A Stage One Feasibility Study of an Online, Asynchronous Intervention for Pain Catastrophizing
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Authors
Cheung, Dominique
Issue Date
2023
Type
Dissertation
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Abstract
The American Pain Society defines chronic pain as persistent pain lasting three months or more and affects at least 50 million adults in the United States (Rikard et al., 2023). It impacts individuals’ mood, cognitive processes, sleep, and quality of life, and has been identified as a leading cause of disability (Fine, 2011, Gaskin & Richard, 2012; Vos et al., 2017). Additionally, chronic pain has also been found to be associated with high economic cost, approximately $560-$638 billion annually, comprised primarily of healthcare spending, disability programs, and lost productivity (Dahlhamer et al., 2018; Smith & Hillner, 2019). Pain catastrophizing, or persistent negative affective and cognitive responses to pain, has been identified in research as a psychosocial risk factor associated with worse pain outcomes in chronic pain patients (Schütze et al., 2018). Although a number of CBT-based interventions have been found to successfully reduce pain catastrophizing, the majority of those interventions include several (e.g., 6-10) sessions, potentially reducing accessibility. From Catastrophizing to Recovery (FCR), later rebranded to Empowered Relief (ER), was designed by Darnall et al. (2014) as a single-session, CBT-based intervention and was found to significantly reduce pain catastrophizing. Both in-person and synchronous online formats were found to be at reducing pain catastrophizing in chronic pain patients (Darnall et al., 2021; Ziadni et al., 2021). The current study focused on determining the feasibility of an online, asynchronous intervention, named Healthy Coping for Pain, for pain catastrophizing. Healthy Coping for Pain utilized components that were included in evidence-based CBT-based interventions and pain catastrophizing and pain management (e.g., ER, CBT for Chronic Pain), including psychoeducation on pain, pain coping skills/relaxation techniques, and recognizing and challenging unhelpful/negative pain-related thoughts. Additionally, participants were asked to create a Coping with Pain Catastrophizing Plan using a template that was provided. ER was also used as a model for a shorter intervention, with Healthy Coping for Pain lasting approximately two hours in length. The stage model for behavioral therapies research approach, as described by Onken et al. (1997), was taken for this study. More specifically, this is a Stage I study which focused specifically on designing a brief intervention (Healthy Coping for Pain) and testing its feasibility. Healthy Coping for Pain comprised of three pre-recorded videos that were hosted on Nevada Box. Participants were recruited both locally and nationally and were invited to complete Healthy Coping for Pain online and fill out pre-intervention (demographics, pain experience, depression) and post-intervention (satisfaction, practicality, relevance, and accessibility ratings, feedback) surveys. Additionally, attention check activities were utilized after the first and second videos, and participants were asked to submit a copy of their Coping with Pain Catastrophizing Plan after the third video. Participant feedback was summarized, and themes were identified. Overall, participants were satisfied with the content and online format of Healthy Coping for Pain, and found the intervention acceptable, relevant, easy to understand, and easy to follow. Limitations of the current study, as well as future research directions, are also discussed.
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Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 United States