Using CBT and Smart Phones for the Self-Management of Chronic Pain

In this age of technology, internet interventions are becoming more common in the practice of Cognitive Behavioral Therapy (CBT).  Chronic Widespread Pain (CWP) causes patients to live in constant pain, as well as fear of that pain, which can lead to avoidant behavior and depression.  Kristjansdottir et al (2011) hope to develop an intervention program that will help patients with CWP to self-manage their pain.  Using CBT with a focus on mindfulness and the acceptance of pain, researchers developed a four week intervention that is administered to the patients via Web-enabled smart phones.  In the present study, the researchers look into the feasibility of the intervention.

Six women with CWP were recruited to participate in the intervention.  Each participant first met one-on-one with a therapist where she was asked about her condition, informed of the intervention, and lent a web-enabled phone.  For the next four weeks, the participants received an SMS text message three times a day (morning, evening, and a random time between 11:30 am and 2 pm) reminding the participants to fill out an online diary.  This diary included a set of questions asking about current thoughts and pain awareness.  Within 90 minutes, each participant received online feedback from a therapist, who was supervised by two other professionals of mindfulness meditation and CBT.

Each online diary included questions regarding the usefulness of the previous diary’s feedback.  The effects of the intervention were quantified by use of the Chronic Pain Acceptance Questionnaire (CPAQ) and the Pain Catastrophizing Scale (PSC), given to participants before and after the intervention.  Half-way through the intervention, and after completion, researchers met with participants to ask them about their experiences and opinions.

Kristjansdottir et al found that the participants were responsive to the intervention and saw it as supportive and useful.  Despite minimal technical difficulties, the program was found to be user-friendly and feasible.  Future randomized studies can adapt the program and explore its effects on CWP.

Kristjansdottir, O. B., Fors, E. A., Eide, E., Finset, A., van Dulmen, S., Wigers, S. H., & Eide, H. (2011).  Written online situational feedback via mobile phone to support self-management of chronic widespread pain: A usability study of web-based intervention.  BMC Musculosketital Disorders, 12(51).