This is a mindfulness-based program for improving the lives of people living with chronic pain and distress that has been implemented over the past 18 years in two teaching hospitals, St Michael’s, and Sunnybrook Health Sciences Centre, in Toronto, Canada. Its founder, Dr. Jackie Gardner-Nix, a physician with a focused practice in chronic pain and an Associate Professor at the University of Toronto, developed the program from the well-researched Mindfulness-Based Stress Reduction (MBSR) course of Jon Kabat-Zinn (“Full Catastrophe Living”), customizing it and studying its effectiveness for those attending pain clinics. She then extended it to patients with pain from other clinics and family practices throughout Ontario.
The Mindfulness-Based Chronic Pain Management Program includes three modules:
Module 1: Learning about and practicing Mindfulness & Meditation
Module 2: Self-care/awareness & compassion, improving interoception – connection with and insight into “self”
Module 3: Working on behaviours in relationship with others and self, and using creative work to further cultivate insight and awareness
Of note, the program allows participants to choose their own rate of acquiring insight and motivation, and is trauma-sensitive and trauma-informed in its delivery.
Materials and Delivery / Structure
Participants are asked to read course materials (“The Mindfulness Solution to Pain” by Jackie Gardner-Nix with Lucie Costin Hall, preface by Jon Kabat-Zinn, 2009, published by New Harbinger Publications, Oakland, California) and to practice guided meditation (from downloads) daily, from 5 to 20 minutes, building their meditation time as the program progresses, between classes.
This group-based program has been delivered in various formats. It was optimized at 12 to 13 group sessions attended once a week for 2.5 hours including a 15 minute break, in person at the host site, and with extension across Ontario via telemedicine to groups of participants attending distant health facilities. It has also been delivered, in-person only, in full day group sessions over 4 days (4 days over 5: one day off after day 2). Since March 2020 with onset of the pandemic it has been delivered online into patients’ homes using the Zoom platform. More recently formats are being tested on those suffering generalized chronic pain conditions which include 8 x weekly synchronous 2.5 hour sessions online into participants’ homes, plus asynchronous work which allow the online classes to be reduced in number, but this briefer version is not recommended yet for those with more intrusive clinical conditions.
It is estimated that more than 12,000 participants have taken this program since 2002, 75% of them at distance facilities via telemedicine.
Outcomes
Publications on the research outcomes in 2008 (in print) and 2012 (online)/2014 (in print) supported the program’s effectiveness in enhancing quality of life and reducing pain and suffering in participants. Data presented at two European Mindfulness conferences in 2015 and 2019 have also demonstrated economic benefits of MBCPMTM in reducing medication needs (for pain, insomnia, depression and hypertension) and improving productivity and return to work.