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.

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).