Abstract
ABSTRACT Background Access to face-to-face cognitive behavioral pain management programs is very limited. Internet-delivered cognitive behavioral pain management has potential to improve client access to care but is not readily available in Canada. Aims The present study explored the effectiveness, acceptability, and feasibility of a previously validated Internet-delivered cognitive behavioral pain management course, the Pain Course, when offered in a publicly funded provincial Online Therapy Clinic. The five-lesson course was delivered over 8 weeks and was accompanied by brief weekly contact from a coach via weekly telephone calls and secure online messages. Methods A single-group open trial design (ISRCTN15509834) was employed (n = 55). Effectiveness was assessed by examining symptom measures at pretreatment, posttreatment, and 3-month follow-up. Completion rates and satisfaction ratings were used to examine acceptability. Feasibility was assessed by examining time required for service delivery. Results Results were highly comparable to past studies of the Pain Course showing improvements on primary measures of disability (Cohen’s d = 0.45; 18% reduction), depression (Cohen’s d = 0.85; 36% reduction), and anxiety (Cohen’s d = 0.52; 32% reduction) at posttreatment that were maintained at follow-up. Completion rates (76%) and course satisfaction ratings (85% would recommend course) were high. Coach time per week was estimated as M = 12.67 (SD = 6.53) min. Conclusions The findings add to existing literature on the Pain Course demonstrating for the first time the effectiveness, acceptability, and feasibility of Internet-delivered cognitive behavioral pain management programs for adults with chronic pain in a routine online therapy clinic.
Highlights
Psychological distress is present in many individuals with chronic pain, and cognitive behavioral pain management programs are recognized as beneficial for alleviating suffering related to chronic pain.[5]
Delivery of cognitive behavioral pain management programs via the Internet has the potential to improve the accessibility of services for individuals who have chronic pain
Program acceptability To assess program acceptability, we examined the number of Pain Course lessons clients completed, the number of times clients accessed the program, the number of online messages exchanged with the coach, and the number of telephone calls
Summary
Chronic pain is prevalent, disabling, costly, and undertreated.[1,2,3,4] Psychological distress is present in many individuals with chronic pain, and cognitive behavioral pain management programs are recognized as beneficial for alleviating suffering related to chronic pain.[5] Access to such treatment programs, is very limited, in terms both of availability and affordability.[6] Delivery of cognitive behavioral pain management programs via the Internet has the potential to improve the accessibility of services for individuals who have chronic pain These programs use structured online lessons, released gradually over time, to provide individuals with the same information and skills as those taught in face-to-face pain management programs. Conclusions: The findings add to existing literature on the Pain Course demonstrating for the first time the effectiveness, acceptability, and feasibility of Internet-delivered cognitive behavioral pain management programs for adults with chronic pain in a routine online therapy clinic
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