Qualitative analysis of lessons learned by Master's-level behavioral health practitioners for remote delivery of cognitive behavioral therapy-based treatment for chronic pain.

PURPOSE: Cognitive behavioral therapy for chronic pain (CBT-CP) is a recommended but underutilized treatment for patients with chronic pain. Access to CBT-CP is limited in part because of a dearth of qualified providers. RESOLVE was a multisite comparative effectiveness study that evaluated a CBT-CP-based intervention delivered by Master's-level behavioral health practitioners (MLPs) via telephone/video. We interviewed the study's MLPs to learn about their experiences and summarize here considerations for future implementation.

METHODS

We conducted semi-structured interviews with MLPs after the start of the intervention (n = 12) and near the end of the intervention (n = 11). Transcripts were analyzed thematically to capture content related to training, implementation, participant engagement strategies, suggested improvements, and considerations for future implementation.

RESULTS

MLPs felt well prepared to deliver the intervention and found their work impactful and rewarding. Seven factors were identified: (1) Consider intervention structure and participants' skill building, (2) enable appropriate flexibility in delivering manualized treatment, (3) make the most of remote delivery, (4) employ MLPs with strong basic counseling skills, (5) provide comprehensive intervention training, (6) invest in ongoing training and supervision, and (7) consider MLP satisfaction and retention.

CONCLUSION

Remote delivery of a CBT-CP-based intervention was rewarding for MLPs and addressed many patients' needs. However, to ensure that MLPs have the confidence and expertise to effectively deliver this intervention, considerable resources must be devoted to training and supervision. We advocate for further exploration of best practices for involving non-psychologists, particularly MLPs, in the delivery of CBT-CP-based protocols within both research and clinical settings.