Emotional Recovery Program for Chronic Pain




Names: Sylvia Maria Gustin and Nell Norman-Nott


Position/s:

Sylvia Maria Gustin: Associate Professor (School of Psychology UNSW), Director of The Centre for Pain IMPACT (Neuroscience Research Australia; NeuRA), AHPRA Registered psychologist

Nell Norman-Nott: Clinical Researcher and PhD Candidate (School of Psychology, UNSW and NeuRA), DBT Skills Trainer.


Project:

Internet-delivered Dialectical Behavioural Therapy Skills Training (iDBT-Pain) to Reduce Psychological and Physical Suffering for People in Chronic Pain


Can you please tell us about the project and why it is needed?

Chronic pain, defined as pain persisting longer than three months, affects one in five people in the population and results in substantial sensory and emotional suffering. Our research focuses on the psychological aspects of chronic pain to see if skills in emotion regulation from dialectical behavioural therapy (DBT) can help people in chronic pain. In alignment with Microsoft' Research arm and a DBT clinician in the United States, we have developed internet-delivered DBT skills training for chronic pain or iDBT-Pain. iDBT-Pain is a blended treatment that includes six online skills training sessions delivered by a DBT skills trainer via Zoom and a web app to practice DBT skills via interactive modules and video tutorials. A key advantage of iDBT-Pain compared to many other psychological chronic pain treatments is accessibility. People in chronic pain frequently face long wait times for treatment of more than a year, with access further restricted for rural, regional, and remote areas and indigenous communities. Moreover, the advent of Covid-19 has contracted access to treatment due to clinic closures and the risk of infection. As an internet-delivered intervention, iDBT-Pain, is remotely accessible to anyone with an internet connection and smart device, increasing access, especially to remote and rural communities and those with restricted mobility, while mitigating risks associated with Covid-19 infection. In a pilot trial, iDBT-Pain demonstrated promising results to improve both the psychological and sensory aspects of chronic pain. Participant's pain levels decreased, and their emotions were better regulated, alongside improvements in sleep quality and wellbeing. We are now exploring the effectiveness of iDBT-Pain in a larger trial where we hope to replicate our previous findings to further generalise the results and make iDBT-Pain more widely accessible.


Who are the project team?

Our team specialises in research into the psychological and neurological aspects of chronic pain. It encompasses clinicians and researchers from a broad range of disciplines including, mental health, neurobiology, clinical trial management, software development, and implementation science. The team is led by A/Professor Sylvia Gustin, an APHRA registered psychologist and Director of the Centre for Pain IMPACT at NeuRA, and Nell Norman-Nott, Doctoral candidate at UNSW and NeuRA, clinical researcher and accredited DBT skills trainer. Personnel involved in the trial include A/Prof Chelsey Wilks (University of Missouri-Saint Louis), a clinical psychologist and DBT practitioner, and Prof James McAuley (School of Health Sciences, UNSW) psychologist and clinical trial designer. The project team further includes from UNSW and NeuRA, Dr Negin Hesam-Shariati (postdoctoral researcher), Dr Yann Quildé (research fellow), Pauline Zahara (clinical researcher, and trial manager), alongside Dr Mary Czerwinski and Jina Suh from Microsoft Research.


What are you hoping to achieve in this project?

The primary purpose of this trial is to investigate efficacy of the iDBT-Pain intervention to reduce difficulties in emotion regulation in people in chronic pain. In addition, we aim to investigate the improvement in pain intensity alongside psychological factors, including, anxiety, depression, sleep quality and wellbeing. We will also explore, through magnetic resonance imaging (MRI), changes in key areas of the brain that may result from this treatment.


What impact do you imagine the project will have?

Chronic pain is a debilitating condition that radically limits individuals' lives. While pain-medication, such as analgesics, are frequently prescribed for chronic pain, many have side effects and risks of addiction and do little for psychological problems such as depression. This study provides important insight into the effectiveness of a new psychological treatment that may alleviate some of the emotional and sensory suffering associated with chronic pain. Moreover, with long wait times, a dearth of remote services for chronic pain, and mobility and Covid-19 related restrictions impacting accessibility, iDBT-Pain offers an important accessible treatment option for people in chronic pain.


Is there any call to action or collaboration needs you would like to highlight?

We are currently seeking applications for potential participants to be part of our trial to investigate the iDBT-Pain intervention. For more information and to express your interest, please email neurorecoveryresearch@unsw.edu.au.


Article originally published in UNSW National Drug & Alcohol Centre, Medicine