIG, American Academy of Pain Medicine (AAPM) (2023 - Present)
  • APPIC Postdoctoral Committee, Association of Psychology Postdoctoral and Internship Centers (APPIC) (2023 - Present)
  • President elect-Pain SIG, Association for Contextual Behavioral Sciences (2023 - Present)
  • President, American Association of Pain Psychology (2016 - 2017)

Professional Education


  • Fellowship: Kaiser Permanente Pain Management Training (2009) CA
  • PhD Training: Alliant International University (2008) CA
  • Board Certification: Biofeedback Certification International Alliance, Biofeedback (2009)
  • Internship: Jesse Brown VA Medical Center Psychology Internship (2008) IL
  • Professional Education: Alliant International University (2008) CA

Current Research and Scholarly Interests


11/01/17 – 10/30/2022
Role: Co-Investigator (0.10 FTE) and Director of Treatments for the Bay Area (Stanford Pain and Primary Care clinics)
PCORI (Patient Centered Outcomes Research Institute). Title: “Comparative Effectiveness of Pain Cognitive Behavioral Therapy and Chronic Pain Self-Management Within the Context of Opioid Reduction.” Total: $8.8M PI: Beth Darnall

2017- present
Dr. King is also collaborating with Fiona Barwick, PhD, at Stanford’s Sleep Medicine Center, to develop an integrated treatment protocol for improving sleep and chronic pain. With the protocol now complete, Dr. Barwick and Dr. King plan to run the six-session group throughout 2019, collecting pre-treatment, post-treatment and follow-up data to analyze outcomes.

2015-present
Role: Lead Therapist, Cognitive Behavioral Therapy manualized intervention
National Institutes of Health P01 AT006651 National Center for Complementary and Integrative Health Title: Stanford Center for Back Pain
PI: Sean Mackey, MD, PhD

2015 -present
Lead Therapist, Cognitive Behavioral Therapy manualized intervention
National Institutes of Health R01AT008561 National Center for Complementary and
Integrative Health Title: Single Session Pain Catastrophizing Treatment: Comparative
Efficacy & Mechanisms Multi-PI: Darnall BD & Mackey SC

Stanford Advisees


Graduate and Fellowship Programs


  • Pain Management (Fellowship Program)

All Publications


  • Empowered Relief, cognitive behavioral therapy, and health education for people with chronic pain: a comparison of outcomes at 6-month Follow-up for a randomized controlled trial. Pain reports Darnall, B. D., Burns, J. W., Hong, J., Roy, A., Slater, K., Poupore-King, H., Ziadni, M. S., You, D. S., Jung, C., Cook, K. F., Lorig, K., Tian, L., Mackey, S. C. 2024; 9 (1): e1116

    Abstract

    We previously conducted a 3-arm randomized trial (263 adults with chronic low back pain) which compared group-based (1) single-session pain relief skills intervention (Empowered Relief; ER); (2) 8-session cognitive behavioral therapy (CBT) for chronic back pain; and (3) single-session health and back pain education class (HE). Results suggested non-inferiority of ER vs. CBT at 3 months post-treatment on an array of outcomes.Here, we tested the durability of treatment effects at 6 months post-treatment. We examined group differences in primary and secondary outcomes at 6 months and the degree to which outcomes eroded or improved from 3-month to 6-month within each treatment group.Empowered Relief remained non-inferior to CBT on most outcomes, whereas both ER and CBT remained superior to HE on most outcomes. Outcome improvements within ER did not decrease significantly from 3-month to 6-month, and indeed ER showed additional 3- to 6-month improvements on pain catastrophizing, pain bothersomeness, and anxiety. Effects of ER at 6 months post-treatment (moderate term outcomes) kept pace with effects reported by participants who underwent 8-session CBT.The maintenance of these absolute levels implies strong stability of ER effects. Results extend to 6 months post-treatment previous findings documenting that ER and CBT exhibit similarly potent effects on outcomes.

    View details for DOI 10.1097/PR9.0000000000001116

    View details for PubMedID 38288134

    View details for PubMedCentralID PMC10824382

  • Application of multidisciplinary team conference for neuromodulation candidates facilitates patient selection and optimization. Frontiers in pain research (Lausanne, Switzerland) Salmasi, V., Rasouli, M. R., Kao, M. C., Ottestad, E., Terkawi, A. S., Morris, G., Qian, X., Coleman, S., Talavera, D. C., Poupore-King, H., Slater, K., Leong, M. S. 2023; 4: 1331883

    Abstract

    Psychological evaluation is required by insurance companies in the United States prior to proceeding with a spinal cord stimulation or a dorsal root ganglion stimulation trial. Since January 2017, we implemented a Multidisciplinary Team Conference for Neuromodulation in our center to facilitate the collaboration between pain physicians and psychologists and to optimize screening of neuromodulation candidates. This study aims to report the impact of this team conference on improvement of neuromodulation outcome in our center.Appropriateness of neuromodulation were discussed in the team conference after initial visit with the pain specialist and psychological evaluation. For this study, we prospectively and retrospectively collected data on neuromodulation candidates who went through the team conference and those who did not as controls.We discussed 461 patients in the team conference sessions from January 2017 to July 2023. Out of these, a spinal cord stimulator or a dorsal root ganglion stimulator trial was performed in 164 patients with 80.5% (132 cases) trial success rate leading to 140 implants. Out of these implants, 26 (18.6%) explanted and 21 (15%) required revision in 41 (29.3%) patients. We performed neuraxial neuromodulation trial for 70 patients without going through the team conference from January 2016 to July 2023 with a trial success rate of 45.7% (32 cases). In this group, 7 (21.9%) and 6 (18.8%) patients underwent explant and revision. The differences between the groups were statistically significant for trial success rate (odds ratio of 4.9 with p-value of <0.01) but not for explant (odds ratio of 0.8 with p-value of 0.627) or revision (odds ratio of 0.8 with p-value of 0.595).Implementing Multidisciplinary Team Conference increased trial success rate in our center. Team conference provides therapeutic benefit for patients, and also provides the opportunity for an educational discussion for trainees.

    View details for DOI 10.3389/fpain.2023.1331883

    View details for PubMedID 38249566

    View details for PubMedCentralID PMC10796794

  • Effectiveness of a multidisciplinary rehabilitation program in real-world patients with chronic back pain: A pilot cohort data analysis JOURNAL OF BACK AND MUSCULOSKELETAL REHABILITATION You, D. S., Ziadni, M. S., Cooley, C. E., Talavera, D. C., Mackey, S. C., Poupore-King, H. 2021; 34 (6): 965-973

    Abstract

    Randomized clinical trials (RCT) suggest a multidisciplinary approach to pain rehabilitation is superior to other active treatments in improving pain intensity, function, disability, and pain interference for patients with chronic pain, with small effect size (ds= 0.20-0.36) but its effectiveness remains unknown in real-world practice.The current study examined the effectiveness of a multidisciplinary program to a cognitive and behavioral therapy (pain-CBT) in real-world patients with chronic back pain.Twenty-eight patients (M𝑎𝑔𝑒= 57.6, 82.1% Female) completed a multidisciplinary program that included pain psychology and physical therapy. Eighteen patients (M𝑎𝑔𝑒= 58.9, 77.8% Female) completed a CBT-alone program. Using a learning healthcare system, the Pain Catastrophizing Scale, 0-10 Numerical Pain Rating Scale, and Patient-Reported Outcomes Measurement Information System® measures were administered before and after the programs.We found significant improvement in mobility and pain behavior only after a multidisciplinary program (p's < 0.031; d= 0.69 and 0.55). We also found significant improvement in pain interference, fatigue, depression, anxiety, social role satisfaction, and pain catastrophizing after pain-CBT or multidisciplinary programs (p's < 0.037; ds = 0.29-0.73). Pain ratings were not significantly changed by either program (p's > 0.207).The effect of a multidisciplinary rehabilitation program observed in RCT would be generalizable to real-world practice.

    View details for DOI 10.3233/BMR-200305

    View details for Web of Science ID 000716490600008

    View details for PubMedID 34151829

  • Comparison of a Single-Session Pain Management Skills Intervention With a Single-Session Health Education Intervention and 8 Sessions of Cognitive Behavioral Therapy in Adults With Chronic Low Back Pain: A Randomized Clinical Trial. JAMA network open Darnall, B. D., Roy, A., Chen, A. L., Ziadni, M. S., Keane, R. T., You, D. S., Slater, K., Poupore-King, H., Mackey, I., Kao, M. C., Cook, K. F., Lorig, K., Zhang, D., Hong, J., Tian, L., Mackey, S. C. 2021; 4 (8): e2113401

    Abstract

    Chronic low back pain (CLBP), the most prevalent chronic pain condition, imparts substantial disability and discomfort. Cognitive behavioral therapy (CBT) reduces the effect of CLBP, but access is limited.To determine whether a single class in evidence-based pain management skills (empowered relief) is noninferior to 8-session CBT and superior to health education at 3 months after treatment for improving pain catastrophizing, pain intensity, pain interference, and other secondary outcomes.This 3-arm randomized clinical trial collected data from May 24, 2017, to March 3, 2020. Participants included individuals in the community with self-reported CLBP for 6 months or more and an average pain intensity of at least 4 (range, 0-10, with 10 indicating worst pain imaginable). Data were analyzed using intention-to-treat and per-protocol approaches.Participants were randomized to (1) empowered relief, (2) health education (matched to empowered relief for duration and format), or (3) 8-session CBT. Self-reported data were collected at baseline, before treatment, and at posttreatment months 1, 2, and 3.Group differences in Pain Catastrophizing Scale scores and secondary outcomes at month 3 after treatment. Pain intensity and pain interference were priority secondary outcomes.A total of 263 participants were included in the analysis (131 women [49.8%], 130 men [49.4%], and 2 other [0.8%]; mean [SD] age, 47.9 [13.8] years) and were randomized into 3 groups: empowered relief (n = 87), CBT (n = 88), and health education (n = 88). Empowered relief was noninferior to CBT for pain catastrophizing scores at 3 months (difference from CBT, 1.39 [97.5% CI, -∞ to 4.24]). Empowered relief and CBT were superior to health education for pain catastrophizing scores (empowered relief difference from health education, -5.90 [95% CI, -8.78 to -3.01; P < .001]; CBT difference from health education, -7.29 [95% CI, -10.20 to -4.38; P < .001]). Pain catastrophizing score reductions for empowered relief and CBT at 3 months after treatment were clinically meaningful (empowered relief, -9.12 [95% CI, -11.6 to -6.67; P < .001]; CBT, -10.94 [95% CI, -13.6 to -8.32; P < .001]; health education, -4.60 [95% CI, -7.18 to -2.01; P = .001]). Between-group comparisons for pain catastrophizing at months 1 to 3 were adjusted for baseline pain catastrophizing scores and used intention-to-treat analysis. Empowered relief was noninferior to CBT for pain intensity and pain interference (priority secondary outcomes), sleep disturbance, pain bothersomeness, pain behavior, depression, and anxiety. Empowered relief was inferior to CBT for physical function.Among adults with CLBP, a single-session pain management class resulted in clinically significant improvements in pain catastrophizing, pain intensity, pain interference, and other secondary outcomes that were noninferior to 8-session CBT at 3 months.ClinicalTrials.gov Identifier: NCT03167086.

    View details for DOI 10.1001/jamanetworkopen.2021.13401

    View details for PubMedID 34398206

  • Comparative Effectiveness of Cognitive Behavioral Therapy for Chronic Pain and Chronic Pain Self-Management within the Context of Voluntary Patient-Centered Prescription Opioid Tapering: The EMPOWER Study Protocol. Pain medicine (Malden, Mass.) Darnall, B. D., Mackey, S. C., Lorig, K. n., Kao, M. C., Mardian, A. n., Stieg, R. n., Porter, J. n., DeBruyne, K. n., Murphy, J. n., Perez, L. n., Okvat, H. n., Tian, L. n., Flood, P. n., McGovern, M. n., Colloca, L. n., King, H. n., Van Dorsten, B. n., Pun, T. n., Cheung, M. n. 2019

    Abstract

    Evidence to date, while sparse, suggests that patients taking long-term opioids require special considerations and protections to prevent potential iatrogenic harms from opioid de-prescribing, such as increased pain or suffering. Following this study protocol, the EMPOWER study seeks to address multiple unmet needs of patients with chronic pain who desire to reduce long-term opioid therapy, and provide the clinical evidence on effective methodology.EMPOWER applies patient-centered methods for voluntary prescription opioid reduction conducted within a comprehensive, multi-state, 3-arm randomized controlled comparative effectiveness study of three study arms (1) group cognitive behavioral therapy for chronic pain; (2) group chronic pain self-management; and (3) usual care (taper only). Specialized electronic data capture systems collect patient reported symptoms and satisfaction data weekly and monthly during the taper, with real-time clinical alerts and electronic feedback loops informing, documenting, and steering needed care actions.The EMPOWER study seeks to provide granular evidence on patient response to voluntary opioid tapering, and will provide evidence to inform clinical systems changes, clinical care, patient satisfaction, and patient outcomes for opioid reduction.

    View details for DOI 10.1093/pm/pnz285

    View details for PubMedID 31876947