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BACKGROUND/RATIONALE:
Cognitive behavioral therapy (CBT) is the most commonly cited psychological alternative to more traditional medical and rehabilitation approaches to chronic pain management. CBT has been shown to be effective in reducing pain intensity, disability, and affective distressin two meta-analyses. Although effective, traditional CBT is time intensive for therapists and requires patients to make frequent office visits. Assessment of pain-related symptoms and adherence to behavioral goals set in prior sessions typically occurs during patient's therapy sessions, making the reports retrospective in nature. Retrospective reports are vulnerable to recall and cognitive biases that attenuate their validity and reliability. An alternative is to improve treatment accessibility, improve efficiency of treatment provision, and enhance the validity and reliability of assessment techniquesthrough the use of electronic methods such as interactive voice response (IVR) technology. IVR is a computerized interface that allows patients to use their telephone to: 1) report self-monitoring data regarding pain-related symptoms and adherence to behvaioral goals; 2) obtain pre-recorded didactic information; and 3) receive personalized therapist feedback.
OBJECTIVE(S):
This pilot project is designed to test the feasibility and perceived value of IVR-based CBT intervention materials for the treatment of chronic pain. The project will involve several iterative steps involving adapting traditional CBT materials for use in a IVR-based chronic pain treatment. Manualized CBT treatment materials and self-monitoring measures developed and tested in the PI's research program will serve as the basis for the IVR-based treatment. The project will have two phases. Phase 1 will include the adaptation of existing treatment materials and Phase 2 will include testing the usability and feasibility of the new materials with a limited number of patients with chronic pain.
METHODS:
Exisiting CBT materials will be revised by a group of clinicians with experience in delivering CBT for chronic pain. The PI and 3 other PHD-level clinicians will meet weekly to review and revise existing CBT materials. The newly developed materials will include: 1) a patient handbook, 2) a library of IVR compatible scripts for the presentation of pain treatment topics, and 3) a library of scripts for providing personalized feedback. After the materials are revised, their usability, feasibility, and perceived value will be tested with a small sample of veterans (n = 9) with chronic non-cancer pain. These participants will receive CBT intervention for chronic pain using the newly created materials over the course of 10 weeks. Outcomes of interest will include: 1) participant ratings of satisfaction with each treatment component (handbook, pre-recorded module explanation, and feedback and real time sessions), 2) average number of module comprehension questions answered correctly per module, and 3) overall satisfaction with the treatment experience.
FINDINGS/RESULTS:
No results at this time.
IMPACT:
In the short term, the results of this study will be used to support a future Merit Review application designed to test the efficacy of an IVR-based CBT treatment for chronic pain. Our ultimate goal is to use IVR-based CBT to extend and strengthen the delivery of high quality, convenient treatment to a greater number of veterans thereby enhancing the accessibility and sustainability of this treatment.
PUBLICATIONS:
None at this time.
DRA:
none
DRE:
none
Keywords:
none
MeSH Terms:
none
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