Internet-delivered aftercare following multimodal rehabilitation program for chronic pain: a qualitative feasibility study
Open accessAbstract
PURPOSE: Methods for delivering aftercare to help chronic pain patients to continue practice self-management skills after rehabilitation are needed. Internet-delivered cognitive behavioral therapy (ICBT) has the potential to partly fill this gap given its accessibility and emphasis on self-care. Methods for engaging and motivating patients to persist throughout the full length of treatment are needed. The aim of this study was to describe how chronic pain patients work in an ICBT program, through their descriptions of what is important when they initiate behavior change in aftercare and their descriptions of what is important for ongoing practice of self-management skills in aftercare. PATIENTS AND METHODS: Following a multimodal rehabilitation program, 29 chronic pain patients participated in a 20-week-long Internet-delivered aftercare program (ACP) based on acceptance-based cognitive behavioral therapy. Latent content analysis was made on 138 chapters of diary-like texts written by participants in aftercare. RESULTS: Attitudes regarding pain and body changed during ACP, as did attitudes toward self and the future for some participants. How participants practiced self-management skills was influenced by how they expressed motivation behind treatment goals. Whether they practiced acceptance strategies influenced their continuous self-management practice. Defusion techniques seemed to be helpful in the process of goal setting. Mindfulness strategies seemed to be helpful when setbacks occurred. CONCLUSION: Self-motivating goals are described as important both to initiate and in the ongoing practice of self-management skills. Experiencing a helpful effect of acceptance strategies seems to encourage participants to handle obstacles in new ways and to persist throughout treatment. Research on whether tailored therapist guidance might be helpful in stating self-motivating goals and contribute to ongoing practice of self-management skills is needed.
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Pain researchers also describe alternative development strategies, such as digitalizing a paper-based self-help book or treatment manual, adapting or testing a digital treatment originally targeting another condition, relying on clinical expertise and knowledge of the research team, and/or following theoretical frameworks.
“Pain researchers also describe alternative development strategies, such as digitalizing a paper-based self-help book or treatment manual (Bendelin et al., 2018; Ljótsson et al., 2014), adapting or testing a digital treatment originally targeting another condition such as depression or anxiety (Blaney et al., 2021; Dear et al., 2018), relying on clinical expertise and knowledge of the research team”
From Using Personas in the development of eHealth interventions for chronic pain: A scoping review and narrative synthesis (2023) · cites this paper as Bendelin et al., 2018
The Patients and methods section (“Internet-delivered ACP after MMRP”; page not available) describes an online treatment that resembled a self-help book. It does not say that an existing paper-based book or treatment manual was digitalized, which is the development strategy attributed to Bendelin et al. in the citing sentence. (LLM, conf=0.84)
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Self-citation
- Authors
- Bendelin, N., Gerdle, B., & Andersson, G.
- Affiliations
- Linköping University (SE)
- Corresponding author
- Bendelin, Nina
- Venue
- Journal of Pain Research
- Publisher
- Informa UK Limited
- Published
- 2018-09
- Volume
- Volume 11
- Pages
- 1715-1728
- ISSN
- 1178-7090 (ISSN-L)
- PMC
- PMC6129031
- OpenAlex
- W2888969411
- Cited by
- 10
- References
- 52
- Citations by year
- 2024: 1 · 2023: 3 · 2021: 4 · 2020: 2
- FWCI
- 1.89
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Pain Research (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (acceptedVersion)
- DiVA (Linkoping University) (submittedVersion, other-oa)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- Funders
- AFA Försäkring
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Keywords
- chronic pain, follow-up care, internet-based cognitive behavioral therapy, self-management skills, multimodal rehabilitation, medication adherence, motivation, goal setting, defusion, mindfulness, acceptance strategies, patient perspectives
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