Development of an online acceptance and commitment therapy program for pain in spinal cord injury and findings from a randomized pilot trial of coached and unguided delivery formats
Rehabil Psychol. 2026 Apr 16. doi: 10.1037/rep0000670. Online ahead of print.
ABSTRACT
PURPOSE/OBJECTIVE: Chronic pain is a common symptom in spinal cord injury (SCI) that requires new and accessible treatment options. We describe the process of developing a web-delivered acceptance and commitment therapy-based program (My SCI Toolkit) for chronic pain management in SCI. Results of a three-arm randomized pilot trial to test the feasibility, acceptability, adverse effects, and effects of the program in unguided and coached formats are presented.
RESEARCH METHOD/DESIGN: Following a stakeholder-informed development phase, we conducted a three-arm randomized pilot trial (N = 60) of unguided website use, coached website use, and waitlist control for 8 weeks with adults with chronic pain and SCI. Treatment feasibility (participant retention and engagement), acceptability (Client Satisfaction Questionnaire-8 [CSQ] scores), Patient Global Impression of Change scores, and pre- to posttreatment change in SCI-QOL Pain Interference and Pain Behavior and Patient Reported Outcomes Measurement Information System Pain Intensity scores were examined.
RESULTS: My SCI Toolkit was developed and released for public use in 2023. Regardless of delivery format, the program was feasible (e.g., retention 95% in both groups) and acceptable (mean CSQ-8 score of 23.94 and 26.42 for unguided and coached arms, respectively). Pilot trial data indicate pre- to posttreatment decreases in clinical pain outcomes of medium to large effect sizes.
CONCLUSION/IMPLICATIONS: My SCI Toolkit is an accessible, stakeholder-informed, web-delivered pain self-management program that is feasible, acceptable, and potentially meaningful for people with SCI. Findings support the value of pursuing a fully powered randomized controlled trial to assess clinical efficacy and implementation potential in real-world settings. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
PMID:41989405 | DOI:10.1037/rep0000670