Development and Usability Testing of a Scalable Digital Acceptance and Commitment Therapy Intervention for Chronic Postsurgical Pain

Background: The Transitional Pain Service (TPS) at Toronto General Hospital is a multidisciplinary program focused on preventing chronic postsurgical pain (CPSP). While the program is effective in terms of patient outcomes, the scarcity of specialized pain psychologists limits its broader implementation. Aims: Acceptance and Commitment Therapy (ACT) is an evidence-based psychology intervention used at the TPS. We aimed to develop a fully self-guided, digital psychology intervention for individuals at risk for CPSP.Methods: The digital self-guided intervention was modeled after a 3-hour ACT group workshop at the TPS. It includes psychoeducation about ACT and pain that revolves around the ACT Matrix, a tool for evaluating coping strategies and enhancing quality of life. The intervention was developed on the digital health application, Manage My Pain (MMP), as an interactive, self-guided program. Development followed an iterative process, with qualitative feedback from TPS patients, clinicians, research staff and app developers. Results: The online intervention was implemented as four sequential 15 min parts plus a fifth optional summary and reference part. Each part includes didactic modules interspersed with interactive activities, experiential exercises, and optional learning checks. The MMP platform’s existing navigation features helped streamline development. Patient and clinician feedback from “think-aloud” and retrospective interviews helped refine key usability factors, including engagement, navigation, and content clarity. Conclusions: The self-guided digital ACT intervention is scalable and can be easily implemented at clinics without specialized pain psychologists. Further testing in a randomized controlled trial will assess its acceptability and efficacy as a substitute for psychologist-led group workshops.