Abstract
Chronic musculoskeletal pain (CMP) is a global condition that has a significant impact on the lives of those individuals suffering from pain related symptoms. The main study in this dissertation aimed to understand if there was a difference on post-telehealth group-based pain management programs` (GPMPs) pain outcome scores for those individuals with chronic pain (CP) at pre-intervention with high readiness to change pain behavior scores (exposed group), vs. subjects with low readiness to change scores (unexposed group). Comparing the groups from pre-to post-treatment, subjects who were in the unexposed group overall appeared to have greater magnitude in favorable changes in pain outcome scores following telehealth GPMPs. Emotional wellbeing (EWB) at baseline was greater and thus better in the the exposed group. However, worse EWB at baseline (as in the unexposed group) was found to be associated with greater improvement in change in all pain manifestations following intervention. Age and length of time with pain was larger in the unexposed group. Each baseline pain manifestation measure, accounted for statistically significant predictions for their individual pre-post-treatment outcome measure scores` differences. Active components in the intervention included relational therapeutic contextual factors such as the therapeutic alliance and group dynamics, subjects` pain science knowledge, change in readiness to change (RTC) maladaptive pain behaviors, and attendance of sessions. Therapeutic relational factors, specifically, and RTC had associations with improvements in pain manifestations, specifically pain self-efficacy. The results of this study suggest that clinicians should make strong use of the therapeutic relationship when working with patients with CP. Furthermore, clinicians should consider using GPMPs more, to further strengthen the outcomes of pain self-management techniques, through various psychosocial interaction effects that take place within group-based interventions.