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.