Individual-Level Effects of a Digital Behavioural Treatment for Chronic Pain : Proof-of-Concept of a Single-Case Experimental Design Study

Background: Chronic pain affects 20%-30% of the population worldwide, leading to significant distress, disability and financial burden. Pain management strategies focusing on pain reduction have shown limited effects on functioning; however, behavioural treatments aimed at enhancing resilience have demonstrated strong empirical support. Digital solutions offer new opportunities for delivering evidence-based treatments, but evaluation at the individual level is needed. The aim of this study is to examine individual-level treatment effects of a digital behavioural treatment for chronic pain in a heterogeneous sample. Methods: A study with a single-case experimental design (SCED) was conducted with participants (N = 11) experiencing chronic pain (> 3 months) recruited through healthcare. Participants were randomised at baseline (5-10-day A-phase) and completed a 6-module digital treatment based on learning theory and well-established theories applied to chronic pain (6-8-week B-phase), with weekly therapist contact. Digital diaries, prompted twice daily, tracked psychological flexibility and acceptance, pain-related functioning, pain intensity and well-being. Data were analysed using visual analysis and effect size calculations. Results: N = 11 enrolled and data from n = 10 were analysed (n = 1 refused digital diary, n = 2 partial completers, n = 8 full completers). Pain profiles varied (e.g., chronic migraine, fibromyalgia, lower back pain, etc.). Several participants benefited from the treatment, though results varied across individuals and across outcomes. Conclusion: The digital behavioural treatment showed promise in addressing diverse pain profiles and associated functioning. The variability in responses highlights the benefit of using SCED to explore individual-level effects, thus offering a methodological proof-of-concept. Findings support further development, including tailoring to match individual needs.