Abstract
OBJECTIVE: Intensive interdisciplinary pain treatment (IIPT), a promising approach to pediatric chronic pain treatment, focuses on functional restoration through the adoption of pain self-management. Few studies have examined the impact of motivational interviewing (MI) on preparing youth for IIPT. The Promoting Readiness and Engagement in Pain Rehabilitation (PREPaRe) intervention aims to improve IIPT efficiency and outcomes through increasing readiness to engage in pain self-management before admission. METHODS: This randomized controlled trial (RCT) investigated the effects of PREPaRe on youth and caregiver readiness to change before IIPT admission, as well as secondary pain-related and functional outcomes at IIPT discharge, including length of stay. Youth and caregivers (n=78 dyads) were randomized to receive PREPaRe alongside standard medical care (SMC) or SMC alone. RESULTS: Readiness ratings (eg, willingness, importance, confidence, awareness) for youth and caregivers receiving PREPaRe significantly improved over time. However, pre-IIPT comparisons of PREPaRe versus SMC revealed main effects for time but no interactions for youth/caregiver pain acceptance and stage of change. Similarly, post-IIPT group comparisons revealed main effects for time (again, no interactions) for youth pain intensity, interference, and disability, and caregiver protective behaviors, catastrophizing, and fear. Importantly, length of IIPT admission was significantly shorter for PREPaRe versus SMC. DISCUSSION: Results of this clinical trial (NCT04093921) show potential promise for PREPaRe in positioning youth and families for increased readiness and more efficient success in IIPT. Future research should seek to replicate these findings, explore PREPaRe in diverse clinical contexts and demographic groups, and identify who might benefit most from the intervention.