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Table 1 PainTRAINER Modules

From: Pilot study of an internet-based pain coping skills training program for patients with systemic Lupus Erythematosus

# Coping Skill(s) Content
1 Progressive Muscle Relaxation • Introduce program and concept of pain coping skills
• Therapeutic rationale (how thoughts, feelings, and actions affect pain through pain “gate”)
• Introduce progressive muscle relaxation
• Exercise: Provide opportunity to practice progressive muscle relaxation
• Help user identify positive aspects of experience to reinforce use of skill
• Help user identify and address barriers to use of skill
• Describe importance of regular practice and how to set up practice reminders
• Set practice goal
2 Mini Relaxation Practices • Review progressive muscle relaxation and practices completed in prior week
• Introduce “mini-practices” (brief relaxation)
• Exercise: Provide an opportunity to do sitting and standing mini-practices
• Help user identify positive aspects of experience to reinforce use of skill
• Help user identify and address barriers to use of skill
• Describe how to set up practice reminders and set practice goal
3 Activity / Rest Cycling • Review mini-practice and practices completed in prior week
• Introduce activity/rest cycling
• Exercise: Identify activities user tends to overdo
• Vicarious learning: Demonstrate how others have changed overdone activities
• Exercise: Create personal plan to use skill that fits personal activities and goals
• Discuss how other skills help with use of this one
• Set practice goals for this skill and review practice goals for other skills
4 Pleasant Activity Scheduling, Negative Automatic Thoughts • Review activity/rest cycling and practices completed in prior week
• Introduce pleasant activity scheduling
• Exercise demonstrating how to select and add pleasant activities to routine
• Schedule 3 pleasant activities for week
• Problem-solve barriers with interactive vicarious learning exercise
• Introduce concept of negative automatic thoughts
• Exercise demonstrating how to identify negative automatic thoughts
• Set practice goals for week and review practice goals for other skills
5 Negative Automatic Thoughts, Coping Thoughts • Review pleasant activity scheduling and practices completed in prior week
• Continue lesson on automatic thoughts, then introduce concept of coping thoughts
• Exercise: Identifying negative thoughts and reactions to them
• Exercise: Creating coping thoughts to address negative thoughts
• Exercise: Identify and address circumstances that hinder use of skill
• Set practice goals for week and review practice goals for other skills
6 Pleasant Imagery and other Distraction Techniques • Review coping thoughts and practices completed in prior week
• Introduce pleasant imagery and other distraction techniques
• Provide an opportunity to practice pleasant imagery and explore experience
• Exercise on identifying negative thoughts and reactions to them
• Set practice goals for week and review practice goals for other skills
7 Problem Solving • Review pleasant imagery, distraction, and practices completed in prior week
• Introduce concept of problem solving
• Demonstrate problem solving, illustrated by stories told by other people
• Exercise: Select skills for different situations, with personal plan for overcoming barriers
• Set practice goals for week and review practice goals for other skills
8 Monitoring for Maintenance • Review content of all modules
• Exercise: Evaluate skill use and helpfulness, including comparison with others’ experiences
• Exercise: Develop plan for maintaining use of skills
• Present rationale to motivate continued practice and skill development
• Review practice goals for skills