Training Psychologists and Nurse Practitioners in the Use of an Evidence-Based Online Pain Self-Management Program: Leveraging the Power of Expert Guidance and Telehealth

SUMMARY/ABSTRACT Over 100 million adults in the U.S. live with chronic pain. They face risks such as prolonged opioid use, depression, anxiety, stress, and various social, occupational, and financial problems. Even though opioids were traditionally used to manage chronic pain, they are no longer the primary option due to their numerous risks (e.g. overdose, addiction). The CDC and other authorities currently advocate the use of non-opioid interventions for pain management. Although the shift in policy has successfully decreased opioid prescriptions, many individuals with pain now encounter a treatment void due to the limited availability of non- opioid therapies and a shortage of professionals skilled in providing alternative treatments. One promising solution to these twin dilemmas is the advent of internet-based pain self-management programs. Such programs have been shown to improve pain-related and mental health outcomes and to reduce prolonged opioid use. However, some face obstacles in engaging and completing self-directed programs. These challenges have been shown to diminish when the systematic guidance of trained professionals is available. The research team plans to create a Psychologist/Nurse Practitioner-guided version of an existing, evidence-based online program, the Chronic Pain Management Program (CPMP) to be delivered via Telehealth. The rigorously tested CPMP has demonstrated significant reductions in opioid use, pain severity, emotional burden, stress, anxiety, and depression, while concurrently enhancing self-efficacy, coping skills, and knowledge about chronic pain and its treatment. Despite these successes, the CPMP currently lacks an option for professional guidance. Consequently, our strategy involves adapting the CPMP's delivery method by developing a curriculum aimed at training and certifying licensed Clinical/Counseling Psychologists (CPs) and Nurse Practitioners (NPs) to offer program guidance. This modified format will be integrated into a Telehealth (virtual) treatment model, broadening the program's availability and accessibility. The research team will 1) develop Psychologist/Nurse Practitioner Training materials (Aim 1), that align with the topics and goals of the CPMP and 2) build a web-based Portal (Aim 2) to house the training program, host profiles of certified CPs/NPs, permit matching of CPs/NPs to adults with chronic pain, provide user access to the CPMP, and generate automated reports of client program use/progress on the CPMP. Feasibility will be examined via formative evaluations of the Training materials and the Portal. An iterative review and product revision process will be carried out by 20 adults with chronic pain and a panel of eight CPs/NPs. These panels will examine factors such as content, usability, satisfaction, functionality, interest, and willingness to use. The Goalistics team employed these methods in prior projects to craft a Phase I prototype, proving its feasibility, technical value, and commercial promise. In Phase II, we aim to formally test the CP/NP training/certification process and compare the efficacy of the CP/NP-guided CPMP to the self-directed version.