Internet-delivered dialectical behaviour therapy (iDBT) skills training to reduce difficulties in emotional dysregulation and pain in people with chronic pain

This study will use a single-case experimental design (SCED) with multiple baselines across participants. The SCED method is based on assessing the dependent variables (emotional regulation and pain intensity) repeatedly for each of the participants across several phases. The design of this study will be AB + follow-up, where A refers to the baseline phase and B is the intervention phase. Three participants will be randomly assigned to different baseline durations. The baseline for the first participant will be 5 days, the second participant will have a 9-day baseline, and the third participant will have a 12-day baseline. All participants will start the baseline phase on the same day. During the baseline phase, participants will complete the self-report questionnaires (i.e., Visual Analogue Scale (VAS) and Difficulties in Emotion Regulation Scale (DERS)) on every day of the baseline phase. Each baseline phase will be followed by 6 sessions of internet delivered Dialectic Behaviour Therapy (iDBT) skills training intervention plus unlimited use of an iDBT skills training web application over a 4-week period. The follow up phase will begin the day after the intervention and will last for one week, whereby each participant will report on the primary and secondary dependent variables (emotional regulation and pain intensity respectively) in order to monitor possible changes in pain intensity and pain interference after completion of the intervention. Intervention: Six iDBT skills training intervention sessions will be delivered individually to each participant over the video conferencing platform Zoom at agreed times during the 4-week period. The iDBT skills training intervention is based on the iDBT protocol developed by Wilks et al. (2017) and has been modified for the chronic pain population (iDBT-Pain skills training intervention including two “Mindfulness” skill training intervention sessions, three “Emotional Regulation” skill training intervention sessions and one “Distress Tolerance” skill training intervention session). Each session will be administered by a researcher (in this trial an AHPRA registered psychologist) and is 60-90 minutes in duration. In-between the iDBT-Pain skills training intervention sessions the participants will be asked to train their newly learned DBT skills using the iDBT skills training web application developed by Wilks and colleagues (2018), which has been modified for the chronic pain population (iDBT-Pain skills training web application). No instruction will be given about the duration of usage of the iDBT-Pain skills training web application. The participants will be contacted everyday to ensure they are using the iDBT-Pain skills training we application.