Technology-Mediated Therapy for Chronic Pain Management: The Challenges of Adapting Behavior Change Interventions for Delivery with Pervasive Communication Technology

OBJECTIVE: Adapting therapeutic practice from traditional face-to-face exchange to remote technology-based delivery presents challenges for the therapist, patient, and technical writer. This article documents the process of therapy adaptation and the resultant specification for the SMART2 project-a technology-based self-management system for assisting long-term health conditions, including chronic pain. MATERIALS AND METHODS: Focus group discussions with healthcare professionals and patients were conducted to inform selection of therapeutic objectives and appropriate technology. RESULTS: Pertinent challenges are identified, relating to (1) reduction and definition of therapeutic objectives, and (2) how to approach adaptation of therapy to a form suited to technology delivery. The requirement of the system to provide dynamic and intelligent responses to patient experience and behavior is also emphasized. CONCLUSION: Solutions to these challenges are described in the context of the SMART2 technology-based intervention. More explicit discussion and documentation of therapy adaptation to technology-based delivery within the literature is encouraged.