Mindfulness-based cognitive therapy for chronic noncancer pain and prescription opioid use disorder: A qualitative pilot study of its feasibility and the perceived process of change.

BACKGROUND: Mindfulness-based interventions have a positive impact on pain, craving, and well-being in both patients with chronic pain and those with opioid use disorder (OUD). Although data are limited, mindfulness-based cognitive therapy (MBCT) might be a promising treatment for patients with chronic noncancer pain combined with OUD. The aim of this qualitative study was to explore the feasibility and process of change during MBCT in this particular population. METHODS: In this qualitative pilot study, 21 patients who were hospitalized for rotation to buprenorphine/naloxone as agonist treatment for chronic pain and OUD were offered MBCT. Semistructured interviews were conducted to explore experienced barriers and facilitators to MBCT. Patients who participated in MBCT were also interviewed on their perceived process of change. RESULTS: Of 21 patients invited to participate in MBCT, 12 initially expressed interest but only four eventually participated in MBCT. The timing of the intervention, group format, somatic complaints, and practical difficulties were identified as the main barriers to participation. Facilitating factors included having a positive attribution toward MBCT, an intrinsic motivation to change, and practical support. The four MBCT participants mentioned several important mechanisms of change, including reduction of opioid craving and improved coping with pain. CONCLUSIONS: MBCT offered in the current study was not feasible for the majority of patients with pain and OUD. Changing the timing of MBCT by providing it at an earlier stage of the treatment and offering MBCT in an online format may facilitate participation.

Access to and use of Internet by adolescents who have a physical disability: a comparative study.

The purpose of this study was to examine access to and use of Internet by 97 physically disabled adolescents. Four main objectives were to: (1) explore frequency and nature of Internet use and the role of care givers, (2) compare these results with non-disabled adolescents, (3) explore associations between access to and use of Internet and adolescents variables, and (4) examine differences between care givers in the guidance of adolescents concerning their Internet use. Outcomes on a questionnaire were compared to those from a control group consisting of 1566 non-disabled adolescents. No differences in access to Internet between physically disabled and non-disabled adolescents were found. In addition, the most common online activities were similar for both groups. Physically disabled adolescents were more often warned by their parents about the risks of Internet and more often had rules at home than their non-disabled peers. Among the group of physically disabled adolescents, gender and environmental setting were found to be related to online activities. In addition, age was found to be related to the amount of rules at home. No associations were found between IQ and the access to and use of Internet. Finally, parents of physically disabled more often warn adolescents and more often check their use of Internet than care staff.