Consumer participation in the development of a manualized behavioral treatment for chronic pain in a methadone population

Issues. Among patients seeking treatment for an opioid use disorder (OUD), 30%-40% will have chronic pain (CP), typically back pain. Integrated treatments have been recommended as a strategy to address these commonly co-occurring disorders. Our goal was to examine the feasibility of using an evidence-based behavioral treatment (Acceptance and Commitment Therapy) for CP in a methadone population. Description. We invited consumers to participate in a bi-directional pre-pilot treatment study of a group therapy manual for individuals with OUD and CP. The purpose was to review content for feasibility, appropriateness, and acceptance. We engaged consumers in evaluation of session content, materials, and overall impressions of the material. Results from these pre-pilot groups indicated that while the content was feasible and acceptable, the delivery and approach required modification to address the needs of this patient population (e.g., adjusting literacy level, cultural competence, and simplifying abstract concepts). Lessons Learned. Results from this pre-pilot group led to substantive changes in the delivery of the manual. Using a modified delivery approach, we are currently conducting a pilot study to examine the manual's treatment effectiveness. Involving consumers early in the development of the manual provided valuable insight into consumer perspectives, and the group process encouraged engagement between researchers and consumers. Recommendations. We recommend involving consumers early in manual development to examine feasibility and ensure delivery and approach is appropriate for the target population.