Chronic Pain Clinical Trial
Official title:
A Self-compassion Group-based Treatment for Chronic Pain Via Video Conferencing During the COVID-19 Pandemic: Feasibility Study for a Potential New Mode of Treatment Delivery
As a result of COVID-19 and measures taken by the Canadian Government to reduce the transmission of the virus, in-person psychology services have been suspended. Psychology services are now being conducted via video conferencing. The purpose of the current project is to pilot-test a 6-week Self Compassion Treatment for Chronic Pain delivered virtually, in order to understand its utility in the current environment. The treatment is to be delivered through a secure professional ZOOM licence. Objective 1 of the project is to assess the feasibility and acceptability of attending the treatment group through virtual participation. Objective 2 is to assess the effectiveness of the group treatment in improving self-compassion, mental health, relationship with pain, and quality of life.
Participants will be adult psychology outpatients of one of the two tertiary care pain
clinics in Winnipeg, or patients of one of the psychologists working in the Clinical Health
Psychology Program, and who would normally have been invited to attend an in-person
group-based intervention at the Health Sciences Centre.
Participants will complete a set of questionnaires that are standard in our clinic, and that
will be accessed via the online survey platform, Survey Gizmo.
Participants will complete 6-weeks of the virtual Self-Compassion for Chronic Pain Treatment
Group. Session 1: Participant introductions. Introduction of concepts: Self-Compassion (and
how it differs from Self-Esteem, Self-Pity, or Self-Indulgence), rationale of self-compassion
for chronic pain. Introductory experiential self-compassion exercises. Assignment of
homework. Session 2: Check-in and homework review. Introduction to mindfulness and its
applicability in self-compassion. Brief body scan and mindfulness of the breath exercises.
ACT Matrix exercise. Additional experiential self-compassion exercises. Discussion of
awareness of pleasant experiences. Assignment of homework (including awareness of pleasant
experiences throughout the week). Session 3: Check-in and homework review. Self-Compassion in
relationships and being present and compassionate in our relationships. Loving-kindness
meditation. Additional experiential self-compassion exercises Assignment of homework. Session
4: Check-in and homework review. Self-Compassion in the face of difficulties. Working with
difficult emotions (e.g., shame, guilt, anger, self-criticism) with self-compassion.
Additional experiential self-compassion exercises. Assignment of homework. Session 5:
Check-in and homework review. Self-care in chronic pain management. Cultivating gratitude,
self-appreciation and savouring attitudes. Additional experiential self-compassion exercises.
Assignment of homework. Session 6: Check-in and homework review. Compassionate body scan.
Review of program. A look forward (strategies to maintain practices, prepare for setbacks and
get back on track). Wrap-up.
Procedure. All participants who were scheduled to attend an in-person group-based therapy
program will be contacted to invite them to participate in this new virtual group. They will
be assured that their decision to participate (or to not participate) in this study will not
impact their eligibility for participation in the next in-person group, when in-person groups
resume. Additionally, current patients of pain psychologists in the Clinical Health
Psychology Program will be invited to the new program at the discretion of the treating
psychologist (this is in line with current practices). They will be informed that because
they are participating in a new group, a novel delivery format, and a unique environment, the
group program will be evaluated as part of a research study. If they agree to be part of the
study verbally, they will be sent a link to the Consent form and baseline questionnaires
through Survey Gizmo. Baseline questionnaires will be reviewed prior to beginning of the
group, and all participants who score in the "severe" range on the PHQ-9 (i.e. a score of 20
or higher), or who score a "2 or higher" on item number 9 (Thoughts that you would be better
off dead, or thoughts of hurting yourself in some way) will be contacted by telephone for
further screening. They may then be offered individual distance therapy rather than the
group-based therapy, as per Dr. Sabourin's assessment. All consented participants will be
contacted by one of the two therapists (Ms. Amanda Shamblaw, Psychology Resident or Dr.
Brigitte Sabourin, PhD, CPsych) prior to beginning the group in order to test out the
connection and problem-solve any difficulties. They will also be given some preliminary
instructions regarding attending a video-based appointment, as per the Clinical Health
Psychology Program's guidelines. These include a 2-part verification of patient
identification (date of birth and Patient health identification number - PHIN), informing
participants that "Despite our best efforts to ensure high level of privacy and secure
technology, there is always a risk that the transmission be breached and accessed by
unauthorized persons", "no sessions are recorded", "no personal information is shared with
Zoom". They will then verbally consent to proceed. Participants will participate in the 6
weekly sessions in groups of 10-12 participants. At the beginning of each session, each
participant will be in a virtual "waiting room", and either Ms. Shamblaw or Dr. Sabourin will
confirm the participant's location and phone number prior to admitting them to the group. The
location and phone numbers are collected in order to be able to reach participants if needed.
They will complete measures post-treatment and at a 3-month follow-up using Survey Gizmo.
Finally, following treatment, participants will have the option to participate in a
semi-structured qualitative interview to discuss their impressions of the group, impressions
of attending virtually, support they felt from other group members, and general group
cohesion feedback. Participants will be informed that the interview is voluntary and will not
affect their participation in the treatment group.
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