Telehealth Group-Based Pain Management Programs Using the Therapeutic Alliance and Group Dynamics as Key Predictor Variables

Abstract

Introduction Telehealth pain management has become instrumental in managing patients with chronic pain (CP) since the onset of the COVID-19 pandemic. The primary aim of this study was to investigate whether various covert therapeutic variables aid in the efficacy of telehealth group-based pain management programs (GPMPs). The therapeutic alliance (TA), group dynamics (GDs), attendance and change in pain neuroscience knowledge were evaluated as potential predictor covert variables of change in pain outcome measures and readiness to change (RTC) maladaptive pain behaviors. Methods Telehealth GPMP groups met once a week for 3 hours via zoom software and ran over a course of 6 weeks in which CP self-management techniques were taught. Pain outcome measures were taken at baseline and after the final telehealth GPMP. In addition, the measures around pain neuroscience understanding were examined at baseline and post-intervention. Finally, the TA and GDs were examined at post-treatment using the Therapeutic Group Context Questionnaire (TGCQ). Various statistical procedures were utilized to determine the predictive nature between the specific variables. Results The TA and GDs showed statistically significant ( p < 0.05) predictive relationships with improved changes in maladaptive pain behaviors and pain self-efficacy. There was also a statistically significant ( p < 0.05) predictive relationship between maladaptive pain behavioral changes and improvements in pain self-efficacy, pain catastrophizing and pain kinesiophobia. Discussion This research suggested that covert components in a telehealth GPMP such as changes in readiness to change (RTC) maladaptive pain behaviors, the TA, and GDs are all strong predictors of improvements in pain outcome measures following such an intervention.